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Introduction: The present article analyzed the number of pesticide accidents registered in Tocantins. In the case of occupational exposure to pesticides, the impact of pesticides on farmers is particularly great during direct handling or improper storage. This paper aims, through notifications of industrial accidents involving pesticides, to provide its target audience with information on notifications of accidents. Objectives: To analyze notifications of occupational accidents with pesticides via SINAN in the state of Tocantins, northern Brazil, from 2012 to 2017. Methods: The research deals with an explanatory literature that provides greater familiarity with the problem, making it clear or structured. Results: We can emphasize that pesticide poisoning is a serious public health problem. Among notifications of this event, 178 involved three types of pesticides, accounting for 12.35% of pesticide notifications. Furthermore, the most marketed pesticides are those whose formulation is based on the following active ingredients: glyphosate, 2,4-D, and mancozeb. Conclusions: After analyzing the data, we observed that the challenges brought by pesticide poisoning are related to the eligibility of the database of occupational accidents involving exogenous intoxications, being necessary to replace the use of agricultural pesticides, use pesticides safely for workers and the population, and seriously combat underreporting.

Introdução: O presente artigo analisou o número de acidentes de agrotóxicos registrados no Tocantins. No caso de exposição ocupacional a pesticidas, o impacto dos pesticidas sobre os agricultores é particularmente grande durante o manuseio direto ou armazenamento inadequado. Este trabalho propõe, por meio das notificações de acidentes industriais envolvendo agrotóxicos, fornecer ao seu público-alvo informações sobre notificações de acidentes. Objetivos: Analisar as notificações de acidente de trabalho com agrotóxicos via SINAN no estado do Tocantins entre os anos de 2012 e 2017. Métodos: A pesquisa trata de uma literatura explicativa que proporciona uma maior familiaridade com o problema, tornando-o claro ou estruturado. Resultados: Podemos enfatizar que a intoxicação por agrotóxicos é um sério problema de saúde pública. Dentre as notificações desse evento, 178 envolveram três tipos de agrotóxicos, representando 12,35% das notificações de agrotóxicos. Os agrotóxicos mais comercializados foram aqueles com formulação à base dos seguintes ingredientes ativos: glifosato, 2,4-D e mancozebe. Conclusões: Após a análise dos dados, observamos que os desafios colocados pela intoxicação por agrotóxicos estão relacionados à elegibilidade do banco de dados de acidentes de trabalho envolvendo intoxicações exógenas, sendo necessário substituir o uso de defensivos agrícolas, usar agrotóxicos com segurança para o trabalhador e para a população, e combater seriamente as subnotificações.

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Resumo O objetivo deste artigo é apontar hipóteses de contradições que estariam incubadas historicamente nos sistemas de atividades da Vale, e que podem ter levado ao maior desastre ambiental do Brasil: o rompimento da barragem B I em Brumadinho, bem como à interdição de muitas outras barragens da empresa no estado de Minas Gerais, Brasil. Trata-se de uma análise de caso a partir de dados secundários disponíveis em entrevistas, documentos e textos publicados em diferentes mídias entre 2011 e 2021. Procuramos demonstrar, a partir da Teoria Histórico-Cultural da Atividade, as contradições verificadas em e entre sistemas de atividades da Vale, pois a empresa distribuiu dividendos vultosos aos seus acionistas, remunerou como nunca seus diretores, reduziu os custos em relação às receitas e diminuiu brutalmente a dívida interna, mas manteve investimentos insuficientes na gestão das barragens, culminando no rompimento da B I em 2019 e em 29 barragens interditadas em março de 2021. A financeirização tornou-se central para as operações da empresa. Este estudo aponta para um caminho metodológico do diálogo interdisciplinar que ajuda a esclarecer como as decisões gerenciais estratégicas, especialmente aquelas da gestão financeira, poderiam influenciar a gestão de produção, de manutenção e de segurança das barragens de rejeitos.

Abstract The objective of this article is to point out hypotheses of contradictions historically incubated in Vale's activity systems and that may have led to Brazil's biggest environmental disaster, the B I dam break in Brumadinho, and the interdiction of many other dams owned by Vale in the state of Minas Gerais, Brazil. This is a case analysis from secondary data available in interviews, documents, and texts published in different media between 2011 and 2021. We try to demonstrate, from the Historical-Cultural Theory of Activity, the contradictions verified in and between Vale's activity systems, since the company distributed large dividends to its shareholders, remunerated its directors as never before, reduced costs in relation to incomes, and brutally reduced internal debt, but keeping insufficient investments in dam management, culminating with the break of B I in 2019 and with 29 dams interdicted in March 2021. Financialization has become central to the company's operations. This study points to a methodological path of the interdisciplinary dialogue to help clarify how strategic managerial decisions, especially those of financial management, could influence the production, maintenance, and safety management of tailings dams.

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Objetivo: Avaliar tendência temporal e magnitude dos indicadores de acidentes do trabalho entre segurados da Previdência Social no Brasil e regiões de 2009 a 2019. Métodos: Estudo de séries temporais dos indicadores de acidentes do trabalho nas regiões do Brasil, no período de 2009 a 2019. Os dados foram extraídos do Anuário Estatístico de Acidentes do Trabalho e do Anuário Estatístico da Previdência Social. Modelos de regressão linear generalizada de Prais-Winsten foram utilizados para estimar as tendências e obteve-se a variação percentual anual e os respectivos intervalos de confiança de 95%. Resultados: Houve 7.253.923 acidentes do trabalho no período. A incidência média de acidentes foi 16,3 por mil vínculos de trabalho, com tendência decrescente (VPA = 4,3%; IC95% -5,63;-3,26). Conclusão: O Brasil e suas regiões apresentaram tendência geral decrescente nos indicadores que representam a força de morbidade e a magnitude dos acidentes do trabalho.

