Rita de Cássia Pereira Fernandes

Trabalho e cárcere: um estudo com agentes penitenciários da Região Metropolitana de Salvador, Brasil

Estudo transversal para identificar possiveis associacoes entre condicoes de trabalho e saude de agentes penitenciarios de Salvador, Bahia, Brasil, utilizou uma amostra aleatoria estratificada proporcional de 311 individuos, que responderam, sem identificacao, questionario auto-aplicavel. Obteve-se os seguintes resultados na regressao logistica: (a) ambiente de trabalho psicologicamente inadequado, condicoes infra-estruturais insuficientes, falta de tempo para lazer, ausencia de esporte, mais de nove anos no Sistema Penitenciario (SP), dobra de turno, jornada > 48 horas semanais e organizacao do trabalho inadequada, foram associados positivamente com disturbios psiquicos menores (DPM); (b) falta de treinamento, sexo feminino, jornada > 48 horas semanais, ambiente de trabalho psicologicamente inadequado, falta de tempo para lazer e ausencia de esporte, foram associados positivamente com estresse persistente; (c) idade £ 45 anos, ³ nove anos no SP, dobra de turno, ausencia de esporte, ambiente de trabalho psicologicamente inadequado, condicoes infra-estruturais e organizacionais inadequadas e presenca de DPM, foram associados positivamente com queixas de saude.

Interactions between physical and psychosocial demands of work associated to low back pain

OBJECTIVE To examine the interaction between physical and psychosocial demands of work associated to low back pain. METHODS Cross-sectional study carried out in a stratified proportional random sample of 577 plastic industry workers in the metropolitan area of the city of Salvador, Northeast Brazil in 2002. An anonymous standard questionnaire was administered in the workplace by trained interviewers. Physical demands at work were self-rated on a 6-point numeric scale, with anchors at each end of the scale. Factor analysis was carried out on 11 physical demand variables to identify underlying factors. Psychosocial work demands were measured by demand, control and social support questions. Multivariate analysis was performed using the likelihood ratio test. RESULTS The factor analysis identified two physical work demand factors: material handling (factor 1) and repetitiveness (factor 2). The multiple logistic regression analysis showed that factor 1 was positively associated with low back pain (OR=2.35, 95% CI 1.50;3.66). No interaction was found between physical and psychosocial work demands but both were independently associated to low back pain. CONCLUSIONS The study found independent effects of physical and psychosocial work demands on low back pain prevalence and emphasizes the importance of physical demands especially of material handling involving trunk bending forward and trunk rotation regardless of age, gender, and body fitness.OBJETIVO: Analisar a interacao entre demandas fisicas e psicossociais no trabalho sobre a ocorrencia de lombalgia em trabalhadores. METODOS: Estudo transversal com amostra aleatoria, estratificada, proporcional de 577 trabalhadores da industria de plasticos da regiao metropolitana de Salvador (BA), realizado em 2002. Questionario padronizado, anonimo, foi administrado no local de trabalho por entrevistadores treinados. As demandas fisicas foram medidas pelo auto-registro de trabalhadores com uma escala numerica de seis pontos, com âncoras nas extremidades. A analise de fator foi realizada com 11 variaveis de demandas fisicas, a fim de identificar os fatores subjacentes. As demandas psicossociais no trabalho foram medidas por meio de questoes sobre demanda psicologica, controle e suporte social. Realizou-se analise de regressao logistica, utilizando o teste da razao de verossimilhanca. RESULTADOS: A analise de fator identificou dois fatores de demandas fisicas no trabalho: fator 1, caracterizando manuseio de carga; fator 2, caracterizando repetitividade. Resultados da regressao logistica multipla mostraram que o fator 1 estava associado com lombalgia (OR=2,35, IC 95% 1,50; 3,66). Nao houve associacao estatistica entre demandas fisicas e psicossociais no trabalho, mas ambas atuaram de forma independente no desfecho. CONCLUSOES: Os achados mostraram que para ocorrencia de lombalgias houve efeitos independentes e importantes para demandas psicossociais e fisicas no trabalho, com destaque para: manuseio de carga, inclinacao e rotacao de tronco na ocorrencia de lombalgia, mesmo considerando a idade, sexo e condicionamento fisico.

