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Resumo Introdução A ruminação relacionada ao trabalho se refere aos pensamentos relativos aos diversos aspectos do trabalho que ocorrem nos períodos de folga. Objetivo Descrever o processo de adaptação transcultural da escala de ruminação relacionada ao trabalho para o contexto brasileiro (B-WRRS) e analisar suas propriedades psicométricas. Método Foi realizada a tradução, retrotradução e avaliação psicométrica inicial de uma escala composta por 15 itens e três dimensões, onde a B-WRRS foi testada em 173 trabalhadores de cargos administrativos de uma instituição pública. Para a avaliação da validade dimensional, iniciou-se com a análise fatorial confirmatória, tendo como base o modelo original proposto pelos autores da escala. Foi realizada também a análise fatorial exploratória, utilizando o Mplus. Resultados A adaptação da escala cumpriu as etapas de avaliação da equivalência conceitual, de itens, semântica e operacional, apresentando grande aceitabilidade e compreensão por parte dos respondentes. A avaliação da estrutura fatorial da B-WRRS corroborou a tridimensionalidade da escala. Conclusão Por ser simples e rápido, o preenchimento da B-WRRS se destaca como promissor para o uso no ambiente de trabalho. O processo de adaptação transcultural do instrumento não apresentou divergências conceituais nem semânticas. Entretanto, as diferenças observadas na composição das dimensões indicam a necessidade de novas avaliações psicométricas para estabelecer a equivalência funcional da B-WRRS.

Abstract Background The work-related rumination scale refers to thoughts related to various aspects of work that occur during periods of rest. Objective To describe the transcultural adaptation process of the work-related rumination scale to the Brazilian context (B-WRRS), and to analyze psychometric properties. Method Translation, back-translation, and initial psychometric evaluation of the scale, which comprised 15 items and 3 dimensions, were performed. B-WRRS was tested on a sample of 173 administrative staff at a public institution. To evaluate the dimensional validity, the confirmatory factor analysis was tested based on the original model proposed by the authors of the scale. Exploratory factor analysis was also performed using Mplus. Results The transcultural adaptation of the scale fulfilled the steps of assessment of conceptual, item, semantic, and operational equivalence, showing acceptability and understanding by the respondents. The evaluation of the factorial structure of B-WRRS corroborated the three-dimensionality of the scale. Conclusion The simple and quick filling of the scale highlights that the use of B-WRRS in the work environment is promising. The process of cross-cultural adaptation of the instrument did not present conceptual or semantic divergences. However, the differences observed in the composition of the dimensions indicate the need for new psychometric assessments to establish the functional equivalence of B-WRRS.

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Resumo Objetivo: descrever etapas de adaptação transcultural e validade dimensional para uso, no Brasil, da escala "indicadora de trabalho-vida" (work-life indicator). Métodos: realizaram-se análises das equivalências conceitual, de itens e da semântica, conduzidas por pesquisadores experientes em uso de escalas e/ou saúde ocupacional. A escala foi aplicada a participantes da terceira onda do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil). Procedeu-se, então, a avaliação da equivalência de mensuração, utilizando-se Análises Fatoriais Exploratória (AFE) e Confirmatória (AFC). Resultados: aplicada a 7.277 participantes (50,3% do sexo masculino), a escala apresentou equivalências conceitual, de itens e semântica pertinentes no contexto brasileiro, bem como adequada correspondência de significado referencial/denotativa de termos e geral/conotativa dos itens. As AFE e AFC corroboraram a estrutura teórica de três dimensões - i) vida pessoal invadindo trabalho, ii) trabalho invadindo vida pessoal e iii) controle de limites percebidos -, com indicadores de ajuste adequados após a exclusão de dois itens da primeira dimensão. Na AFC, obteve-se índice de ajuste comparativo=0,968, índice de Tucker-Lewis=0,957 e raiz do erro quadrático médio de aproximação=0,039 (IC90%: 0,035;0,041). Conclusão: a escala é promissora para avaliar o gerenciamento de limites entre trabalho e vida pessoal no contexto brasileiro, assim como facilitará a realização de estudos sobre a influência desse gerenciamento na saúde e bem-estar dos(as) trabalhadores(as).

Abstract Objective: to describe the stages in the transcultural adaptation and dimensional validation of the "life-work indicator" scale for use in Brazil. Methods: equivalence analyses regarding concept, items, and semantics were conducted by researchers experienced in using scales and/or occupational health. The scale was applied to the third wave of the Longitudinal Study of Adult Health (Estudo Longitudinal de Saúde do Adulto, ELSA-Brasil). Measurement equivalence was then assessed using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Results: applied to 7,277 participants (50.3% of them male), the scale displayed equivalences regarding concept, items, and semantics proper to the Brazilian context, as well as appropriate correspondences in referential/denotative meaning of terms and overall/connotative meaning of items. EFA and CFA corroborated its theoretical structure in three dimensions -i) personal life invading work, ii) work invading personal life, and iii) perceived boundary control - returning suitable fit indices after exclusion of two items from the first dimension. CFA returned comparative fit index of 0.968, Tucker-Lewis index of 0.957, and root mean square error of approximation of 0.039 (90%CI: 0.035;0.041). Conclusion: the scale shows to be promising for assessing the management of boundaries between work and personal life in the Brazilian context, and will facilitate studies on the influence of such management on workers' health and wellbeing.

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The Deepwater Horizon oil rig accident, in 2010, is considered the biggest disaster of the 21st century in the oil and gas industry. A total of 11 workers died, 17 were injured, total loss of the unit, and the largest environmental disaster in the Gulf of Mexico (United States). The existing literature encompasses its environmental, chemical, biological, and economic effects, focusing on immediate causes, that is, situations close to the event in time and space, especially human errors and technical failures. This approach is taken at the expense of identifying possible underlying causes, which refer to managerial and organizational factors. This essay aims to answer the question: wich factors may have contributed to the disaster that affected the platform, considering the relevance of the collective dimension of work? Our theoretical-methodological contribution is based on the activity ergonomics and the work psychodynamics, also valuing the synergistic conduction of the relationship between the knowledge of the sciences and the experience of the workers, as proposed by the ergological perspective. We identified decision failures from those who are at the tip of the process, operating systems of high complexity, that should not be interpreted as an endpoint, but as a starting point in the analysis of major accidents. Understanding such decisions demands the comprehension of the representations constructed by the workers, including in their collective and shared dimension. The communication (or communication gaps) between workers and organizational factors in the context of the accident are essential aspects to be considered in the analysis of events involving complex systems.