Objective: To evaluate the temporal trend and magnitude of occupational accident indicators among Social Security beneficiaries in Brazil and its regions from 2009 to 2019. Methods: A time series study was conducted on occupational accident indicators in the regions of Brazil, from 2009 to 2019. Data were retrieved from the Statistical Yearbook of Occupational Accidents and the Statistical Yearbook of Social Security. Prais-Winsten generalized linear regression models were used to estimate trends, and annual percentage change and their respective 95% confidence intervals were obtained. Results: There were 7,253,923 occupational accidents during the study period. The average incidence rate was 16.3 per 1,000 employment relationships, with a decreasing trend (APC = 4.3%; 95%CI -5.63;-3.26). Conclusion: Brazil and its regions showed an overall decreasing trend in indicators representing morbidity burden and the magnitude of occupational accidents.

Objetivo: Evaluar las tendencias temporales y la magnitud de los indicadores de accidentes laborales entre los beneficiarios del Sistema de Seguridad Social en Brasil y sus regiones, durante el período de 2009 a 2019. Métodos: Estudio de series temporales sobre los indicadores de accidentes de trabajo en las regiones de Brasil, en el período de 2009 a 2019; los datos fueron extraídos de las bases del Anuario Estadístico de Accidentes de Trabajo y del Anuario Estadístico de la Seguridad Social. Se utilizaron modelos de regresión lineal generalizada de Prais-Winsten para estimar las tendencias y los cambios porcentuales anuales y se obtuvieron sus intervalos de confianza del 95%. Resultados: Hubo 7.253.923 accidentes laborales en el período analizado; la incidencia media de accidentes de trabajo fue de 16,28 por 1.000 vínculos, con una tendencia decreciente (VPA = 4,3%; IC95% -5,63; -3,26). Hubo desigualdades entre las regiones, pero la tendencia predominante fue de disminución en todo el país. Conclusión: Brasil y sus regiones han mostrado una tendencia general decreciente en los indicadores que representan la fuerza de morbilidad y la magnitud de los accidentes de trabajo.

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BACKGROUND: Despite constant technological evolution, the forestry sector is still characterised as one with the highest risk of occupational accidents. There is no doubt that accidents penalise workers considerably, as well as the companies, insurers, and, consequently, the society, to which many of the costs are externalised, namely in cases where the worker is incapacitated and unable to work. OBJECTIVE: The aim of this work is to analyse data on occupational accidents in forestry operations in Brazil between 2007 and 2018 in both native and planted forests. METHODS: Data were made available by the Brazilian Statistical Directory of Accidents at Work. RESULTS: The results show that, although most accidents occurred in planted forests, mortality was higher in native forests. It was also found that, overall, the rate of serious accidents resulting in an incapacity to work and, consequently, sick leave is considerably high. CONCLUSIONS: These results highlight that integrating an occupational safety system into a forest management system is crucial for reducing work-related accidents in both native and planted forests. However, the success of this measure will only be effective if it is accompanied by a review of both the Brazilian labour policy and the Brazilian occupational safety management policy, to ensure compliance with legislation, mainly on the part of outsourced companies.

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Scientific publications in the occupational area have a growing trend towards management of safety in the workplace, despite lack of knowledge on the distribution and characteristics of scientific evidence on occupational accidents in healthcare professionals. This study aims to determine the characteristics and collaboration networks of publications, the co-occurrence of terms, and the main journals on occupational accidents in healthcare professionals among publications indexed in Scopus from 2010 to 2019. This is an observational, cross-sectional, bibliometric study based on publications indexed in the Scopus database. The indicators were number of publications per year, main journals of publication and its quality index, collaboration networks between authors, and co-occurrence of terms. The predominant language of publication was English, the main type of study was the observational one, and nursing professionals represent the main group of interest (31.14% of the articles), contrary to radiologists and/or physical therapists (4% each). The main source of publication about occupational accidents was Workplace Health and Safety, and the main themes of investigation were related to puncture injuries and infection by hepatitis B and C. There is a growing trend towards research on occupational accidents of independent authorship, despite the creation of collaboration networks in the last years. Furthermore, nurses and surgeons are the target group of greatest interest, and the main topics cover infectious diseases.

Las publicaciones científicas en el área ocupacional tienen una creciente tendencia en el manejo de la seguridad en el entorno laboral; no obstante, se desconocen la distribución y las características de la evidencia científica sobre accidentes laborales en los profesionales de salud. Este estudio tiene como objetivo determinar las características, redes de colaboración, la co-ocurrencia de términos, y las principales revistas científicas de publicación en accidentes ocupacionales en personal de salud indizadas en Scopus desde 2010 a 2019. Este es un estudio observacional, transversal, bibliométrico a partir de publicaciones indizadas en la base de datos Scopus. Los indicadores fueron número de publicaciones por año, principales revistas de publicación y su índice de calidad, redes de colaboración de autores y co-ocurrencia de palabras. El idioma de publicación predominante fue el inglés, el principal tipo de estudio fue el observacional, y los enfermeros representaron el principal grupo de interés (31,14% de los artículos), al contrario de los radiólogos y/o terapeutas físicos (4% cada uno). La principal fuente de publicación sobre accidentes ocupacionales fue la revista Workplace Health and Safety, y los principales temas de investigación se relacionan a lesiones punzocortantes y contagios por hepatitis B y C. Se muestra una creciente tendencia en investigación sobre accidentes ocupacionales de autoría independiente, a pesar de la formación de redes en los últimos años. Además, enfermeras y médicos cirujanos son el grupo objetivo de mayor interés, y los tópicos principales abarcan enfermedades infecciosas.

