Sérgio Roberto de Lucca

Desafios ao estudo da contaminação humana e ambiental por agrotóxicos

O impacto do uso de agrotoxicos sobre a saude humana e um problema que tem merecido atencao da comunidade cientifica em todo o mundo, sobretudo nos paises em desenvolvimento. Sua avaliacao demanda o conhecimento e a visualizacao da importância/magnitude relativa de cada uma das vias de contaminacao. Inumeros fatores, tais como as dificuldades metodologicas relacionadas com o monitoramento da exposicao ocupacional aos agrotoxicos, as elevadas taxas de subnotificacao de casos, a nao-consideracao de determinantes sociais e economicos na avaliacao de riscos relacionados a estes agentes quimicos e a influencia da pressao da industria produtora de agrotoxicos no perfil do consumo destes agentes no meio rural brasileiro. No presente trabalho discute-se a importância destes fatores como determinantes da situacao de saude do homem do campo, a partir dos resultados de pesquisas de campo realizadas em regioes agricolas do Estado do Rio de Janeiro.

Percepção das condições de trabalho em uma tradicional comunidade agrícola em Boa Esperança, Nova Friburgo, Rio de Janeiro, Brasil

The impact of pesticide use on human and environmental health has received attention from the international scientific community for some time, especially in developing countries where such chemical agents are used extensively and indiscriminately. The present study adopts a methodological approach to risk perception analysis based on rapid surveys, including: participatory observation; semi-structured interviews with key informants; and evaluation of local work processes. Field data analysis revealed several issues related to the risk perception profile of the study population, including the development of defensive strategies toward work hazards, subjective responses to potentially hazardous situations, and the role of individual risk perception as a determinant of human exposure to pesticides.

Síndrome de burnout em técnicos de enfermagem de um hospital público do Estado de São Paulo

INTRODUCTION The burnout syndrome is a psychosocial phenomenon that arises as a response to chronic interpersonal stressors present at work. There are many aspects that make nursing assistants vulnerable to chronic stress situations that may lead to burnout, highlighting the low degree of autonomy in the healthcare staff and spending more in direct contact with patients. OBJECTIVES To assess the prevalence of the burnout syndrome in nursing assistants in a public hospital, as well as its association with socio-demographic and professional variables. METHODS A socio-demographic and professional questionnaire and the Maslach Burnout Inventory (MBI-SS) were applied to 534 nursing assistants. RESULTS The prevalence of burnout syndrome among nursing assistants was 5.9%. High emotional exhaustion was observed in 23.6%, 21.9% showed high depersonalization, and 29.9% low professional achievement. It was found statistically significant associations between emotional exhaustion, job sector and marital status; depersonalization, having children and health problems; low professional achievement and job sector and number of jobs. There was association between job satisfaction and the three dimensions. CONCLUSISON Professionals working in the health area must pay intense and extended attention to people who are dependent upon others. The intimate contact of the nursing assistants with hard-to-handle patients, as well as being afraid to make mistakes in healthcare are additional chronic stress factors and burnout syndrome cases related in this study.

Prevalence of Burnout syndrome in health professionals of an onco-hematological pediatric hospital

OBJECTIVE To identify the prevalence of Burnout Syndrome in medical professionals, nurses and nursing technicians working in an Onco-Hematological Pediatric Hospital in São Paulo. METHOD An exploratory, descriptive study with cross-sectional design and quantitative approach, with a sample of 188 health professionals. Data were collected using two self-report instruments: the Maslach Burnout Inventory (MBI-HSS) which is a biosocial data form, and a non-participant observation guide. RESULTS High depersonalization for nurses (29.8%), low job performance for physicians (27.8%), and of nursing technicians (25.5%). High scores were identified in at least two domains of Burnout in 19.2% of nurses, 16.8% of nursing technicians, and 16.6% of doctors. CONCLUSION Health professionals are highly vulnerable to each of the dimensions of Burnout syndrome - namely emotional exhaustion, alienation, and low job performance/satisfaction- in the hospital work.Objective: To identify the prevalence of Burnout Syndrome in medical professionals, nurses and nursing technicians working in an Onco-Hematological Pediatric Hospital in Sao Paulo. Method: An exploratory, descriptive study with cross-sectional design and quantitative approach, with a sample of 188 health professionals. Data were collected using two self-report instruments: the Maslach Burnout Inventory (MBI-HSS) which is a biosocial data form, and a non-participant observation guide. Results: High depersonalization for nurses (29.8%), low job performance for physicians (27.8%), and of nursing technicians (25.5%). High scores were identified in at least two domains of Burnout in 19.2% of nurses, 16.8% of nursing technicians, and 16.6% of doctors. Conclusion: Health professionals are highly vulnerable to each of the dimensions of Burnout syndrome – namely emotional exhaustion, alienation, and low job performance/ satisfaction- in the hospital work