O acidente com a plataforma Deepwater Horizon, em 2010, é considerado o maior desastre do século no setor de óleo e gás. Esse evento teve como consequências 11 trabalhadores mortos, 17 feridos, perda total da unidade e maior desastre ambiental no Golfo do México (Estados Unidos). A literatura existente abarca seus impactos ambientais, químicos, biológicos e econômicos, concentrando-se nas causas imediatas, ou seja, situações próximas no tempo e no espaço do evento, em especial erros humanos e falhas técnicas. Tal abordagem se dá em detrimento da identificação de possíveis causas subjacentes, que remetem a fatores gerenciais e organizacionais. O objetivo deste ensaio é responder à pergunta: que fatores teriam contribuído para a ocorrência do desastre que acometeu a plataforma, considerando-se a relevância da dimensão coletiva do trabalho? Nosso aporte teórico-metodológico se baseia na ergonomia da atividade e na psicodinâmica do trabalho, valorizando também a condução sinérgica da relação entre os saberes das ciências e da experiência dos trabalhadores, como propõe a perspectiva ergológica. Foram identificadas falhas de decisão tomadas por quem se situa à ponta do processo, na operação de sistemas de alta complexidade, mas que não devem ser vistas como ponto de chegada, e sim de partida na análise de grandes acidentes. O entendimento de tais decisões demanda a compreensão das representações construídas pelos trabalhadores, inclusive em sua dimensão coletiva e compartilhada. A comunicação (ou lacunas de comunicação) entre os trabalhadores e fatores organizacionais no contexto do acidente são aspectos essenciais a serem considerados na análise de eventos que envolvem sistemas complexos.

El accidente de Deepwater Horizon en 2010 es considerado el mayor desastre del siglo en el sector del petróleo y gas. Este evento resultó en 11 trabajadores muertos, 17 heridos, pérdida total de la unidad y un gran desastre ambiental en el Golfo de México (EE.UU.). La literatura existente abarca sus impactos ambientales, químicos, biológicos y económicos, enfocándose en las causas inmediatas, es decir, situaciones próximas en el tiempo y espacio del evento, especialmente errores humanos y fallas técnicas. Tal enfoque no identifica las posibles causas subyacentes, que se refieren a factores gerenciales y organizacionales. El objetivo de este ensayo es responder a la pregunta: ¿qué factores habrían contribuido a la ocurrencia del desastre que afectó a la plataforma, considerando la relevancia de la dimensión colectiva del trabajo? Nuestro aporte teórico-metodológico se fundamenta en la ergonomía de la actividad y en la psicodinámica del trabajo, valorando además la conducción sinérgica de la relación entre el saber de las ciencias y la experiencia de los trabajadores, tal como lo propone la perspectiva ergológica. Se identificaron fallos de decisión, tomados por quienes están al final del proceso, en la operación de sistemas de alta complejidad, pero que no deben ser vistos como un punto de llegada, sino un punto de partida en el análisis de accidentes mayores. Comprender tales decisiones requiere comprender las representaciones construidas por los trabajadores, incluso en su dimensión colectiva y compartida. La comunicación (o brechas de comunicación) entre los trabajadores y los factores organizacionales en el contexto del accidente son aspectos esenciales a ser considerados en el análisis de eventos que involucran sistemas complejos.

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This study sought to analyze the effect of work-to-family conflict (demands from work that affect one's family/personal life), family-to-work conflict (demands from family/personal life that affect work), and lack of time for self-care and leisure due to professional and domestic demands on the incidence of weight gain and increase in waist circumference by gender in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Our study included 9,159 ELSA-Brasil participants (4,413 men and 4,746 women) who attended baseline (2008-2010) and the first follow-up visit (2012-2014). Weight gain and increase in waist circumference were defined as an annual increase ≥ 75th percentile, i.e., ≥ 1.21kg/year and ≥ 1.75cm/year, respectively for women; and ≥ 0.96kg/year and ≥ 1.41cm/year respectively for men. Associations were estimated by Poisson regression applying robust variance with the R software. Analyses were stratified by gender and adjusted for socioeconomic variables. Adjusted models showed a higher risk of weight gain among women who reported family-to-work conflict frequently and sometimes (relative risk - RR = 1.37 and RR = 1.15, respectively) and among those who reported frequent lack of time for self-care and leisure (RR = 1.13). Among men, time-based work-to-family conflict (RR = 1.17) and strain-based work-to-family conflict (RR = 1.24) were associated with weight gain. No associations were observed between work-family conflict domains and increase in waist circumference. These findings suggest that occupational and social health promotion programs are essential to help workers balance work and family life to reduce weight gain.

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The objective was to analyze associations between perceived risk from COVID-19 and symptoms of depression, anxiety, and stress among workers in healthcare units. This was a cross-sectional study of workers from different professions who appeared voluntarily at one of the first COVID-19 Testing Centers in the municipality of Rio de Janeiro, Brazil. The workers were invited to answer an online questionnaire from May to August 2020. The COVID-19 Risk Perception Scale and the Depression, Anxiety, and Stress Scale (DASS-21) were used. Odds ratios (OR) and 95% confidence intervals were estimated. Of the total sample (N = 2,996), 81.5% were women, and mean age was 40.7 years. About half presented mild, moderate, or severe depression, anxiety, or stress, and the rates for workers with severe symptoms were 18.5%, 29.6%, and 21.5%, respectively. The associations between perceived risk and symptoms of depression, anxiety, and stress increased with the increase in each symptom's severity. Workers with higher perceived risk from COVID-19 showed higher OR for severe symptoms of depression (OR = 4.67), anxiety (OR = 4.35), and stress (OR = 4.97). The findings point to the demand for measures to protect workers' health and that should not be limited to personal protective equipment. It is essential for health system administrators to promote collective spaces for discussion and actions to favor workers' recovery in the context of a prolonged pandemic.