Factors Related to Musculoskeletal Disorders in Nursing Workers

Este estudio de corte transversal identifico factores asociados a los disturbios musculo-esqueleticos en auxiliares y tecnicas de enfermeria en Salvador-BA. Trescientas y ocho trabajadoras, seleccionadas aleatoriamente, respondieron un cuestionario aplicado por un entrevistador, con preguntas sobre demandas fisicas y psicosociales en el trabajo, caracteristicas individuales y actividades extra-laborales. El analisis multivariado revelo disturbios musculo-esqueleticos en pescuezo, hombro o parte alta del dorso y disturbios musculo-esqueleticos en la region lumbar, que se asocian a la demanda fisica (manoseo de carga, postura inadecuada del tronco y gestos repetitivos), demanda psicosocial y acondicionamiento fisico precario. Los disturbios musculo-esqueleticos en extremidades superiores distales se asocian con la demanda fisica (repetitividad y fuerza) y anos de trabajo (> 19). Los resultados apuntan para la necesidad de presentar estrategias de intervencion que incorporen tanto los aspectos organizacionales del trabajo asi como las adecuaciones en el ambiente fisico y en las caracteristicas de las tareas.This cross-sectional study identified factors associated to musculoskeletal disorders in nursing auxiliaries and technicians in Salvador - Bahia. Three hundred and eight randomly selected female workers answered a questionnaire administered by an interviewer, with questions related to physical and psychosocial demands at work, individual characteristics and activities outside work. Multivariate analysis revealed that musculoskeletal disorders in neck, shoulder or upper back and musculoskeletal disorders in low back are associated to physical demand (material handling, poor back posture and work repetitiveness), psychosocial demand and precarious physical fitness. Musculoskeletal disorders in distal upper extremities are associated to physical demands (repetitiveness and force) and years of work (> 19). The results appoint the need for intervention strategies, incorporating both the organizational aspects of work and adaptations in the physical environment and in the characteristics of tasks.

Prevalence of musculoskeletal disorders among plastics industry workers

The prevalence of musculoskeletal disorders among workers in the plastics industry in Salvador, Bahia State, Brazil was estimated. Cases were defined by reported symptoms of pain in the previous 12 months, lasting more than a week or having monthly minimum frequency, which had given rise to restrictions at work or to seeking medical attention, or where respondents had a severity score greater than or equal to 3 (on a numerical scale of 0 to 5). A stratified proportional random sample of 577 workers was studied. The prevalence of musculoskeletal disorders, considering of all body segments, was 50.1%. The prevalence of musculoskeletal disorders was higher among women than among men at distal upper extremities (34.6% and 11.6% respectively) and also in the region of the neck, shoulder or upper part of the back (27.4% and 17.6% respectively). There was no difference between genders for the prevalence of lower back pain (21.2% and 21.4% respectively); 65% of cases in this region had reports of pain in the previous seven days. Due to the importance and prevalence of musculoskeletal disorders, it is necessary that their measurement in epidemiological studies be done properly.

Musculoskeletal disorders among workers in plastic manufacturing plants

BACKGROUND Epidemiological studies have indicated an association between musculoskeletal disorders (MSDs) and physical work demands. Psychosocial work demands have also been identified as possible risk factors, but findings have been inconsistent. OBJECTIVES To evaluate factors associated with upper back, neck and upper limb MSD among workers from 14 plastic manufacturing companies located in the city of Salvador, Brazil. METHODS A cross-sectional study design was used to survey a stratified proportional random sample of 577 workers. Data were collected by questionnaire interviews. Factor analysis was carried out on 11 physical demands variables. Psychosocial work demands were measured by demand, control and social support questions. The role of socio-demographic factors, lifestyle and household tasks was also examined. Multiple logistic regression was used to identify factors related to upper back, neck and upper limb MSDs. RESULTS Results from multiple logistic regression showed that distal upper limb MSDs were related to manual handling, work repetitiveness, psychosocial demands, job dissatisfaction, and gender. Neck, shoulder or upper back MSDs were related to manual handling, work repetitiveness, psychosocial demands, job dissatisfaction, and physical unfitness. CONCLUSIONS Reducing the prevalence of musculoskeletal disorders requires: improving the work environment, reducing biomechanical risk factors, and replanning work organization. Programs must also be aware of gender specificities related to MSDs.

Hipertensão arterial entre trabalhadores de petróleo expostos a ruído

A cross-sectional study with a retrospective component was conducted to evaluate occupational noise exposure as a potential risk factor for arterial hypertension among 775 workers from an oil-drilling industry. Hypertension was defined as ³ 140/90mmHg. Occupational noise exposure was measured as: (1) exposure to sound pressure levels ³ 85dbA for 10 years or more and (2) moderate-to-severe noise-induced hearing loss (NIHL). The effects of age, education, shift work, and obesity were evaluated by stratification and logistic regression analysis. A positive association between occupational noise exposure and hypertension was found, using both the level/duration of noise exposure (RP = 1.8; 95% CI: 1.3-2.4) and NIHL (RP = 1.5; 95% CI: 1.1-2.0) as exposure indicators. Considering the study limits, long-term occupational noise exposure thus appears to be a risk factor for arterial hypertension.

