Tarcísio Márcio Magalhães Pinheiro

Agrotóxico e trabalho: uma combinação perigosa para a saúde do trabalhador rural

Analisaram-se os riscos e danos a saude dos agricultores causados pelos agrotoxicos, tendo como eixos centrais o processo e as relacoes de trabalho presentes na agricultura brasileira. Trata-se de um tema polemico, complexo e conflituoso. Foram abordadas questoes referentes a informacao e as politicas publicas para o setor. Este artigo traz a contribuicao e a reflexao do Grupo de Estudos de Saude e Trabalho Rural de Minas Gerais (Gestru), que apresenta alguns resultados de seus trabalhos realizados em regioes hortifrutigranjeira, floricultora, canavieira e cafeeira de Minas Gerais. Propoe-se a incorporacao de um conjunto de variaveis a serem consideradas no processo de avaliacao da exposicao e dos danos a saude gerados pelos agrotoxicos. Sao apresentadas algumas propostas e sugestoes para a construcao de uma agenda de politicas e acoes no campo da saude do trabalhador agricola brasileiro.

Perfil da demanda atendida em ambulatório de doenças profissionais e a presença de lesões por esforços repetitivos

OBJECTIVE To assess the profile of outpatients seen at an occupational disease clinic of a general and repetitive strain injury (RSI) patients by using multivariate analyze. METHODS The first 565 visit registries for the year 1996 were assessed regarding their social and demographics aspects, work characteristics, and diagnosis. All the variables were analyzed by univariate analysis method. Bivariate data were analyzed using Chi square test (chi2) for categorical variables, comparison of means or ranges for quantitative and categorical variables. Multivariate data were analyzed using log-linear models with logit-transformation to identify the groups with a larger proportion of RSI. RESULTS Women sought the occupational diseases clinic more frequently than men, and there was a predominance of RSI cases. The occupation distribution was in order of priority as following: office workers, factory workers, and service workers. Of them, 56.9% were from the economic sector of services. RSI was seen in 56% of the patients diagnosed at their first visit. CONCLUSIONS The analysis confirms the trends seen in the 80s regarding the epidemiological changes in occupational diseases, when RSI started to be identified and displaced to a secondary position the other common diseases (due to physical and chemical hazards) because of inadequacy of ergonomics.

Perfil do absenteísmo em um banco estatal em Minas Gerais: análise no período de 1998 a 2003

The purpose of this paper was to study the profile of absenteeism in a state bank and to establish the more frequent causes for sick leaves among the members of the staff. A cross-cut, descriptive and quantitative study was developed for approaching absenteeism and its most frequent causes in a state bank in the state of Minas Gerais between 1998 and 2003. The absenteeism rates were homogenous, with a decrease during the period of the study, except for the frequency rates, as a result of alterations in their numerators and denominators. The prevalence of musculoskeletal diseases and mental disorders was of 33,25 and 22,21 leaves per 1,000 workers respectively. Leaves of women and workers in relatively low-pay positions, aged between 40 and 49, married, working in the institution for over 21 years predominated. The study indicated that sick leaves due to musculoskeletal diseases that where predominating before in the company are decreasing. On the other hand, there was an increase of cases of mental and behavioral disorders, indicating a possible change in the health profile. However, further studies will be necessary to corroborate these results.

Saúde, democracia e organização do trabalho no contexto do Programa de Saúde da Família: desafios estratégicos

Democracy should work towards satisfying diverse interests (for the common good), which is indispensable for establishing consensuses between the various stakeholders whenever possible. Since the mid-1970s, Brazil has undergone important political and democratic changes, making this a period of fundamental transformation in the countrys health paradigms. With the 1988 Constitution and the creation of the Unified National Health System (SUS), health system administrators, workers, and patients are dealing with a new way of conceiving, organizing, developing, and producing healthcare services, namely the social healthcare production model. However, to promote a real break with the previous Flexnerian health model, labor relations must overcome the flexibilization (casualization) of health work through such measures as consistent investments in human resources management, with the creation of means for discussing democratic administration. The current article aims to rethink the relations between democracy and health, reflecting analytically on the work management practices in the Family Health Program (FHP) in the context of policy reforms. Consolidation of the FHP as the key element for reorganizing primary healthcare in Brazil will allow shaping new institutional arrangements, capable of impacting the countrys sociopolitical culture, thereby contributing to fairer and more effective policies with solidarity, as proposed under the National Health System.