O objetivo foi analisar as associações entre a percepção de risco de adoecimento por COVID-19 e os sintomas de depressão, ansiedade e estresse em profissionais atuantes em unidades de saúde. Estudo transversal com trabalhadores de diversas categorias profissionais que buscaram voluntariamente um dos primeiros Centros de Referência em Testagem de COVID-19 no Município do Rio de Janeiro, Brasil. Os trabalhadores foram convidados a responder a um questionário online entre maio e agosto de 2020. Foram utilizadas a escala Percepção de Risco de Adoecimento por COVID-19 e a Escala de Depressão, Ansiedade e Estresse (DASS-21). Foram estimados razão de chance (OR) e intervalo de 95% de confiança. Do total (N = 2.996), 81,5% eram mulheres com idade média de 40,7 anos. Cerca da metade apresentava grau leve, moderado ou severo de depressão, ansiedade ou estresse, sendo a frequência de trabalhadores com sintomas severos, respectivamente, 18,5%, 29,6% e 21,5%. Observou-se que as associações entre a percepção de risco e os sintomas de depressão, ansiedade e estresse foram mais fortes à medida que aumentava a classificação de gravidade de cada sintoma. Os trabalhadores com alta percepção de risco de adoecimento por COVID-19 apresentaram OR mais elevadas para sintomas severos de depressão (OR = 4,67), ansiedade (OR = 4,35) e estresse (OR = 4,97). Os achados apontam a demanda por medidas de proteção à saúde dos trabalhadores, que não devem se restringir aos equipamentos de proteção individual. É essencial que os gestores promovam espaços coletivos de discussão e ações que favoreçam a recuperação dos trabalhadores em contexto pandêmico de longa duração.

El objetivo fue analizar las asociaciones entre la percepción de riesgo de enfermedad por COVID-19 y los síntomas de depresión, ansiedad y estrés en profesionales activos en unidades de salud. Estudio transversal con trabajadores de diversas categorías profesionales que buscaron voluntariamente uno de los primeros Centros de Referencia en Tests de COVID-19 en el municipio de Río de Janeiro, Brasil. Los trabajadores fueron invitados a responder a un cuestionario online entre mayo y agosto de 2020. Se utilizaron la escala Percepción de Riesgo de Enfermedad por COVID-19 y la Escala de Depresión, Ansiedad y Estrés (DASS-21). Se estimaron razón de oportunidad (OR) e intervalo de 95% de confianza. Del total (N = 2.996), un 81,5% eran mujeres con una edad media de 40,7 años. Cerca de la mitad presentaba grado leve, moderado o severo de depresión, ansiedad o estrés, siendo la frecuencia de trabajadores con síntomas severos, respectivamente, 18,5%, 29,6% y 21,5%. Se observó que las asociaciones entre la percepción de riesgo y los síntomas de depresión, ansiedad y estrés fueron más fuertes a medida que aumentaba la clasificación de la gravedad de cada síntoma. Los trabajadores con alta percepción de riesgo de enfermedad por COVID-19 presentaron OR más elevadas para síntomas severos de depresión (OR = 4,67), ansiedad (OR = 4,35) y estrés (OR = 4,97). Los resultados apuntan la demanda de medidas de protección a la salud de los trabajadores, que no se deben restringir a equipamientos de protección individual. Es esencial que los gestores promuevan espacios colectivos de discusión y acciones que favorezcan la recuperación de los trabajadores en un contexto pandémico de larga duración.

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BACKGROUND: Job strain has been reported as a trigger for binge eating, yet the underlying mechanisms have been unclear. The aim of this study was to evaluate whether work-family conflict is a pathway in the association between job strain and binge eating, considering the possible effect-modifying influence of body mass index (BMI). METHODS: This cross-sectional analysis included 12,084 active civil servants from the multicenter Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Job strain was assessed using the Demand-Control-Support Questionnaire. Work-family conflict was considered as a latent variable comprising three items. Binge eating was defined as eating a large amount of food in less than 2 h at least twice a week in the last six months with a sense of lack of control over what and how much was eaten. Structural equation modelling was used to test the role of work-family conflict in the association between job strain and binge eating, stratifying for BMI. RESULTS: For individuals of normal weight, positive associations were found between skill discretion and binge eating (standardized coefficient [SC] = 0.209, 95%CI = 0.022-0.396), and between psychological job demands and work-family conflict (SC = 0.571, 95%CI = 0.520-0.622), but no statistically significant indirect effect was found. In overweight individuals, psychological job demands, skill discretion, and work-family conflict were positively associated with binge eating (SC = 0.099, 95%CI = 0.005-0.193; SC = 0.175, 95%CI = 0.062-0.288; and SC = 0.141, 95%CI = 0.077-0.206, respectively). Also, work-family conflict was observed to be a pathway on the associations of psychological job demands and decision authority with binge eating (SC = 0.084, 95%CI = 0.045-0.122; and SC = - 0.008, 95%CI = - 0.015- - 0.001, respectively). CONCLUSIONS: Work-family conflict partly explains effects of high levels of psychological job demands and low levels of decision authority on binge eating among overweight individuals. Moreover, skill discretion is positively associated with binge eating, regardless of BMI category.

Recent studies have found work-family conflict (i.e., incompatible work and family demands) to link between work issues and physical and mental health. Accordingly, this study investigated whether the relationship between job strain and binge eating is explained by work-family conflict, by body mass index (BMI), in a large sample of Brazilian civil servants. Overall, this study demonstrated that, among overweight individuals, excessive job demands and low decision authority (over what to do at work and how) contribute to binge eating by increasing work-family conflict. Also, excessive skill discretion at work, including opportunities to acquire and use specific job skills, is related to binge eating, regardless of BMI, which deserves further investigation. In conclusion, the results indicate that work-family conflict is a potential mechanism through which job strain can affect eating behavior among overweight individuals.