Doença do disco intervertebral em trabalhadores da perfuração de petróleo

A cross-sectional study among 1,026 oil drilling workers in Northeast Brazil found a prevalence rate of 5% for intervertebral disk disease, varying from 1.8% (activities without heavy lifting) and 4.5% (occasional lifting) to 7.2% (routine lifting). Disease prevalence was 10.5% among drilling workers with more than 15 years in the industry and 11.3% among those over 40 years of age. Prevalence ratio (PR) for the association between working in oil drilling operations and intervertebral disk disease was 2.3 (95% CI: 1.3-4.0). Retrospective information about exposure was collected to minimize the healthy worker survival effect. Using information on current occupation instead of occupational life history would cause an underestimated PR of 1.1 (95% CI: 0.6-1.9). Logistic regression showed results similar to the tabular analysis. Neither confounding nor interaction was evident. Growth of the Brazilian oil industry and recent changes in the work force contract and management, involving changes in risk management and health control, indicate a need for prompt ergonomic intervention in order to control intervertebral disk disease among oil drilling workers.

Prevalência de distúrbios osteomusculares relacionados ao trabalho em profissionais de enfermagem

Estudo de corte transversal estimou a prevalencia de disturbios osteomusculares relacionados ao trabalho em auxiliares e tecnicas de enfermagem em Salvador, Bahia. Trezentas e oito trabalhadoras, selecionadas aleatoriamente, responderam um questionario aplicado por entrevistadores treinados durante o expediente de trabalho. A maioria das entrevistadas trabalhava no turno diurno e nao costumava fazer hora extra. Cerca de 34% relataram ter outra atividade regular remunerada e o tempo medio no mercado de trabalho formal ou informal foi de 19 anos. Verificou-se alta exposicao ocupacional a movimentos repetitivos com as maos, posturas de trabalho em pe e andando, posturas inadequadas do tronco e levantamento de carga. A prevalencia de DORT em pelo menos um segmento corporal foi de 83,4%. As principais regioes corporais acometidas foram: lombar (53,9%), pernas (51,9%), pescoco (36,4%), parte alta do dorso (35,7%) e ombros (33,8%). Verificou-se elevada prevalencia de DORT na populacao estudada, o que aponta para necessidade de melhoria nas condicoes de trabalho dessas profissionais.

Heavy physical work and low back pain: the reality in urban cleaning

Low back pain (LBP) is a major public health issue. There is lack of research on this disorder affecting urban cleaning workers. A cross-sectional study was conducted to describe the prevalence of LBP, occupational and extra-occupational characteristics, as well as associated factors in these workers. A census was performed with 624 workers in Salvador, Brazil, using a questionnaire administered by an interviewer in 2010. Cases of LBP were defined by reported symptoms of pain in the previous 12 months, lasting more than a week or with monthly minimum frequency, which led to restrictions at work or to seeking medical attention, or in cases when respondents had a severity score > 3 on a numerical scale from 0 to 5. Physical demands at work were measured on a numerical 6-point scale with 14 variables. Psychosocial demands were measured using the Job Content Questionnaire. Sociodemographic factors, lifestyle habits and domestic work were evaluated. Multiple logistic regression (LR) was used to identify factors associated with LBP, for which the prevalence was 37.0%. Among them, 62.8% of workers felt pain in the last 7 days. LBP was associated with longer working hours, flexion and trunk rotation, psychosocial demands, working directly in collection and low schooling. Dynamic work (walking, running) served as a protective factor. It was concluded that many workers develop their activity at the presence of pain. The results emphasize the need for preventive measures through multifactorial approach encompassing adaptations in physical environment and changes in work organization.

Heavy physical work under time pressure: the garbage collection service- a case study

The increased generation of garbage has become a problem in large cities, with greater demand for collection services. The collector is subjected to high workload. This study describes the work in garbage collection service, highlighting the requirements of time, resulting in physical and psychosocial demands to collectors. Ergonomic Work Analysis (EWA) - a method focused on the study of work in real situations was used. Initially, technical visits, global observations and unstructured interviews with different subjects of a garbage collection company were conducted. The following step of the systematic observations was accompanied by interviews conducted during the execution of tasks, inquiring about the actions taken, and also interviews about the actions, but conducted after the development of the tasks, photographic records and audiovisual recordings, of workers from two garbage collection teams. Contradictions between the prescribed work and activities (actual work) were identified, as well as the variability present in this process, and strategies adopted by these workers to regulate the workload. It was concluded that the insufficiency of means and the organizational structure of management ensue a situation where the collection process is maintained at the expense of hyper-requesting these workers, both physically and psychosocially.