Exposição ocupacional e ocorrência de pneumoconioses na região de Campinas (SP) Brasil, 1978-2003

OBJECTIVE To develop and consolidate a comprehensive database on the occurrence of pneumoconioses in an industrialized region of Brazil, with a special focus on the activities most frequently related to these diseases. METHODS A retrospective, observational study was conducted in order to gather data on cases of pneumoconioses treated at the outpatient clinic of the State University at Campinas Hospital das Clínicas between 1978 and 2003. Individuals diagnosed with pneumoconiosis, based on their occupational history and on chest X-ray findings of abnormalities consistent with interstitial lung disease involving the parenchyma, in accordance with the 1980 and 2000 recommendations of the International Labour Organization, were included in the study. RESULTS A total of 1147 cases of pneumoconiosis were identified (1075 in males and 72 in females): 1061 cases of silicosis (92.5%); 51 cases of mixed-dust pneumoconiosis (4.45%); 15 cases of asbestosis (1.31%); 13 cases of phosphate rock-related pneumoconiosis (1.13%); and 7 cases of other types of pneumoconiosis (0.6%), including those related to exposure to coal, graphite and hard metals. The most common chest X-ray findings were 1/0, 1/1 or 1/2 profusion and small regular opacities (p, q or r), although 192 patients (16.74%) presented large opacities. There has been a substantial decline in the occurrence of the disease since the 1990s, and the duration of exposure was typically shorter than that observed in a study conducted in the United States. CONCLUSIONS Our findings have been compiled into a comprehensive database for the investigation of pneumoconiosis in an industrialized area of Brazil. These data make it possible to conduct follow-up studies and develop health policies related to occupational respiratory disorders.

Associações entre significados de velhice e bem-estar subjetivo indicado por satisfação em idosos

Objectives: To investigate the meanings attributed by the elderly to healthy aging and to being happy in old age, and the associations between these meanings and the evaluations of the elderly individuals of their overall and domain-referenced satisfaction. Method: A cross-sectional and multicenter study was performed. The verbal utterances of representative samples of community-dwelling elderly persons (N=1,242, aged 65 years and older) registered in the databases of two Brazilian cities, were submitted to content analysis and compared with satisfaction indicators, considering gender, age and family income. Results: Four themes and 14 categories explained the two concepts: physical health and functioning (42.1% of utterances), psychological well-being (25.4%), interpersonal relationships (23.5%) and material resources and access to health services (9.0%). No significant differences were observed for the prevalence ratios between the categories of meaning and great satisfaction with life, with the exception of satisfaction and pleasure. Conclusion: The two concepts raised common meanings associated with positive aspects of old age and had an impact on satisfaction ratings, showing that healthy and happy aging is more than just being healthy, but also involves psychological well-being and interpersonal relationships.

Prevalencia del síndrome de Burnout en profesionales de la salud de un hospital oncohematológico infantil

OBJECTIVE To identify the prevalence of Burnout Syndrome in medical professionals, nurses and nursing technicians working in an Onco-Hematological Pediatric Hospital in São Paulo. METHOD An exploratory, descriptive study with cross-sectional design and quantitative approach, with a sample of 188 health professionals. Data were collected using two self-report instruments: the Maslach Burnout Inventory (MBI-HSS) which is a biosocial data form, and a non-participant observation guide. RESULTS High depersonalization for nurses (29.8%), low job performance for physicians (27.8%), and of nursing technicians (25.5%). High scores were identified in at least two domains of Burnout in 19.2% of nurses, 16.8% of nursing technicians, and 16.6% of doctors. CONCLUSION Health professionals are highly vulnerable to each of the dimensions of Burnout syndrome - namely emotional exhaustion, alienation, and low job performance/satisfaction- in the hospital work.Objective: To identify the prevalence of Burnout Syndrome in medical professionals, nurses and nursing technicians working in an Onco-Hematological Pediatric Hospital in Sao Paulo. Method: An exploratory, descriptive study with cross-sectional design and quantitative approach, with a sample of 188 health professionals. Data were collected using two self-report instruments: the Maslach Burnout Inventory (MBI-HSS) which is a biosocial data form, and a non-participant observation guide. Results: High depersonalization for nurses (29.8%), low job performance for physicians (27.8%), and of nursing technicians (25.5%). High scores were identified in at least two domains of Burnout in 19.2% of nurses, 16.8% of nursing technicians, and 16.6% of doctors. Conclusion: Health professionals are highly vulnerable to each of the dimensions of Burnout syndrome – namely emotional exhaustion, alienation, and low job performance/ satisfaction- in the hospital work

Negative self-rated health in the elderly in cities with different levels of economic well-being: data from FIBRA

This comparative, cross-sectional study analyzed negative self-rated health in elderly people, according to sociodemographic and health variables, use of public or private health services, functional performance, frailty and depressive symptoms. The participants lived in Belém (n = 571) and Campinas (n = 676), cities with different socioeconomic conditions, and the research formed part of a multicentric study on frailty (Fibra Study, Unicamp). Multivariate regression analysis showed that in both cities, negative self-rated health was associated with low education, three or more chronic diseases and sight deficiencies. In Belem, additional observations included associations with fatigue, three or more signs and symptoms and use of public health services; in Campinas, negative self-rated health was also associated with depressive symptoms. The associations suggest that poor health in old age is the result of an accumulation of deficits for lack of socioeconomic resources throughout life and that deficits are not sufficiently compensated for health services in old age.