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This study sought to analyze the effect of work-to-family conflict (demands from work that affect one's family/personal life), family-to-work conflict (demands from family/personal life that affect work), and lack of time for self-care and leisure due to professional and domestic demands on the incidence of weight gain and increase in waist circumference by gender in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Our study included 9,159 ELSA-Brasil participants (4,413 men and 4,746 women) who attended baseline (2008-2010) and the first follow-up visit (2012-2014). Weight gain and increase in waist circumference were defined as an annual increase ≥ 75th percentile, i.e., ≥ 1.21kg/year and ≥ 1.75cm/year, respectively for women; and ≥ 0.96kg/year and ≥ 1.41cm/year respectively for men. Associations were estimated by Poisson regression applying robust variance with the R software. Analyses were stratified by gender and adjusted for socioeconomic variables. Adjusted models showed a higher risk of weight gain among women who reported family-to-work conflict frequently and sometimes (relative risk - RR = 1.37 and RR = 1.15, respectively) and among those who reported frequent lack of time for self-care and leisure (RR = 1.13). Among men, time-based work-to-family conflict (RR = 1.17) and strain-based work-to-family conflict (RR = 1.24) were associated with weight gain. No associations were observed between work-family conflict domains and increase in waist circumference. These findings suggest that occupational and social health promotion programs are essential to help workers balance work and family life to reduce weight gain.

O objetivo foi analisar o efeito de conflitos entre o trabalho e a família (demandas do trabalho que interferem na vida familiar ou pessoal) e entre a família e o trabalho (demandas da vida que interferem no trabalho), além da falta de tempo para autocuidado e lazer em função de demandas profissionais e domésticas, na incidência de ganho de peso e aumento da circunferência abdominal, de acordo com gênero, no Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil). O estudo presente incluiu 9.159 participantes do ELSA-Brasil (4.413 homens e 4.746 mulheres) que frequentaram a linha de base (2008-2010) e a primeira visita de seguimento (2012-2014). O ganho ponderal e o aumento de circunferência abdominal foram definidos enquanto ganho anual ≥ 75º percentil, i.é., ≥ 1,21kg/ano e ≥ 1,75cm/ano, respectivamente, em mulheres, e ≥ 0,96kg/ano e ≥ 1,41cm/ano, respectivamente, em homens. As associações foram estimadas pela regressão de Poisson com variância robusta, usando o software R. As análises foram estratificadas por gênero e ajustadas por variáveis socioeconômicas. Os modelos ajustados mostraram risco maior de ganho ponderal em mulheres que relatavam conflitos frequentes ou eventuais de família para o trabalho (risco relativo - RR = 1,37 e RR = 1,15, respectivamente), e naquelas que relatavam frequentemente falta de tempo para autocuidado e lazer (RR = 1,13). Nos homens, os conflitos de tempo do trabalho para a família (RR = 1,17) e os conflitos de tensão do trabalho para a família (RR = 1,24) mostraram associação com ganho ponderal. Não foram observadas associações nos domínios dos conflitos de trabalho para a família e o aumento de circunferência abdominal. Os achados sugerem a necessidade de programas de promoção ocupacional e de saúde social para ajudar homens e mulheres economicamente ativos a equilibrarem o trabalho e a vida familiar para reduzir o ganho de peso.

El objetivo fue analizar el efecto del trabajo en conflictos de familia (exigencias del trabajo que interfieren en la familia/vida personal), conflictos de familia en el trabajo (exigencias de la familia/vida personal que interfieren con el trabajo), y la falta de tiempo para el autocuidado y ocio, debido a exigencias profesionales y domésticas en la incidencia de aumento de peso y aumento de contorno de cintura por género en el Estudio Longitudinal de Salud del Adulto brasileño (ELSA-Brasil). Este estudio incluyó a 9.159 participantes del ELSA-Brasil (4.413 hombres y 4.746 mujeres) que formaban parte de la base de referencia (2008-2010) y de la primera visita de seguimiento (2012-2014). El aumento de peso y contorno de cintura se definió como un aumento anual ≥ 75º percentil, p.ej., ≥ 1,21kg/año y ≥ 1,75cm/año, respectivamente, en mujeres, y ≥ 0,96kg/año y ≥ 1,41cm/año, respectivamente, en hombres. Se estimaron las asociaciones por regresión de Poisson, aplicando variancia robusta, usando R software. Se estratificaron análisis por género y se ajustaron para variables socioeconómicas. Los modelos ajustados mostraron un riesgo mayor de aumento de peso entre mujeres que informaron de un conflicto de familia para trabajar frecuentemente y a veces (riesgo relativo - RR = 1,37 y RR = 1,15, respectivamente), y entre quienes informaron de falta de tiempo para el autocuidado y ocio frecuentemente (RR = 1,13). Entre hombres, el trabajo basado en el tiempo respecto a conflictos familiares (RR = 1,17), así como el trabajo basado en el esfuerzo respecto a la misma cuestión (RR = 1,24) estuvieron asociados al aumento de peso. No se observaron asociaciones entre los ámbitos trabajo-conflictos de familia y aumento de peso. Estos resultados sugieren la necesidad de programas sociales de promoción ocupacional y de salud para ayudar a hombres y mujeres a equilibrar la fuerza laboral en el trabajo y la vida familiar, con el fin de reducir el aumento de peso.