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La exposición a peligros biológicos para la salud y las medidas preventivas implementadas para evitar o minimizar esta exposición, es parcialmente desconocida en Ecuador; particularmente, por los estudiantes de enfermería, los cuales, durante sus prácticas pre-profesionales, están expuestos a factores que pueden afectar negativamente el bienestar en su lugar de trabajo. El riesgo puede ser de origen diversos, físicos, ergonómicos, químicos, psicosociales y biológicos. Entre los biológicos se incluyen pinchazos con agujas, salpicaduras de sangre y otros fluidos corporales, cortes de ampollas de medicamentos, cortes de bisturí, perforación de guantes durante la cirugía, contacto con la sangre de los pacientes con las manos sin guantes y contaminación de heridas abiertas con la sangre de los pacientes. Este estudio tuvo como objetivo establecer la relación entre el cumplimiento de los protocolos y técnicas de enfermería con la exposición accidental a riesgos biológicos en estudiantes. Los resultados demostraron asociación estadísticamente significativa entre las variables en estudios, evidenciándose que, a menor cumplimiento de los protocolos e inexperiencias en las maniobras técnicas de enfermería, mayor era la probabilidad a accidentes por riesgo biológico. Se concluye que el conocimiento de los protocolos de enfermería, la vigilancia sobre la prevención de infecciones, la adherencia a las normas de bioseguridad son algunas de las medidas a seguir para reducir la exposición de los estudiantes de enfermería a los riesgos laborales biológicos. Se recomienda, establecer sistemática para el reporte y abordaje de accidentes por riesgo biológicos que ocurran a los estudiantes de enfermería, durante su proceso formativo(AU)

Exposure to biological health hazards and the preventive measures implemented to avoid or minimize this exposure are partially unknown in Ecuador; particularly by nursing students, who, during their pre-professional practices, are exposed to factors that can negatively affect well-being in their workplace. The risk can be of various physical, ergonomic, chemical, psychosocial and biological origins. Biological include needle sticks, splashes of blood and other body fluids, cuts from medication blisters, scalpel cuts, perforation of gloves during surgery, contact with blood from patients on bare hands, and contamination of wounds opened with the blood of patients. This study aimed to establish the relationship between compliance with nursing protocols techniques and accidental exposure to biological risks in students. The results showed a statistically significant association between the variables in the studies, showing that, the less compliance with the protocols and inexperience in nursing technical maneuvers, the greater the probability of accidents due to biological risk. It is concluded that knowledge of nursing protocols, surveillance of infection prevention, adherence to biosafety standards are some of the measures to be followed to reduce the exposure of nursing students to biological occupational hazards. It is concluded that knowledge of nursing protocols, surveillance of infection prevention, adherence to biosafety standards are some of the measures to be followed to reduce the exposure of nursing students to biological occupational hazards. It is recommended to establish a system for reporting and addressing biological risk accidents that occur to nursing students during their training process(AU)

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No Brasil, as condições psicopatológicas no ambiente laboral têm merecido uma alta atenção, pois o afastamento por tal motivo tem aumentado significativamente e impactando o setor empregatício e financeiro. Para avaliar essa questão, o presente estudo objetivou investigar o perfil do adoecimento por transtornos mentais na região Sul do Brasil. Trata-se de um estudo ecológico, com dados do Anuário Estatístico de Acidentes do Trabalho (AEAT). A comparação entre anos e estados foi realizada pelo teste de ANOVA de uma via para amostras pareadas. Verificou-se que, em Santa Catarina, os acidentes de trabalho relacionados aos transtornos mentais e comportamentais estão majoritariamente atrelados aos "Transtornos neuróticos, transtornos relacionados com o stress e transtornos somatoformes", mais especificamente, às "Reações ao stress grave e transtornos de adaptação" (74,06%). Enquanto que no Paraná e Rio Grande do Sul se relacionam com "Transtornos de humor [afetivos]", sendo que, desses os "Episódios depressivos" são a maioria (66,49%). (AU)

In Brazil, the psychopathological conditions in the work environment have deserved a high level of attention, as the absence for this reason has increased significantly and impacting the employment and financial sector. To assess this issue, this study aimed to investigate the profile of illness due to mental disorders in southern Brazil. This is an ecological study, with data from the Anuário Estatístico de Acidentes do Trabalho (AEAT). Comparison between years and states was performedusing the one-way ANOVA test for paired samples. It was found that, in Santa Catarina, work accidents related to mental and behavioral disorders are mostly linked to "Neurotic disorders, disorders related to stress and somatoform disorders", more specifically, to "Reactions to severe stress and adaptation disorders" (74.06%). While in Paraná and Rio Grande do Sul they are related to "Mood [affective] disorders", and of these "Depressive episodes" are the majority (66.49%). (AU)

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We compared the living and working conditions and mental health between miners who worked in Mariana when the Fundão dam broke, to other miners who worked in another city. We based our work on the ecological, social causation, biopsychosocial models, and other contributions. We applied the General Health Questionnaire-12, Rosenberg's self-esteem scale, and the Work-Family Conflict scales to 164 miners, interviewing 25 of them. We observed that the living and working conditions of the miners of Mariana differ unfavorably and are more prone to common mental disorders. The impoverishment of the social environment, the loss of social support, the increasing conflicts in families , the attribution of guilt for the dam collapse, and the economic decline of the city contributed to accentuating feelings of malaise, depression, and anxiety.

Comparamos as condições de vida, de trabalho e a saúde mental dos mineiros que trabalhavam em Mariana quando se rompeu a barragem de Fundão com as de outros que trabalhavam em outra cidade. Baseamo-nos nos modelos: ecológico, de causação social e biopsicossocial. Aplicamos o Questionário de Saúde Geral-12, as escalas de Autoestima de Rosenberg e de Conflito Trabalho-Família a 164 mineiros e entrevistamos 25 deles. Observamos que as condições de vida e de trabalho dos mineiros de Mariana diferem desfavoravelmente e estão mais sujeitos a transtornos mentais comuns. O empobrecimento do meio social, a perda de apoios sociais, os conflitos crescentes na família, a atribuição de culpa pela ruptura da barragem e a decadência econômica da cidade contribuíram para acentuar os sentimentos de mal-estar, depressão e ansiedade.

Comparamos las condiciones de vida y de trabajo y la salud mental de los mineros que trabajaban en Mariana cuando se rompió la presa de Fundão con las de otros que trabajaban en otra ciudad. Para eso, nos basamos en los modelos: ecológico, de causación social y biopsicosocial. Aplicamos el Cuestionario de Salud General (GHQ-12), las escalas de Autoestima de Rosenberg (RSE) y de Conflicto Trabajo-Familia a 164 mineros y entrevistamos 25 de ellos. Observamos que las condiciones de vida y de trabajo de los mineros de Mariana difieren desfavorablemente y que ellos están más susceptibles a trastornos mentales comunes. El empobrecimiento del medio social, la pérdida de apoyos sociales, los crecientes conflictos en la familia, la atribución de culpa por la ruptura de la presa y la decadencia económica de la ciudad contribuyeron para reforzar los sentimientos de malestar, depresión y ansiedad.