A silicose e o perfil dos lapidários de pedras semipreciosas em Joaquim Felício, Minas Gerais, Brasil

A cross-sectional study was performed to determine the prevalence of silicosis among semiprecious gem cutters (n=70) and describe their clinical, epidemiological, and occupational profiles in Joaquim Felício, Minas Gerais State, Brazil, from April to December 2002. Occupational history was used with a respiratory questionnaire, chest x-ray, and spirometry. Silicosis prevalence was 7.1%. All affected individuals were men, with a mean age of 21.5 and mean exposure to silica of 7.1 years. All belonged to the informal economy and had been working at small and rudimentary workshops, using improvised lathes, with intense exposure to silica dust. According to the ILO Radiological Classification, four of the five cases of silicosis were classified as grade 1 and one as grade 3. Silicosis among gem cutters constitutes a serious public health problem that requires efforts to minimize risk through work by multidisciplinary teams from government agencies and nongovernmental organizations, with active participation by the workers themselves.

Juvenile neuronal ceroid-lipofuscinosis: clinical and molecular investigation in a large family in Brazil

OBJECTIVE Juvenile Neuronal Ceroid-Lipofuscinosis (JNCL, CLN 3, Batten Disease) (OMIM #204200) belongs to the most common group of neurodegenerative disorders of childhood. We report the clinical data and molecular analysis of a large Brazilian family. METHOD Family composed of two consanguineous couples and thirty-two children. Clinical data of ten JNCL patients and molecular analyses on 13 participants were obtained. RESULTS The large 1.02 kb deletion was detected. The most severe phenotype, with autistic behavior, tics and parkinsonism was seen in a 12-year-old female and a milder phenotype in a 14-year-old male. Nyctalopia was the first symptom in one deceased child. The visual loss of six patients has been first observed in the school and not at home. CONCLUSION The report highlights the phenotypical intrafamily variation in 10 affected children of this family. The molecular investigation of this large family in our metabolic center turned possible the diagnosis, right approach and genetic counseling.

Epidemiological and occupational profile of anesthesiologists practicing in Belo Horizonte, Minas Gerais - Brazil, in 2010

BACKGROUND AND OBJECTIVES Exposed to many occupational risk factors, the anesthesiologist should know how to experience situations related to work and everyday life, so that illness is not part of his reality. Knowledge of work through the worker himself is one way to look deeper into the universe surrounding health professionals in order to seek effective solutions that increase satisfaction and minimize damage. The objective of this paper was to outline an epidemiological and occupational profile of the anesthesiologist in Belo Horizonte, Minas Gerais. METHODS Quantitative, cross-sectional randomized study conducted among members of the Society of Anesthesiology of Minas Gerais. Data collected through a questionnaire, including the CAGE, for evaluation of alcoholism and Self-Report Questionnaire (SRQ-20) to evaluate the prevalence of common mental disorders (CMD). RESULTS There was predominance of male (62.4%) working on-call schedule (91.1%), both day and at night. The average number of night shifts was 5.4% in the last 30 days. Most of them (88.3%) working in emergency departments. Most professionals reported being very tired and overloaded or very overloaded, but satisfied with the work. There was statistical association between CAGE positive and work overload and between CAGE and SRQ-20. CONCLUSIONS The population studied indicates that the anesthesiologist is a professional rather overloaded, which corroborates trends seen in the medical field. Major attention should be given to these professionals who live surrounded by harmful occupational hazards.

Avaliação da completitude das notificações compulsórias relacionadas ao trabalho registradas por município polo industrial no Brasil, 2007 - 2011