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O objetivo foi analisar as associações entre a percepção de risco de adoecimento por COVID-19 e os sintomas de depressão, ansiedade e estresse em profissionais atuantes em unidades de saúde. Estudo transversal com trabalhadores de diversas categorias profissionais que buscaram voluntariamente um dos primeiros Centros de Referência em Testagem de COVID-19 no Município do Rio de Janeiro, Brasil. Os trabalhadores foram convidados a responder a um questionário online entre maio e agosto de 2020. Foram utilizadas a escala Percepção de Risco de Adoecimento por COVID-19 e a Escala de Depressão, Ansiedade e Estresse (DASS-21). Foram estimados razão de chance (OR) e intervalo de 95% de confiança. Do total (N = 2.996), 81,5% eram mulheres com idade média de 40,7 anos. Cerca da metade apresentava grau leve, moderado ou severo de depressão, ansiedade ou estresse, sendo a frequência de trabalhadores com sintomas severos, respectivamente, 18,5%, 29,6% e 21,5%. Observou-se que as associações entre a percepção de risco e os sintomas de depressão, ansiedade e estresse foram mais fortes à medida que aumentava a classificação de gravidade de cada sintoma. Os trabalhadores com alta percepção de risco de adoecimento por COVID-19 apresentaram OR mais elevadas para sintomas severos de depressão (OR = 4,67), ansiedade (OR = 4,35) e estresse (OR = 4,97). Os achados apontam a demanda por medidas de proteção à saúde dos trabalhadores, que não devem se restringir aos equipamentos de proteção individual. É essencial que os gestores promovam espaços coletivos de discussão e ações que favoreçam a recuperação dos trabalhadores em contexto pandêmico de longa duração.

The objective was to analyze associations between perceived risk from COVID-19 and symptoms of depression, anxiety, and stress among workers in healthcare units. This was a cross-sectional study of workers from different professions who appeared voluntarily at one of the first COVID-19 Testing Centers in the municipality of Rio de Janeiro, Brazil. The workers were invited to answer an online questionnaire from May to August 2020. The COVID-19 Risk Perception Scale and the Depression, Anxiety, and Stress Scale (DASS-21) were used. Odds ratios (OR) and 95% confidence intervals were estimated. Of the total sample (N = 2,996), 81.5% were women, and mean age was 40.7 years. About half presented mild, moderate, or severe depression, anxiety, or stress, and the rates for workers with severe symptoms were 18.5%, 29.6%, and 21.5%, respectively. The associations between perceived risk and symptoms of depression, anxiety, and stress increased with the increase in each symptom's severity. Workers with higher perceived risk from COVID-19 showed higher OR for severe symptoms of depression (OR = 4.67), anxiety (OR = 4.35), and stress (OR = 4.97). The findings point to the demand for measures to protect workers' health and that should not be limited to personal protective equipment. It is essential for health system administrators to promote collective spaces for discussion and actions to favor workers' recovery in the context of a prolonged pandemic.

El objetivo fue analizar las asociaciones entre la percepción de riesgo de enfermedad por COVID-19 y los síntomas de depresión, ansiedad y estrés en profesionales activos en unidades de salud. Estudio transversal con trabajadores de diversas categorías profesionales que buscaron voluntariamente uno de los primeros Centros de Referencia en Tests de COVID-19 en el municipio de Río de Janeiro, Brasil. Los trabajadores fueron invitados a responder a un cuestionario online entre mayo y agosto de 2020. Se utilizaron la escala Percepción de Riesgo de Enfermedad por COVID-19 y la Escala de Depresión, Ansiedad y Estrés (DASS-21). Se estimaron razón de oportunidad (OR) e intervalo de 95% de confianza. Del total (N = 2.996), un 81,5% eran mujeres con una edad media de 40,7 años. Cerca de la mitad presentaba grado leve, moderado o severo de depresión, ansiedad o estrés, siendo la frecuencia de trabajadores con síntomas severos, respectivamente, 18,5%, 29,6% y 21,5%. Se observó que las asociaciones entre la percepción de riesgo y los síntomas de depresión, ansiedad y estrés fueron más fuertes a medida que aumentaba la clasificación de la gravedad de cada síntoma. Los trabajadores con alta percepción de riesgo de enfermedad por COVID-19 presentaron OR más elevadas para síntomas severos de depresión (OR = 4,67), ansiedad (OR = 4,35) y estrés (OR = 4,97). Los resultados apuntan la demanda de medidas de protección a la salud de los trabajadores, que no se deben restringir a equipamientos de protección individual. Es esencial que los gestores promuevan espacios colectivos de discusión y acciones que favorezcan la recuperación de los trabajadores en un contexto pandémico de larga duración.

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Resumo Objetivos: avaliar a validade dimensional da escala de percepção de risco de adoecimento por COVID-19 e sua associação com fatores sociodemográficos, ocupacionais e com queixas de sono, entre trabalhadores da saúde. Métodos: estudo seccional, com trabalhadores da saúde do Rio de Janeiro que, entre maio e agosto de 2020, preencheram questionário online sobre seu trabalho, percepção de risco de adoecimento por COVID-19 e comportamentos de saúde. Utilizou-se análise fatorial e modelos de regressão logística binomial e multinomial, ajustados por variáveis de confusão. Resultados: participaram 2.996 trabalhadores. A análise fatorial corroborou a unidimensionalidade da escala. Chances mais elevadas de alta percepção de risco foram observadas entre mulheres, os que cuidavam de crianças/idosos, aqueles com jornada de trabalho > 40h/semana e trabalhadores das Unidades Básicas de Saúde, Unidades de Pronto Atendimento, hospitais gerais e especializados. A alta percepção de risco associou-se à alteração na duração do sono (OR = 2,39; IC95% = 1,95; 2,94), uso (OR = 2,08; IC95% = 1,67; 2,58) e aumento da dose de medicamentos para dormir (OR = 1,91; IC95% = 1,47; 2,48). Conclusão: a percepção de risco esteve associada ao sexo feminino, cuidar de crianças/idosos, maior jornada de trabalho, queixas de sono e uso de medicamentos para dormir. A investigação dos fatores associados a eventos estressantes, como a pandemia da COVID-19, pode corroborar o planejamento de ações para a prevenção de doenças entre trabalhadores de saúde.