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INTRODUCTION: Occupational accidents occur as a result of work, and can lead to bodily harm or functional impairments that lead to death, or to the reduction or loss of working capacity. Occupational accidents are associated with two possible outcomes: morbidity or mortality. Morbidity refers to the subset of a population that develops an illness over a given period of time, while mortality refers to the number of individuals who die over a specified time period. OBJECTIVES: To assess occupational morbidity and mortality in Brazil in the period of 2009 to 2016. METHODS: An ecological study was conducted based on secondary data collected from incident records in the Social Security database. RESULTS: The outcomes of all occupational accidents reported in Brazil from 2009 to 2016 were extracted from the database. These data were then classified by geographical region and category in the National Classification of Economic Activities (Classificação Nacional de Atividades Econômicas), so as to calculate the prevalence of each outcome and the accident mortality rates, and compare these values across regions and occupational categories. CONCLUSIONS: The data show that the outcomes of occupational accidents are directly associated with socioeconomic sectors and the sociocultural characteristics of different regions in the country. These results make an important contribution to the characterization of occupational morbidity and mortality in Brazil.

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INTRODUCTION: Current estimates suggest that 317 million occupational accidents occur annually worldwide. OBJECTIVES: To estimate the prevalence of occupational accidents and associated variables in the Brazilian workforce. METHODS: A cross-sectional study was performed using data from adults aged 18 or older who participated in the National Health Survey (Pesquisa Nacional de Saúde) (2013). This study was based on participants' responses to questions regarding their history of occupational accidents in the previous 12 months. Socioeconomic, lifestyle and health-related variables were also examined. Prevalence rates and ratios were calculated using Poisson multivariate regression models (with 95% confidence intervals), followed by Wald's tests for robust variance estimation. RESULTS: The prevalence of occupational accidents was 2.79% (95% confidence interval, 2.53-3.08%). These incidents were associated with male gender (prevalence ratio = 1.42; 95% confidence interval, 1.14-1.77), living in rural areas (prevalence ratio = 1.27; 95% confidence interval, 1.06-1.62), age 18 to 24 (prevalence ratio = 2.02; 95% confidence interval, 1.20-3.40), illiteracy (prevalence ratio = 3.12; 95% confidence interval, 1.96-4.96) and having two or more chronic illnesses (prevalence ratio = 2.12; 95% confidence interval, 1.29-3.47). CONCLUSIONS: Though the prevalence of occupational accidents in the Brazilian workforce was low, these incidents were associated with multimorbidity, socioeconomic status and lifestyle variables.

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INTRODUCTION: According to the World Health Organization (2018), recent changes in the epidemiological profile of working populations point to an increase in non-communicable chronic illnesses and a decrease in communicable chronic illnesses. OBJECTIVES: To estimate the prevalence of multimorbidity in the Brazilian working population (≥18 years) and identify associated factors based on data from the 2013 national health survey (Pesquisa Nacional de Saúde). METHODS: This was a cross sectional study based on data from the 2013 national health survey, which included n = 47,629 people aged 18 years or older. As part of the survey, participants were asked whether they had ever been diagnosed with any of several chronic diseases. The prevalence of multimorbidity in this population and its association with socioeconomic, lifestyle and occupational characteristics were examined. Bivariate analyses were used to calculate prevalence ratios and 95% confidence intervals. Multivariate analyses were conducted using Poisson regression and Wald's tests to estimate the coefficients of significant variables. RESULTS: The prevalence of multimorbidity was 19.98% (95% confidence interval: 19.29%-20.70%). Higher rates of multimorbidity were associated with female gender, age 60 years or older, living with a spouse, past history of smoking, low education levels (illiterate/primary), living in urban areas, having medical or dental insurance and a history of work accidents. CONCLUSIONS: The prevalence of multimorbidity in the Brazilian population is low. When present, multimorbidity is associated with specific occupational, socioeconomic and lifestyle characteristics.

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Resumo Objetivo: analisar a tendência temporal da mortalidade por acidentes de trabalho (AT) no Brasil de 2006 a 2015 e investigar desigualdades segundo sexo, raça/cor da pele, faixa etária, escolaridade e macrorregiões. Métodos: estudo ecológico de tendência temporal, com dados do Sistema de Informações sobre Mortalidade (SIM) e do Instituto Brasileiro de Geografia e Estatística (IBGE). Utilizaram-se regressões de Poisson. Resultados: as taxas anuais médias (TAM) de mortalidade por acidente de trabalho mantiveram-se relativamente estáveis no período (variação anual de até 5%), mas alguns grupos e regiões apresentaram tendência de aumento. Mulheres acima de 60 anos da região Centro-Oeste (TAM: 1,21-IC95%: 1,03-1,42) e os trabalhadores pardos de todas as regiões (TAM: 1,03 IC95%: 1,02-1,04) apresentaram aumento significativo na mortalidade. Em 2015, a mortalidade por AT na região Nordeste foi 88% maior entre os pardos (2,45/100 mil) do que entre os brancos (1,30/100 mil), e no Brasil, a mortalidade de trabalhadores com menos de oito anos de estudo foi 15 vezes superior à daqueles com 12 anos de estudo ou mais (4,74/100 mil vs. 0,31/100 mil). Conclusões: embora estável, a taxa de mortalidade por AT no Brasil é elevada, se comparada à dos países de alta renda. Alguns grupos populacionais (homens, pretos, pardos, índios, pessoas com baixa escolaridade) e regiões do país (Norte, Nordeste e Centro-Oeste) apresentam taxas ainda mais elevadas.

