Marco Antônio Carneiro Menezes

Exposição ao benzeno em postos de revenda de combustíveis no Brasil: Rede de Vigilância em Saúde do Trabalhador (VISAT)

The scope of this article is to present the surveillance networks experience of exposure to benzene in gas stations, describing its components developed in the Unified Health System. It is a report and analysis of the experience of monitoring and its impact on the health of gas station workers in six Brazilian states. It presents the prospect of action, operated by the circulation of information, national meetings, discussions of specific strategies and shared experiences, methodologies and common tools. Inspection procedures, individual assessments and training are described. Risk situations and occupational and environmental exposure were identified in 1,311 gas stations and 564 workers were assessed. Forecourt attendants, superintendents and measuring, offloading and testing employees were all exposed. The integrated and complementary features of this surveillance, implemented in the occupational and environmental areas, suggest intervention in a broader and network-linked territory. The intervention would transcend fragmentation between individual and collective practices, services and education, becoming an example of action for assessment and mitigation of the impact on health workers, the articulation of action in health, the environment and intersectorial connection.

Classificação clínico-laboratorial para manejo clínico de trabalhadores expostos ao benzeno em postos de revenda de combustíveis

Introduction: gas stations workers are exposed to volatile organic compounds, especially benzene. Clinical management of the broad spectrum of symptoms and signs observed in these workers is still a challenge for health care. Objective: to present a clinical-laboratory classification, based on hemogram analysis and clinical evaluation of workers exposed to benzene, as guidelines for health care professionals. Methods: the clinical-laboratory classification was defined based on priority-setting criteria for the results of clinical evaluations and health surveillance in order to allow the organization of health care flows and procedures. Results: the proposal defines the clinical management based on classification of workers exposed to benzene in four levels of clinical and laboratory alterations that determine procedures according to level of exposure and health effects: 1) without significant alterations; 2) unspecific or incomplete alterations; 3) clinical and/or laboratory alterations; and 4) alterations suggesting benzene poisoning. Conclusion: the proposal for classification of clinical and laboratory findings is potentially able to guide medical practice in the assessment of health conditions and risks of benzene exposure, and subsidize the systematic and continuous monitoring necessary for establishing health care practices offered to workers.

Roteiro de inspeção sanitária de ambientes e processos de trabalho em postos de revenda de combustíveis: análise de usos e aplicações no estado de Santa Catarina

Introduction: the Form for Sanitary Inspection of Work Processes and Environments in Gas Stations (RIAT-PRC) is used for health surveillance by Reference Centers in Occupational Health (Cerest). Objective: to describe the uses and applications of the RIAT-PRC tool from the experience of the Surveillance of Occupational Health in the state of Santa Catarina, Brazil. Method: descriptive and analytical report of the RIAT-PRC tool and of the evaluation of its quality and use in Santa Catarina, from 2010 to 2014. Results: the form was introduced in 459 gas stations, with good filling degree in general. The application of the tool, made it possible to verify that the companies carried out only a few biological and environmental monitoring. It also allowed us to follow workers’ occupational and health conditions along the study time as well as to identify risk factors in work environments. Conclusion: the RIAT-PRC was useful for surveillance and for supporting studies on benzene exposure in gas stations. The results highlighted the need to improve the training of surveillance technical teams, aiming at an effective monitoring of gas stations workers’ exposure to benzene and other chemicals.

Avaliação ambiental de BTEX (benzeno, tolueno, etilbenzeno, xilenos) e biomarcadores de genotoxicidade em trabalhadores de postos de combustíveis

Introduction: gas station workers are exposed to several chemicals in their workplace, highlighting benzene, due to its carcinogenic properties. Objective: to assess the genotoxic damage related to occupational exposure to BTEX (benzene, toluene, ethylbenzene, xylenes) in workers of five gas stations in Rio de Janeiro, RJ. Methods: analysis of BTEX concentrations in the air were carried out; as well as activities of catalase and glutathione S-transferase; and comet assay in whole blood samples of 97 workers. Results: BTEX levels were within the Brazilian threshold levels recommended by the NR 15, including Annex 13-A. However, an oscillation of the comet assay results was observed among workers of different gas stations, mainly in workers from gas stations with lower concentrations of benzene. Discussion: this result is in accordance with the current international scientific literature that indicates a supralinear exposure-response curve for benzene. In lower concentrations we could observe a high non-linear risk of leukemia, probably due to a greater benzene metabolism and a higher production of its toxic metabolites. Conclusion: the results of this study suggest that exposure to BTEX, even in low concentrations, contributes to genotoxic risk to human health.

Assessment of the use of online communities to integrate educational processes development teams: An experience in popular health education

– The aim of this paper is to present the use of virtual communities in work processes in Popular Education, a field strongly supported by presentiality because of historical social inequalities in Brazil. It presents the assessment of the Virtual Community Work (CVT) used in the Popular Healthcare Education Policy (PNEPS). , – The exploratory research adopted two paths of analysis, one quantitative (using questionnaire) aimed to collect the participants’ perceptions regarding the navigation, tools and features of CVT, and the other qualitative through observation of the interventions in its different spaces, having discourse analysis as the technique for analysis. , – The hands-on nature of Popular Education, revealed in the posts and in the speech of the participants, showed the potential and challenges of the territory and the need for change, both of the professional’s outlook on his or her own work process and working with health in the communities that are, still today, very centered around authoritarian models. , – Because the participation was not mandatory, the reduced number of participants was the main limitation of this work. , – The health problems specified in the interactions and much discussed in CVT may help the consolidation of the policy as the main practical implication. , – Contribute to the creation of a network for the exchange of educational experiences in the field of Popular Education. , – The innovating character of this work lies in the application of Virtual Community in the field of popular education within the health sector as a strategy for implementation of a national policy.