Abstract Objectives: to evaluate the dimensional validity of the perception scale of the risk of contracting COVID-19 and its association with sociodemographic and occupational factors, as well as with sleep complaints, among healthcare workers. Methods: cross-sectional study, carried out between May and August 2020, involving healthcare workers from Rio de Janeiro, Brazil. They filled in an online questionnaire regarding their work activities, risk perception of contracting COVID-19, and health behavior. We used factor analysis and binomial and multinomial regression models, adjusted for confounders. Results: 2,996 workers participated. Factor analysis confirmed the scale unidimensionality. Greater chances of high-risk perception were reported by: women; caretakers of children/elderly; those with a work journey of more than 40h/week; workers from primary health care and emergency units, and from general and specialized hospitals. High risk perception was associated with altered sleep duration (OR = 2.39; 95%CI = 1.95; 2.94), use (OR = 2.08; 95%CI = 1.67; 2.58) and increased dose of sleep medications (OR = 1.91; 95%CI = 1.47; 2.48). Conclusion: the risk perception was associated with women, caretakers of children/elderly, longer working hours, sleep complaints, and use of sleeping pills. Investigating factors associated with stressful events, such as the COVID-19 pandemic, can support actions planning aimed at preventing diseases among healthcare workers.

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RESUMO O artigo visou refletir acerca da produção intelectual da pesquisadora Helena Hirata como importante referência para o campo da saúde coletiva, em especial para a compreensão das relações entre o trabalhar e as dinâmicas que envolvem a saúde. Recorreram-se às suas publicações teórico-acadêmicas e entrevistas concedidas a revistas especializadas, cuja análise foi aprofundada por meio de uma conversa virtual com a pesquisadora. Com suas pesquisas comparativas no Brasil, na França e no Japão, Hirata apresenta as diversidades e semelhanças dos mundos do trabalho, dos processos de globalização e seus efeitos, fortalecendo a discussão sobre a ampliação do conceito de trabalho - para além do trabalho assalariado - e sua centralidade. Seus estudos enriquecem o debate sobre a indissociabilidade entre as relações sociais de sexo/gênero e a divisão sexual do trabalho. A imbricação e a interdependência do conjunto das relações sociais figurarão de forma exemplar em suas análises acerca do trabalho de cuidado, possibilitando a condensação de ideias e conceitos. Dessa forma, a produção intelectual de Hirata, ao afirmar a transversalidade das relações sociais de sexo/gênero, subsidia reflexões sobre a determinação do processo saúde-doença, contribuindo decisivamente para os estudos da relação saúde e trabalho.

ABSTRACT The article aims to reflect on the intellectual production of researcher Helena Hirata, as an important reference for the field of collective health, especially for understanding the relationships between work and the dynamics that involve health. Her theoretical-academic publications and interviews with specialized journals were used, whose analysis was deepened through a virtual conversation with the researcher. With her comparative research in Brazil, France, and Japan, Hirata presents the diversities and similarities of the worlds of work, the processes of globalization and their effects, strengthening the discussion about the expansion of the concept of work - beyond wage labor - and its centrality. Her studies enrich the debate on the inseparability between the social relations of sex/gender and the sexual division of labor. The imbrication and interdependence of the set of social relations will appear in an exemplary way in her analysis of care work, enabling the condensation of ideas and concepts. In this way, Hirata's intellectual production, when affirming the transversality of the social relations of sex / gender, subsidizes reflections on the determination of the health-disease process, contributing decisively to the studies of the health-work relationship.

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Background: Balancing work and family demands is often a challenge. Family and job responsibilities may affect many aspects of health, and sleep is an important issue. Work-family conflict (WFC) refers to situations where it is difficult to reconcile family and professional demands. WFC can act in two directions: work-to-family conflicts occur when job demands interfere in family life; family-to-work conflicts arise when family demands interfere with job performance. This study evaluated whether dimensions of WFC-time- and strain-related, work-to-family conflict; family-to-work conflict; and lack of time for self-care and leisure due to work and family demands-were cross-sectionally and longitudinally associated with sleep complaints, by gender. Methods: The sample comprised 9,704 active workers (5,057 women and 4,647 men) from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Standardized questionnaires were used to collect data. WFC was measured at baseline (2008-2010), and sleep complaints were measured at baseline and approximately 4 years after the first visit (2012-2014). To test the association between the four WFC dimensions and sleep complaints, crude and multiple logistic regressions were conducted to estimate odds ratios and 95% confidence intervals. The adjusted model included age, education, marital status, hours worked and work schedule. Results: Mean age at baseline was 48.2 years. Most participants were educated to University degree level (54.5%), married (68.2%) and worked ≤ 40 h/week (66.1%). At baseline, 48.3% of women and 41.1% of men reported sleep complaints. Frequent WFC was reported by women and men, respectively, as follows: time-related work-to-family conflict (32.6 and 26.1%), strain-related work-to-family conflict (25.3 and 16.0%), family-to-work conflict (6.6 and 7.6%) and lack of time for self-care (35.2 and 24.7%). For both women and men, time- and strain-related work-to-family conflicts and conflicts for lack of time for self-care were cross-sectionally and longitudinally associated with sleep complaints. The findings also suggest a weaker and non-significant association between family-to-work conflict and sleep complaints. Conclusions: The statistically significant associations observed here underline the importance of reducing WFC. In the modern world, both WFC and sleep problems are increasingly recognized as frequent problems that often lead to ill health, thus posing a public health challenge.

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A growing number of people keep working after retirement, a phenomenon known as bridge employment. Sleep features, which are related to morbidity and mortality outcomes, are expected to be influenced by bridge employment or permanent retirement. The objective of this study was to analyze sleep duration and quality of bridge employees and permanent retirees compared to nonretired, i.e., active workers, from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Participants (second wave of ELSA-Brasil, 2012-2014) comprised permanently retired (n = 2348), career bridge workers (n = 694), bridge workers in a different place (n = 760), and active workers (n = 6271). The associations of all studied retirement schemes and self-reported sleep quality and duration were estimated through logistic and linear regression analysis. Workers from all studied retirement schemes showed better sleep patterns than active workers. In comparison to active workers, bridge workers who had changed workplace also showed a reduced chance of difficulty falling asleep and too-early awakenings, which were not found among career bridge workers. Bridge employment and permanent retirement were associated with a reduced chance of reporting sleep deficit. Bridge work at a different place rather than staying at the same workplace seems to be favorable for sleep. Further study is needed to explain mechanisms.