Abstract Objective: to analyze the temporal trend of mortality due to occupational accidents (OA) in Brazil from 2006 to 2015 and investigate inequalities related to gender, race/skin color, age group, education level, and macro-regions. Methods: ecological time series study conducted with data from the Mortality Information System (SIM) and the Brazilian Institute of Geography and Statistics (IBGE). Data were analyzed by Poisson regressions. Result: the average annual rate (AAR) for deaths due to OA remained relatively stable over the analyzed period (annual variation of up to 5%), but some groups and regions showed an upward trend. Mortality was significantly higher among women over 60 years old from the Midwest region (AAR: 1.21-95%CI: 1.03-1.42) and brown-skinned people from all regions (AAR: 1.03-95%CI: 1.02-1.04). In 2015, mortality from OA in the Northeast region was 88% higher among brown-skinned people (2.45/100,000) than among white people (1.30/100,000). In Brazil, mortality was 15 times higher among individuals with less than eight school years when compared to those with 12 school years or more (4.74/100,000 vs. 0.31/100,000). Conclusions: although stable, the mortality rate due to OA in Brazil is elevated when compared to high-income countries. These rates are even higher among some population groups (men, Blacks, brown-skinned, indigenous, and lower-educated people) and in certain regions of the country (North, Northeast, and Midwest).

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BACKGROUND: Work-related disorders have considerable impact on the health of workers at a high cost for national budgets. Yet these conditions are globally underreported, less than 8% in Brazil. Shortcomings in health policies and records hinder attempts at establishing the health profile of civil servants in Brazil, who represent 8% of the local workforce. OBJECTIVE: To establish the profile of federal civil servants with work-related disorders and relate it to diagnoses recorded in Civil Servant Work Accident Reports (CS/WAR) issued at a federal public university in southern Brazil. METHODS: We analyzed 166 CS/WAR; 79.52% corresponded to women, average age 46.46 (SD=10.06), ≥21 years in the job (34.9%), workers at the university hospital (64.46%) and medium- or technical level health care workers (45.78%). Mean duration of sick leave spells was 11.89 (SD=21.33) days. About 41.57% of CS/WAR did not provide an ICD-10 code; 82.5% of the rest corresponded to work accidents, mainly lower extremity injury (31.5%) and 17.50% to occupational diseases, most commonly low back injury and infectious diseases (17.7% each). CONCLUSION: The results reinforce the need to improve the record system in public service facilities to enable strategies targeting the main health problems exhibited by this population of workers.

INTRODUÇÃO: O regime estatutário, que representa 8% da força de trabalho do Brasil, enfrenta problemas quanto à implementação de políticas e registros de saúde, impactando no conhecimento do perfil de saúde dos servidores estatutários. OBJETIVOS: Identificar o perfil do servidor público federal acometido por agravos ocupacionais e relacioná-lo com o diagnóstico registrado na Comunicação de Acidente de Trabalho do Servidor Público (CAT/SP) de uma universidade federal do sul do Brasil. MÉTODO: Estudo transversal, retrospectivo, realizado com dados secundários. Amostra censitária com a totalidade de CAT/SP emitida pela universidade. Para análise estatística, foi utilizado o programa Statistical Package for the Social Sciences (SPSS) versão 22. Fez-se apenas análise bivariada por teste χ2 ou por análise de variância (ANOVA), com nível de significância de 95%. RESULTADOS: Foram analisadas 166 CAT/SP, 79,52% corresponderam a mulheres, com idade média de 46,46 (desvio padrão - DP=10,06) anos, 21 anos ou mais de atuação no cargo (34,9%), lotadas no hospital universitário (64,46%) e média de tempo de afastamento do trabalho de 11,89 (DP=21,33) dias. Do total, 41,57% das CAT não apresentaram qualquer registro de enfermidades, codificadas ou não pela Classificação Estatística Internacional de Doenças e Problemas Relacionados com a Saúde (CID-10). Das CAT/SP com essa informação, 82,5% apresentaram CID-10 compatível com acidente de trabalho, sendo a ocorrência mais comum o trauma de membros inferiores (31,5%). As demais 17,5% CAT/SP foram compatíveis com doença ocupacional, sendo as ocorrências mais comuns lesão de coluna lombar, doença infecciosa e outros, com prevalência de 17,7% cada uma. CONCLUSÃO: Ratifica-se a importância de qualificar o sistema de registros de CAT/SP na administração pública, possibilitando a proposição de estratégias direcionadas e focadas nos principais agravos à saúde dessa população.

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Introdução: O regime estatutário, que representa 8% da força de trabalho do Brasil, enfrenta problemas quanto à implementação de políticas e registros de saúde, impactando no conhecimento do perfil de saúde dos servidores estatutários. Objetivos: Identificar o perfil do servidor público federal acometido por agravos ocupacionais e relacioná-lo com o diagnóstico registrado na Comunicação de Acidente de Trabalho do Servidor Público (CAT/SP) de uma universidade federal do sul do Brasil. Método: Estudo transversal, retrospectivo, realizado com dados secundários. Amostra censitária com a totalidade de CAT/SP emitida pela universidade. Para análise estatística, foi utilizado o programa Statistical Package for the Social Sciences (SPSS) versão 22. Fez-se apenas análise bivariada por teste χ2 ou por análise de variância (ANOVA), com nível de significância de 95%. Resultados: Foram analisadas 166 CAT/SP, 79,52% corresponderam a mulheres, com idade média de 46,46 (desvio padrão ­ DP=10,06) anos, 21 anos ou mais de atuação no cargo (34,9%), lotadas no hospital universitário (64,46%) e média de tempo de afastamento do trabalho de 11,89 (DP=21,33) dias. Do total, 41,57% das CAT não apresentaram qualquer registro de enfermidades, codificadas ou não pela Classificação Estatística Internacional de Doenças e Problemas Relacionados com a Saúde (CID-10). Das CAT/SP com essa informação, 82,5% apresentaram CID-10 compatível com acidente de trabalho, sendo a ocorrência mais comum o trauma de membros inferiores (31,5%). As demais 17,5% CAT/SP foram compatíveis com doença ocupacional, sendo as ocorrências mais comuns lesão de coluna lombar, doença infecciosa e outros, com prevalência de 17,7% cada uma. Conclusão: Ratifica-se a importância de qualificar o sistema de registros de CAT/SP na administração pública, possibilitando a proposição de estratégias direcionadas e focadas nos principais agravos à saúde dessa população