Avaliação de um programa regular de atividade física sobre os custos médico-hospitalares de uma empresa de serviços de saúde

Background The protective effect of regular physical activity against risk of development of noncommunicable diseases and reduction of medical-hospital costs are well established in the literature. However, no study investigated the financial impact of workplace physical activity promotion programs in Brazil. Objective To investigate the financial impact of a workplace physical activity promotion program on the medical-hospital costs of a private healthcare company. Methods The average healthcare cost per capita was monitored along one year and compared between employees who performed physical activity with sufficient frequency and the ones who did not adhere to the program. Employees were matched per age, sex and length of work at the company. Results From 3,744 employees offered participation in the program, only 80 performed physical activity 2 or more times per week. The average medical-hospital cost per capita/year was BRL 2,874.00 (SD=5.259), being BRL 125.00 higher, on average, for the employees who did not adhere to the program. The average medical-hospital cost per capita/year was BRL 1,901.00 lower, on average, for the employees who performed physical activity 3 or more times per week (n=3) compared to the ones who did not (p=0.34). Conclusions The results of the present study do not allow asserting that the medical-hospital costs of employees who adhered to the program decreased. Longer follow-up and adjustments in the program design are needed to assess its actual impact.Background The protective effect of regular physical activity against risk of development of noncommunicable diseases and reduction of medical-hospital costs are well established in the literature. However, no study investigated the financial impact of workplace physical activity promotion programs in Brazil. Objective To investigate the financial impact of a workplace physical activity promotion program on the medical-hospital costs of a private healthcare company. Methods The average healthcare cost per capita was monitored along one year and compared between employees who performed physical activity with sufficient frequency and the ones who did not adhere to the program. Employees were matched per age, sex and length of work at the company. Results From 3,744 employees offered participation in the program, only 80 performed physical activity 2 or more times per week. The average medical-hospital cost per capita/year was BRL 2,874.00 (SD=5.259), being BRL 125.00 higher, on average, for the employees who did not adhere to the program. The average medical-hospital cost per capita/year was BRL 1,901.00 lower, on average, for the employees who performed physical activity 3 or more times per week (n=3) compared to the ones who did not (p=0.34). Conclusions The results of the present study do not allow asserting that the medical-hospital costs of employees who adhered to the program decreased. Longer follow-up and adjustments in the program design are needed to assess its actual impact.

Sequestros de bancários e seus impactos psicossociais e na saúde do trabalhador

Esse estudo busca compreender um tipo de violencia especifica que atinge um numero cada vez maior de bancarios, que e o sequestro de funcionarios e seus familiares para retirar o dinheiro diretamente dos cofres dos Bancos Financeiros. O trabalhador vitima do sequestro apresenta transtornos mentais graves apos a ocorrencia desse tipo de violencia comprometendo seu desempenho profissional e psicossocial. Cabe ressaltar que o cenario atual do setor bancario apresenta uma organizacao precaria devido ao intenso processo de reestruturacao do trabalho, intensificado a partir dos anos 90, com objetivo de adaptacao ao mercado financeiro altamente competitivo, impactando diretamente na saude ocupacional dessa populacao. Os principais Transtornos Mentais e Comportamentais verificados nos afastamentos de bancarios segundo as estatisticas da Previdencia Social sao: depressao, transtorno de adaptacao e transtorno de estresse pos-traumatico (TEPT). O desenvolvimento dessa pesquisa se deu a partir de entrevistas em profundidade com quatro bancarios vitimas de sequestro e foram compreendidas a partir do referencial metodologico da analise de conteudo. Os resultados obtidos demonstram o impacto psicossocial negativo do sequestro na vida das vitimas agravadas pelo inadequado manejo destas ocorrencias contribuindo para as manifestacoes de transtornos psiquicos apos o evento traumatico. Com esse estudo, espera-se contribuir para o desenvolvimento de intervencoes nas praticas organizacionais, na preservacao da seguranca e saude dos trabalhadores bancarios. A gravidade desse tipo de violencia ao trabalhador deve tambem receber maior atencao da Saude e Seguranca Publica. Abstract