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Introduction: Exposure to night work (NW) has been identified as a possible risk factor for body weight gain. Recent studies highlight the need to assess the intensity and frequency of exposure to night work (i.e., years of exposure and number of nights worked). Objectives: To investigate the relationships between the dose of exposure to night work (years working nights and number of nights worked) and nutritional status (excess weight, waist circumference), abdominal obesity, and body mass index in nursing professionals. Methods: Data were analyzed on night workers (n = 529) from a public hospital in Rio de Janeiro, Brazil. Descriptive analyses were conducted and crude and adjusted regression models were constructed to test the associations between exposures and outcomes. Analyses were performed using R, version 2.15. Results: Working at night for 10 years or more was associated with excess weight (odds ratio [OR] = 1.76; 95% confidence interval [95%CI] 1.14-2.72), with abdominal obesity (OR = 1.76; 95%CI 1.14-2.74), with increased body mass index (ß = 2.28; 95%CI 1.31-3.26), and with increased waist circumference (ß = 4.63; 95%CI 2.38-6.88), when compared with exposure to NW for less than 10 years, after adjusting for covariates. The current dose of night work only exhibited a borderline association between > 5 nights/fortnight and abdominal obesity (OR = 1.55; 95%CI 1.01-2.01). Conclusions: Detailing night work exposure can contribute data to support strategies for organizing working hours that consider the possibility of limiting the time exposed to night work.

Introdução: A exposição ao trabalho noturno (TN) vem sendo apontada como possível fator de risco para o aumento do peso corporal. Estudos recentes destacam a necessidade de avaliação da intensidade e da frequência da exposição ao TN (ou seja, anos de exposição e número de noites trabalhadas). Objetivos: Investigar a relação entre a dose de exposição ao TN (anos e número de noites trabalhadas) e o estado nutricional (excesso de peso, circunferência abdominal, obesidade abdominal e índice de massa corporal) em profissionais de enfermagem. Métodos: Foram analisados os dados referentes aos trabalhadores noturnos (n = 529) de um hospital público do Rio de Janeiro. Realizaram-se análises descritivas e modelos de regressão brutos e ajustados para testar as associações entre as exposições e os desfechos. As análises foram realizadas no programa R, versão 2.15. Resultados: Trabalhar à noite por 10 anos ou mais associou-se ao excesso de peso (odds ratio [OR] = 1,76; intervalo de confiança de 95% [IC95%] 1,14-2,72), à obesidade abdominal (OR = 1,76; IC95% 1,14-2,74), ao índice de massa corporal aumentado (ß = 2,28; IC95% 1,31-3,26) e à cintura abdominal aumentada (ß = 4,63; IC95% 2,38-6,88), comparado ao TN realizado há menos de 10 anos, após ajuste pelas covariáveis. No que se refere à dose atual de TN, foi observada apenas uma associação limítrofe entre mais de 5 noites/quinzena e a obesidade abdominal (OR = 1,55; IC95% 1,01-2,01). Conclusões: O detalhamento da exposição ao TN pode contribuir para subsidiar as estratégias de organização dos horários de trabalho que considerem a possibilidade de limitação do tempo de exposição ao TN.

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Resumo Objetivo: determinar se os níveis de exposição ao trabalho noturno (dose atual; dose acumulada) estão associados à hipertensão (HAS), pressão arterial sistólica (PAS) e pressão arterial diastólica (PAD). Métodos: estudo transversal realizado com 893 profissionais de enfermagem. Foram coletados dados sobre aspectos sociodemográficos, relacionados ao trabalho e a comportamentos de saúde. A pressão arterial foi aferida por meio de monitor digital. Resultados: após o ajuste pelas variáveis sociodemográficas, observou-se que trabalhar mais de 4 noites por quinzena foi associado ao aumento da PAS (4,0 mmHg; intervalo de confiança [IC 95%]: 1,01; 6,97) e PAD (2,3 mmHg; IC 95%: 0,24; 4,35). O trabalho em mais de 4 noites por quinzena foi associado à ocorrência de hipertensão (RC 1,57; IC 95%: 1,01; 2,43). Indivíduos que trabalharam à noite por mais de 9 anos apresentaram, em média, níveis de pressão arterial mais elevados (PAS de 3,7 mmHg [IC 95%: 1,49; 5,92] e PAD de 2,0 mmHg [IC 95%: 0,46; 3,52]), em comparação com aqueles que trabalharam à noite por 9 ou menos anos. Conclusão: esses resultados sugerem que os efeitos do trabalho noturno começam após uma certa dose de exposição, ou seja, após 9 anos de trabalho noturno ou quando exposto ao trabalho noturno por mais de 4 noites por quinzena.

Abstract Objective: to determine whether levels of night work exposure (current dose; accumulated dose) are associated with hypertension (HBP), systolic blood pressure (SBP) and diastolic blood pressure (DBP). Methods: cross-sectional study of 893 nursing personnel. We collected data on sociodemographic, work-related and health behaviour factors and measured blood pressure using a digital monitor. Results: after adjusting for sociodemographic variables, working >4 nights per fortnight was associated with increased SBP (4.0 mmHg; 95% CI: 1.01; 6.97) and DBP (2.3 mmHg; 95% CI: 0.24; 4.35). Working more than four nights per fortnight was associated to hypertension (OR 1.57; 95% CI 1.01; 2.43). Individuals who worked at night for >9 years displayed, on average, higher blood pressure levels (SBP of 3.7 mmHg [95% CI: 1.49; 5.92] and DBP of 2.0mmHg [95% CI: 0.46; 3.52]), compared to those who worked at night for ≤9 years. Conclusion: these findings suggest that effects of night work begin after a certain exposure dose, i.e, after 9 years of night work or when exposed to night work for more than 4 nights per fortnight.