Background: Work-related disorders have considerable impact on the health of workers at a high cost for national budgets. Yet these conditions are globally underreported, less than 8% in Brazil. Shortcomings in health policies and records hinder attempts at establishing the health profile of civil servants in Brazil, who represent 8% of the local workforce. Objective: To establish the profile of federal civil servants with work-related disorders and relate it to diagnoses recorded in Civil Servant Work Accident Reports (CS/WAR) issued at a federal public university in southern Brazil. Methods: We analyzed 166 CS/WAR; 79.52% corresponded to women, average age 46.46 (SD=10.06), ≥21 years in the job (34.9%), workers at the university hospital (64.46%) and medium- or technical level health care workers (45.78%). Mean duration of sick leave spells was 11.89 (SD=21.33) days. About 41.57% of CS/ WAR did not provide an ICD-10 code; 82.5% of the rest corresponded to work accidents, mainly lower extremity injury (31.5%) and 17.50% to occupational diseases, most commonly low back injury and infectious diseases (17.7% each). Conclusion: The results reinforce the need to improve the record system in public service facilities to enable strategies targeting the main health problems exhibited by this population of workers.

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Resumo Fizemos estudo transversal para iniciar coorte em dois Hospitais Universitários de dois países - Brasil e Colômbia - para avaliar a prevalência de acidentes com material biológico (AT-MB), o nível de adesão às Precauções Padrão (PP) e o conhecimento sobre patógenos transmissíveis pelo sangue e fatores associados entre trabalhadores e estudantes da saúde, no marco da implementação da norma NR-32. Criamos escalas para estimar conhecimento e adesão baseadas em 12 e 11 perguntas respectivamente. Utilizamos Regressão de Poisson-Tweedie para avaliar a associação do conhecimento e da adesão às PP com sofrer AT-MB. Avaliamos 965 indivíduos (348 estudantes e 617 profissionais). O conhecimento teve média de 10,98 com mediana de 11 (10, 12) e α-Cr de 0,625. A média de adesão foi de 30,74 com mediana de 31 (28, 34) e α-Cr de 0,745, associando-se a País, grupo (estudantes) e percepção de risco. Entre os fatores associadas ao relato de AT-MB encontraram-se o conhecimento, a adesão às PP, País de origem e ter tomado o esquema completo de vacinação contra Hepatites B. Concluímos que o nível de conhecimento e adesão foram adequados, ainda melhores entre os participantes do Brasil e associaram-se ao relato AT-MB.

Abstract This was a cross-sectional study to start a cohort in two University Hospitals of two countries - Brazil and Colombia - for assessing the prevalence of needlestick and sharps injuries (NSI), the level of compliance with standard precautions (SPs), and knowledge on blood borne pathogens and associated factors among health students and professionals, within the framework of the implementation of the NR-32 standard. We created compliance scales based on 12 and 10 questions, for assessing knowledge. We used the Multinomial Poisson-Tweedie Regression to evaluate the relationship between knowledge and compliance with SPs within NSI. We evaluated 965 individuals (348 students and 614 professionals). The mean score points for level of knowledge was 10.98, with a median of 11 (10; 12) and α-Cr of 0,625. Compliance with SP had a mean of 30.74 and median of 31 (28; 34), with a α-Cr coefficient of 0.745, associated with country, group (student) and risk perception. Among the factors associated with the report of NSI, we singled out knowledge and compliance, country of origin, and full vaccination scheme against the Hepatitis B virus. We concluded that the level of knowledge and compliance were adequate among participants, but better among Brazilian participants, and it was associated with NSI reporting.

Resumen Hicimos estudio transversal como punto de partida de estudio de cohorte en dos Hospitales Universitarios en dos países - Brasil y Colombia - para evaluar la prevalencia de accidentes con material biológico (AT-MB), el nivel de adhesión a las Precauciones Estándares (PUs) y el conocimiento sobre patógenos transmisibles y factores asociados entre trabajadores y estudiantes de la Salud en el marco de la implementación de la norma NR-32. Creamos escalas para evaluar el conocimiento y la adhesión con base en 12 e 11 preguntas respectivamente. Utilizamos Regresión de Poisson-Tweedie para evaluar asociación entre el conocimiento y la adhesión a las PUs con sufrir AT-MB. Evaluamos 965 individuos (348 estudiantes e 617 profesionales). El puntaje medio de conocimiento fue 10,98 con mediana de 11 (10, 12) y α-Cr de 0,625. La media de adhesión fue de 30,74 con mediana de 31 (28, 34) e α-Cr de 0,745, asociándose a país, grupo (estudiantes) e percepción de riesgo. Entre los factores asociados al relato de AT-MB encontramos conocimiento, adhesión a las PUs, país de origen y tener el esquema completo de vacunación contra Virus da Hepatitis B. Concluimos que el nivel de conocimiento y adhesión fueron adecuados, aunque mejores entre los participantes del Brasil y se asociaron a los AT-MB.

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Focaliza-se neste artigo os processos de terceirização e flexibilização das relações trabalhistas, cujas práticas encontram se atreladas ao fenômeno da precarização do trabalho, incidindo de modo perverso sobre os sujeitos, promovendo seu adoecimento e gerando impactos de diversas ordens sobre eles. Como cenário concreto para promover esta reflexão, apresenta-se um caso real, relativo à contaminação de trabalhadores brasileiros por carbonato de níquel, uma substância de elevada toxidade, bem como os desdobramentos desse acidente para os sujeitos envolvidos.

This article discusses the outsourcing processes and flexibility of labor relations, whose practices are linked to the precariousness phenomenon, analyzing how these processes act in a perverse way on the workers, promoting their illness and generating impacts of various orders on them. As a concrete scenario to promote this reflection, the text presents a real case concerning the contamination of Brazilian workers by nickel carbonate, a substance of high toxicity, and the consequences of this accident on the men involved.