OBJECTIVE To analyze the completeness of workers health problems notification fields registered in a Brazilian municipal industrial hub in the period from January 1st, 2007 to December 31st, 2011. METHODS Descriptive study based on secondary data and composed of all records related to work (n = 2,345 ) in the National Disease Notification System, using criteria recommended by the Guidelines for Evaluating Public Health Surveillance Systems created by the Center for Disease Control and Prevention. The completeness of the fields present in the research and report forms was assessed by the percentage of filled fields, the Spearman correlation coefficient and graphical analysis. RESULTS In most of the essential fields it was identified a decrease in the percentage of filling (n = 18; 64%). The degree of completeness of compulsory fields was high (> 85%); most of the non-discriminated fields were 0 - 25% filled; there were variable indexes for key fields (0 - 98%). Considerable variability was observed in the completeness of the key fields, having three variables with significant negative correlation (rs = -0.9; p = 0.0347). Only one variable showed significant positive correlation. CONCLUSION The quality of most of the stored data was classified as regular to excellent for important variables on the design of worker health and surveillance actions. However, we recommend routine quality data assessments in workers health information systems in the Unified Health System.OBJECTIVE: To analyze the completeness of workers health problems notification fields registered in a Brazilian municipal industrial hub in the period from January 1st, 2007 to December 31st, 2011. METHODS: Descriptive study based on secondary data and composed of all records related to work (n = 2,345 ) in the National Disease Notification System, using criteria recommended by the Guidelines for Evaluating Public Health Surveillance Systems created by the Center for Disease Control and Prevention. The completeness of the fields present in the research and report forms was assessed by the percentage of filled fields, the Spearman correlation coefficient and graphical analysis. RESULTS: In most of the essential fields it was identified a decrease in the percentage of filling (n = 18; 64%). The degree of completeness of compulsory fields was high (> 85%); most of the non-discriminated fields were 0 - 25% filled; there were variable indexes for key fields (0 - 98%). Considerable variability was observed in the completeness of the key fields, having three variables with significant negative correlation (rs = -0.9; p = 0.0347). Only one variable showed significant positive correlation. CONCLUSION: The quality of most of the stored data was classified as regular to excellent for important variables on the design of worker health and surveillance actions. However, we recommend routine quality data assessments in workers health information systems in the Unified Health System.

Development and prevention of work related disorders in a sample of Brazilian violinists.

BACKGROUND The present study is part of a project designed to investigate the development of disorders related to the work of orchestra violinists. OBJECTIVE To describe and analyze the functional disorders of the musculoskeletal systems of violinists from the four orchestras in Belo Horizonte, Brazil. METHOD Analyses of musculoskeletal system disorders found in violinists from orchestras in Belo Horizonte, Brazil, were completed using a variety of approaches, including Occupational Therapy, Epidemiology and the Social Science methodologies. RESULTS Participants sustained musculoskeletal disorders despite their common sense belief that musicians are generally healthier than other professional groups. The struggle for a better financial situation forced study participants to work harder, in a variety of work environments, increasing and diversifying their exposure to risk factors. Protective and preventive measures were scarce and in most cases these were only employed after the onset of musculoskeletal disorders. CONCLUSIONS The use of inadequate strategies and the lack of appropriate options to deal with risk factors contributed to the maintenance of symptoms or the onset of health disorders.

Perfil epidemiológico e ocupacional dos anestesiologistas inseridos no mercado de trabalho de Belo Horizonte, Minas Gerais, em 2010

JUSTIFICATIVA E OBJETIVOS: Exposto aos diversos fatores de riscos ocupacionais, o anestesiologista deve saber como vivenciar as situacoes relacionadas ao trabalho e a vida cotidiana para que o adoecimento nao faca parte da sua realidade. O conhecimento do trabalho atraves do trabalhador e uma forma de buscar a fundo o universo que cerca o profissional para que solucoes eficientes aumentem a satisfacao e minimizem os danos. O objetivo desta investigacao e tracar um perfil epidemiologico e ocupacional do anestesiologista de Belo Horizonte, Minas Gerais. METODOS: Estudo quantitativo, transversal, aleatorio entre os membros da Sociedade de Anestesiologia de Minas Gerais. Dados coletados atraves de questionario especifico, incluindo o CAGE, para avaliacao do alcoolismo, e o Self-Report Questionnaire (SRQ-20), para avaliacao da prevalencia dos transtornos mentais comuns (TMC). RESULTADOS: Houve um predominio de homens (62,4%) trabalhando em esquema de plantao (91,1%), tanto diurno quanto noturno. A media de plantoes noturnos foi de 5,4% nos ultimos 30 dias. A maior parte deles (88,3%) em servicos de urgencia. A maioria dos profissionais considerase muito cansada e sobrecarregada ou muito sobrecarregada, porem se diz realizada com o trabalho. Houve associacao estatistica entre CAGE positivo e sobrecarga de trabalho e entre esse e o SRQ-20. CONCLUSOES: O universo estudado mostra o medico anestesiologista como um profissional bastante sobrecarregado, o que vai de encontro as tendencias da profissao medica. Atencao importante deve ser dada a esse profissional, que vive cercado de danosos riscos ocupacionais.