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The aim of this research project was to test the effects of lifetime night work exposure on type 2 diabetes (T2DM) risk. The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) is a prospective cohort study of chronic conditions, such as diabetes and cardiovascular disease. The participants (N = 15105) were recruited (2008-2010) at five public universities and one research institute in six cities in Brazil. Participants from the first wave (2008-2010) were followed up for a mean of 3.8 years. Current analyses comprise 4671 women and 3965 men. Hazard ratios (HR) were estimated using Cox regression models. Crude T2DM incidence rates were 2.26 and 1.44 per 100 person-years, respectively, for women and men who reported ≥ 10 years' working nights. In women, ≥ 10 years of night work was associated with a higher risk of T2DM (HR 1.46 [95% CI: 1.03; 2.08]), after adjusting for age, education, work hours, and BMI. The additional adjustment for physical activity attenuated the association (HR 1.36 [95% CI: 0.94; 1.96]). In men, the results were not statistically significant (HR = 0.65 [95% CI: 0.40; 1.07]). The findings indicate the effects of lifetime night work on T2DM incidence seem to be greater among women than men.

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Few studies have analyzed on-shift naps with regard to shift workers' health. The aim of this study was to examine the association between exposure to night work (intensity and length of exposure to night work) and blood pressure (BP), considering the impact of on-shift naps. A cross-sectional study was carried out at a hospital based on a questionnaire and measurement of BP. The outcomes were systolic blood pressure (SBP), diastolic blood pressure (DBP), and casual hypertension (HTN), i.e., SBP > 140 mmHg, or DBP > 90 mmHg, or reporting a prescription of antihypertensive medication. The sample comprised 449 fixed 12 h night workers who were (unofficially) allowed to nap during the night shift for up to 3 h. Approximately 42% of the sample reported napping. Among non-nappers (but not among nappers), those exposed to more work nights (≥5/fortnight) showed a DBP that was 3.66 mmHg higher than that of the reference group. The likelihood of casual HTN was more than three-fold greater among non-nappers working more nights/fortnight than among those working fewer nights/fortnight. A similar tendency was observed in a subsample of workers who did not take antihypertensive medication. The results were less consistent regarding length of exposure to night work (in years). A possible explanation is that workers who usually take on-shift naps could experience suppression of the BP increase derived from the many nights worked, while the non-nappers did not experience this suppression. The results may be explained by the relationship between napping, melatonin secretion, and attenuation of circadian misalignment. Napping likely contributes to creating a "physiologically nocturnal environment" that tends to favor the circadian system and, therefore, health. Possible negative effects related to sleep inertia deserve attention. The findings encourage new studies on this topic to improve the management of night work at hospitals in regard to workers' health.

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Presenteeism is the term used to describe going in to work even with a health problem. The phenomenon has been identified as one prior factor in sickness absence and, accordingly, the better it is understood, the better will be the prevention strategies. This study aimed to examine the mediating role of presenteeism (the ability to concentrate on work and to complete work despite a health problem) in the association between psychosocial factors at work and common mental disorders (CMD). This cross-sectional study included 1218 nursing personnel at a public hospital in Brazil. Structural equation modelling was performed. The sample comprised mostly women (85.4%), and the mean age was 44.1 (SD = 11.3; range: 24-70) years. Prevalence of presenteeism was 32.8%. Among presenteeist workers (n = 400), a relationship was observed between presenteeism and higher CMD scores. Furthermore, being able to concentrate on work even with a health problem mediated the relationship between social support and CMD and between psychological demands and CMD. Working when sick impairs both the work and the worker's health. Interventions designed to improve working conditions and interpersonal relations can be effective strategies against presenteeism.

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OBJECTIVE: To characterize the dietary pattern of nursing professionals at a public hospital in Rio de Janeiro, RJ, Brazil. METHOD: A sectional study with nursing professionals (nurses, technicians and nursing assistants). Two 24-hour food recall records were applied, totaling 459 foods, being reduced to 24 food groups. Food patterns were identified using the Principal Component Analysis technique, followed by orthogonal varimax rotation. A Scree Plot graph indicated three factors to be extracted and loads > +0.30 were adopted to define dietary patterns. RESULTS: A total of 309 professionals participated. The sample consisted of 85.8% of female individuals. The patterns were named "traditional" which included rice (0.747), beans (0.702) and meat (0.713); "healthy": vegetables (0.444), greens (0.450), fruits (0.459), bananas and oranges (0.379), and "snacks": sugar (0.661), bread (0.471), cakes and cookies (0.334), non-alcoholic drinks (0.727). CONCLUSION: The results highlight the "traditional" food pattern of Brazilian food consumption based on the combination of rice, beans and meat. Future studies may investigate the effect of dietary patterns on health outcomes among nursing workers.

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BACKGROUND: The U-shaped associations between sleep durations and cardiometabolic risk factors (glycated hemoglobin levels, obesity, hypertriglyceridemia, hypertension and cholesterol levels) are still inconclusive. Moreover, as sleep is comprised of quantitative and qualitative aspects, exploring both insomnia symptoms and sleep duration are relevant when evaluating the potential effects of sleep problems on health. The aim was to evaluate sex-specific associations between sleep problems and cardiometabolic risk factors. METHODS: This cross-sectional study used data from wave two of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), including 7491 women and 6232 men. Questionnaires were administered to provide information about socioeconomic conditions, lifestyle, and sleep characteristics. A 12-h fasting blood sample was drawn to measure serum cholesterol, triglycerides, and glycated hemoglobin. Blood pressure, weight and height were also measured using standard equipment. Generalized additive models were used to evaluate the curve shape of the relationship between self-reported sleep duration and the outcomes. Logistic regression was performed to investigate the magnitude of the associations of self-reported sleep duration, insomnia symptoms, and short sleep plus insomnia symptoms with cardiometabolic risk factors. RESULTS: For women, self-reported sleep duration and insomnia symptoms (either separately or linked to short sleep duration) were associated with obesity, hypertension and glycated hemoglobin after adjusting for the confounders. The magnitudes of the associations between self-reported short sleep duration plus insomnia symptoms and the outcomes were slightly increased, considering sleep duration or insomnia symptoms separately. For men, both long sleep duration and insomnia symptoms were associated with hypertriglyceridemia after adjusted for the confounders. CONCLUSION: These findings suggest possible sex-specific patterns, since obesity, hypertension and high glycated hemoglobin were associated with self-reported sleep duration and insomnia symptoms in women, but not in men, and reinforce the importance of considering quantitative and qualitative aspects of sleep for the prevention and management of the outcomes.