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RESUMEN Una de las vías de transmisión del virus del VIH es la sanguínea a través de accidentes cortopunzantes, los trabajadores sanitarios que están expuestos a lesiones por pinchazos con agujas que contienen sangre infectada con el VIH, tienen un riesgo de 0.23 % de ser infectados. El objetivo de este estudio es caracterizar los accidentes de riesgo biológico y el uso de profilaxis post exposición ocupacional en los trabajadores sanitarios que consultaron en el Programa Nacional de Lucha contra el SIDA desde enero a diciembre del año 2013. Material y Método: Diseño observacional, descriptivo, de corte transverso. Fueron incluidos 66 fichas para este estudio. Las variables analizadas fueron: edad, sexo, procedencia, ocupación o puesto de trabajo, hora del accidente, exposición ocupacional, trabajador sanitario, paciente fuente, tipo de accidente laboral o clasificación del accidente según el riesgo, tipo de exposición, indicación de profilaxis post exposición, efectos colaterales de los medicamentos antiretrovirales. Resultados: 85% fueron mujeres y 15% fueron hombres. La edad media fue de 33,1 ± 8,9 (20 a 62) años. En cuanto a la profesión a los trabajadores sanitario los expuestos ocupacionalmente fueron el personal de enfermería en 36,6%; seguido de Personal de limpieza en 24,24%, y personal médicos en 18,8%. El accidente fue clasificado como leve en un 62,1 % y como grave en un 37,8%. El tipo de exposición, en un 65,1% fue de tipo 1 (pinchazos, corte con agujas acanalada o hueca, bisturí), La paciente fuente era conocido en un 54,5% de los casos. De entre los pacientes fuente conocidos, el 62% con serología positiva para el VIH, 77% inició Profilaxis Post Exposición. Solo 6% completó el esquema de tratamiento. De entre los que completaron PPE, uno de ellos presentó efectos colaterales (mareos, náuseas y eritema facial). Conclusión: La precaución universal es la primera línea de defensa para prevenir la exposición ocupacional. El asumir que todos los pacientes están potencialmente infectados constituye la única manera de optimizar las medidas para prevenir la trasmisión de esta patología, con aseguramiento de controles y medidas para completar la profilaxis si fuera necesario

ABSTRACT One of the routes of transmission of the HIV virus is blood through sharps accidents; health workers who are exposed to needle stick injuries that contain HIV-infected blood have a 0.23% risk of being infected. The objective of this study is to characterize the biological hazard accidents and the use of occupational post-exposure prophylaxis in health workers, who consulted in the National Program to Fight AIDS from January to December 2013. Material and Method: Observational, descriptive, cross-sectional design. 66 tokens were included for this study. The variables analyzed were: age, sex, origin, occupation or workplace, time of accident, occupational exposure, health worker, source patient, type of work accident or accident classification according to risk, type of exposure, indication of postprophylaxis exposure, side effects of antiretroviral drugs. Results: 85% were women and 15% were men. The mean age was 33.1 ± 8.9 (20-62) years. Health Workers more exposed were the nursing staff in 36.6%; followed by cleaners 24.24%, and medical personnel 18.8%. The accident was classified as mild in 62.1% and as severe in 37.8%. The type of exposure, in 65.1% was type 1 (punctures, cut with needles grooved or hollow, scalpel), the patient source was known in 54.5% of cases. Among the known source patients, 62% with serology positive for HIV, 77% started Prophylaxis Post Exposure. Only 6% completed the treatment schedule. Among those who completed PPE, one of them presented side effects (dizziness, nausea and facial erythema). Conclusion: Universal precaution is the first line of defense to prevent occupational exposure. Assuming that all patients are potentially infected is the only way to optimize measures to prevent the transmission of this pathology, with assurance of controls and measures to complete prophylaxis if necessary.

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This study analyzes the relationship between having experienced a work accident and developing depressive symptoms six months later, considering the subjective severity of accidents, the use of both positive and negative religious coping strategies, and brooding as predictors variables. Fifty seven women and 187 men were evaluated during the month following their accident (T1) and six months later (T2). The results show that after controlling for initial depressive symptoms, all predictors showed a statistically significant relationship with depression at six months, including the interaction between brooding and subjective severity of accident. Forty nine percent of resilient participants exhibited low symptoms at T1 and T2, 22% of recovered individuals showed high symptoms at T1 and low symptoms afterwards, 20% of depressive individuals had high symptoms at T1 and T2, and 8% exhibited high symptoms only at T2. High severity, brooding and religious coping at T1 differentiated those who exhibited stable symptoms from those who were resilient. Resilience was specifically predicted with a negative coefficient by the interaction of brooding with subjective severity of accident. We conclude that brooding is a variable that moderates the relationship between subjective severity of accident and the development and maintenance of depressive symptoms. Subjective severity of accident, brooding and negative religious coping are risk factors, while positive religious coping is not a sufficient protection factor.

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Contexto: A Norma Regulamentadora 35 (NR-35) define trabalho em altura como "qualquer atividade executada acima de dois metros do nível inferior, onde haja risco de queda", e propõe que sejam realizados exames médicos voltados "a patologias que poderão originar mal súbito e queda de altura". Muitos médicos do trabalho passaram a solicitar o eletroencefalograma (EEG) de rotina para trabalhadores que exercem trabalho em altura. No entanto, a validade desse exame para trabalhadores assintomáticos é discutível. Objetivo: Analisar os acidentes de trabalho relacionados a trabalho em altura ocorridos entre 1º de janeiro de 2000 e 31 de dezembro de 2014 em um hospital universitário, correlacionando-os ao resultado dos EEGs realizados no mesmo período. Métodos: Trata-se de estudo transversal com revisão de EEGs, prontuários clínico-ocupacionais e Comunicações de Acidente do Trabalho (CATs) de todos os trabalhadores que exerceram trabalho em altura entre 1º de janeiro de 2000 e 31 de dezembro de 2014. Foram definidos termos na descrição da CAT para avaliar a relação do acidente com "mal súbito ou queda em altura", como "queda", "perda da consciência", "mal súbito", "vertigem", "tontura" e "síncope". Os EEGs foram classificados em três categorias, de acordo com os resultados: normais, com alterações inespecíficas ou com alterações epileptogênicas. Foram correlacionadas as CATs com os resultados dos respectivos EEGs. Resultados: De 2.464 CATs emitidas no período, 2.228 foram excluídas por não serem de trabalhadores em altura. Das 236 CATs restantes, 61 foram excluídas por não haver pelo menos 1 EEG realizado nos respectivos trabalhadores. Entre os 175 acidentes restantes, observou-se 171 EEGs normais e 4 com alterações inespecíficas; nenhum dos exames apresentou alterações epileptogênicas. Entre esses 175 acidentes, 13 traziam em sua descrição termos como "mal súbito ou queda em altura", como "queda", "perda da consciência", "mal súbito", "vertigem", "tontura" e "síncope". Entre os 13 acidentes, nenhum EEG apresentou alterações. Conclusão: O EEG não foi um exame preditor de risco de acidente envolvendo trabalho em altura entre os trabalhadores avaliados no período. O EEG não deve ser utilizado para trabalhadores assintomáticos, e só deve ser realizado quando houver indicação clínica.

Background: Regulating standard 35 (NR-35) defines work at height as "any activity performed two meters above from ground level and involving risk of falls" and recommends the performance of medical examination to detect "conditions that might cause sudden loss of consciousness and falls from heights". As a result many occupational physicians began to recommend routine electroencephalogram (EEG) to assess employees working at height. However, the validity of EEG for asymptomatic workers is uncertain. Objective: To analyze occupational accidents related to work at height occurring from January 1, 2000 to December 31, 2014, at a university hospital, and to correlate them with the results of EEGs performed along that period. Methods: Cross-sectional study involving review of EEG test,s clinical-occupational records and Work Accident Reports (WAR) of all employees working at height from January 1, 2000 to December 31, 2014. Terms in the WAR descriptions were established to investigate the relationship of accidents with "sudden loss of consciousness and falls from heights", such as "fall from a height", "sudden ill feeling", "loss of consciousness", "vertigo", "dizziness" and "syncope". EEG results were classified in three categories: normal, non-epileptic abnormalities and epileptic patterns. WAR descriptions were correlated with EEG results. Results: From 2,464 WARs issued along the investigated period, 2,228 were excluded because they did not correspond to work at height. From the remaining 236 WARs, 61 were excluded because EEG was not performed, therefore, 175 cases were included for analysis. Among the EEG tests assessed, 171 were normal, 4 exhibited non-epileptic abnormalities and none an epileptic pattern. Among all the analyzed cases, 13 descriptions included terms such as "fall from height", "loss of consciousness", "sudden ill feeling", "vertigo", "dizziness" and "syncope"; all the corresponding cases had normal EEG. Conclusions: EEG was not a good predictor of risk for accidents related with work at height in the analyzed sample. EEG should not be performed for assessment of asymptomatic workers, but only in cases with clinical suspicion of neurological abnormalities.

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Introduction: Statistical study about the health care provided to seafarers on board their ships by the Spanish Radio Medical Center of the Marine Social Institute (Ministry of Employment and Social Security). Material and results: In 2015, 1658 calls were received requesting medical assistance and 1014 patients were attended (average: 1.64 calls / case). The use of satellite communication was the most common means of communication used (92.2%). The mean age of the patients was 44.51 (standard deviation = 9.892). The average age of Spanish and European Union crew members is higher than those of other origin (p < 0.01). Trawlers account for the 76.4% of the calls asking for medical assistance, merchant ships the 13.2%, travelling ships 1%, yachts 0.5% and others 8.8%. No significant differences were found between the pathology seen and the type of vessel (p> 0.1). 25% of medical consultations were due to trauma conditions and 75% to other diseases. In trauma patients, the affected body regions were: the upper limbs (40.2%), the head (10.8%), the lower limbs (16.7%) and the trunk (12.7%). Isolated eye traumas represented the 11.2% of cases. 81.6% of all the cases were treated on board until port destination. In the 18.4% of the cases, rescue was required (3.2% per helicopter). In the trauma cases, only 61.26% were able to remain on board. Rescue was more frequent in the event of trauma (p < 0.01). Conclusions: Assistances due to diseases are more frequent than those due to trauma. Most patients could be assisted on board. It was observed that seafarer population is becoming older.

Introducción: Estudio estadístico de la atención sanitaria prestada por el Centro Radio Médico Español del Instituto Social de la Marina a los marinos a bordo de sus buques. Material y resultados: Durante un año, se asistieron 1014 pacientes y se recibieron 1658 llamadas demandando consulta médica (media: 1.64 llamadas/caso). El satélite es el medio de comunicación más empleado para la consulta (92.2%). La media de edad de los pacientes fue de 44.51 (desviación estándar = 9.892). La media de edad de los tripulantes españoles y de la Unión Europea es mayor que el resto (p = 0,00). Los pesqueros representan un 76.4% de las asistencias; los mercantes, 13.2%; pasaje, 1%; buques de recreo, 0.5%, y otros, 8.8%. No se han encontrado diferencias significativas entre la afección consultada y el tipo de buque (p > 0.1). El 25% de las atenciones se debieron a accidentes y el 75% a enfermedades. En los accidentes, las regiones corporales afectadas fuern: miembros superiores (10%), cabeza (5.5%), miembros inferiores (4.1%) y tronco (3.2%). Los ojos representan el 2.8% de los casos. El 81.6% de todos los casos fue atendido a bordo hasta la siguiente llegada a puerto. En el 18.4% fue necesaria la evacuación (3.2% por helicóptero). En el caso de los accidentados, sólo el 6.26% pudo permanecer a bordo. La evacuación es más frecuente en caso de accidente (p = 0.00). Conclusiones: Son más frecuentes las asistencias por enfermedad que por accidente. La mayoría de los pacientes pueden permanecer a bordo. Se observa un envejecimiento de la población embarcada.

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