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Silicosis is an occupational lung disease caused by the inhalation of silica dust. The clinical presentation can be acute, with up to 5 years of exposure; accelerated, with less than 10 years; and chronic, with more than 10 years of exposure. The World Health Organization and the International Labor Organization include among their actions the identification of workers at risk. This study presents a case of pneumoconiosis in a worker in charge of the production of sand and clay as raw materials for other industries and who was exposed to the silicate, which has a lower concentration of silica in its composition, with an exposure time of 5 years and 11 months. The interest of this study lies in the identification of new sources of risk, since this sector very rarely reported at the national level and the need for adequate preventive measures, such as monitoring of particulate matter, engineering controls, administrative controls, and use of respiratory protection. These aspects, together with workers' education and information, are main components in the prevention of this disease.

La silicosis es una enfermedad pulmonar profesional ocasionada por la inhalación de polvo de sílice. La presentación clínica puede ser aguda, con 5 años de exposición; acelerada, con menos de 10 años; y crónica, con más de 10 años de exposición. La Organización Mundial de la Salud y la Organización Internacional del Trabajo incluyen entre sus acciones la identificación de trabajadores en riesgo. Se presenta el caso de una neumoconiosis de un trabajador encargado de la producción de arena y arcilla como materias prima para otras industrias que se encontraba expuesto al silicato, que tiene menor concentración de sílice en su composición, y con tiempo de exposición de 5 años y 11 meses. El interés de este estudio radica en la identificación de nuevas fuentes de riesgo, como este sector muy raramente reportado a nivel nacional y la necesidad del uso de medidas preventivas adecuadas, como el monitoreo de material particulado, controles de ingeniería, controles administrativos y uso de protección respiratoria. Estos aspectos, a los que se suman la educación e información al trabajador, son componentes principales en la prevención de esta enfermedad.

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Introduction: The National Health and Nutrition Assessment Survey (NHANES) is being adopted for interpreting spirometry in occupational examinations. Rubber workers have an elevated risk of respiratory health issues due to industrial exposure, and changes in the equations would affect spirometry monitoring programs. Objective: To determine the differences in the use of the Knudson and NHANES III equations in nonsmoking workers in the rubber industry. Method: A cross-sectional study was conducted with 75 nonsmoking workers with occupational exposure to rubber for at least two years. The factory had engineered protection controls and provided respiratory protection to the workers. Spirometry was conducted according to Spirometry Testing in Occupational Health Programs and Standardization of Spirometry: American Thoracic Society/European Respiratory Society. Result: Spirometric prediction differences were present in the restrictive pattern assessment based on forced vital capacity (FVC), in which three individuals (4%) classified as normal according to Knudson presented restrictive disease according to NHANES III; only in the record of one participant was there restrictive disease using both equations. There was an 8% discrepancy for small airway obstruction in which six workers classified as normal using NHANES III were classified as diseased (FEF 25-75 <50%) using the Knudson equation. Conclusion: In the respiratory examination of workers exposed to rubber, the NHANES III equation is better able to detect restrictive diseases than is the Knudson equation; however, the Knudson equation is more sensitive to obstructive patterns.

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Resumo Este ensaio destaca o perfil do trabalhador de área rural, portador da Esquistossomose mansônica, doença endêmica adquirida durante suas atividades laborais em áreas alagadas da baixada maranhense. Faz-se uma análise da legislação previdenciária e trabalhista utilizada para fins de concessão de benefícios e do nexo causal que estabelece a relação entre a situação de trabalho e o surgimento da doença. Para tal, utilizamos pesquisa bibliográfica sobre a temática e pesquisa documental do plano jurídico formal da previdência. O estudo aponta para a necessidade de reconhecer esta relação nas regiões endêmicas, no sentido de aprimorar o proposto na "Lista de Doenças Relacionadas ao Trabalho".

Abstract This study highlights the profile of rural workers with schistosomiasis mansoni, an endemic disease acquired during their work activities in flooded areas in the Baixada Maranhense. In order to analyze the social security and labor legislation used to grant benefits and the causal link that establishes the relationship between the work situation and the onset of the disease, we performed a bibliographical research on the topic and a documentary research on the formal legal plan of social security. This study addresses the need to recognize this relationship in endemic regions in order to improve what is proposed by the List of Work-Related Diseases.

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ABSTRACT Brucellosis is one of the most important and widespread bacterial zoonotic diseases worldwide, and it is transmitted to humans from various sources, including direct contact with infected animals and the ingestion of contaminated products, including unpasteurized milk. There are only a few epidemiological studies on said disease in humans in Western Santa Catarina, a region instantiated by agriculture. Thus, the objective of this study was to characterize the epidemiological aspects of human brucellosis reported in Western Santa Catarina from 2013 to 2018. The data were provided by the Epidemiological Surveillance Board (Diretoria de Vigilancia Epidemiologica). The frequency of the disease in humans and the epidemiological profile of confirmed human cases were evaluated. Cases that were screened positive and those that were confirmed and submitted to the therapeutic protocol were analyzed. During the study period, 3,671 people were tested, of which 12.34% were screened positive (453/ 3,671) and 3.40% were confirmed (125/3,671). The year with the highest number of people testing positive was 2015 (123 cases), and 2018 was the year with the highest number of confirmed cases (39 cases). Confirmed cases predominated in males (48.8%), self-declared white (22.4%), aged 20-59 years old (60%), with incomplete primary education (22.4%), of rural origin (59.2%), with occupational contact with cattle (64.8%), engaged in professions directly linked to agricultural and livestock activities (55.5%), and who reported consumption of unpasteurized dairy products (59.2%). No seasonal variation was observed in case numbers. The results demonstrated that brucellosis is an endemic disease in Western Santa Catarina.

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El presente trabajo se realizó en el marco de las actividades de investigación y extensión del Departamento de Salud Ocupacional de la Facultad de Medicina Universidad de la República, por iniciativa de los trabajadores del sindicato único de la construcción y afines. El objetivo fue conocer el perfil de salud y enfermedad de los trabajadores del sector con el propósito de generar acciones que promuevan la salud laboral del colectivo involucrado. La investigación realizada es de carácter descriptivo a partir de fuentes secundarias. De los resultados se destacaron las enfermedades del aparato osteomioarticular, lesiones por traumatismos o envenenamiento y patologías del aparato respiratorio como principales causas de ausentismo de origen médico. La patología osteomioarticular fue la primera causa de incapacidad total y también es la primera causa de incapacidad para la tarea en el periodo estudiado. La tasa de incidencia acumulada de los accidentes en el año 2014 fue de 81,8 por 1.000 trabajadores cotizantes de la construcción, presentando una caída sostenida hasta el 2018 que alcanzó el valor de 60,2 por 1.000 trabajadores cotizantes. El tipo de accidente más frecuente observado en el periodo fueron las lesiones a esfuerzo excesivo. Con respecto a los accidentes mortales existe una caída marcada entre los años 2014 al 2016 con un ascenso progresivo en 2018. De la investigación surge como necesidad mejorar el reconocimiento de la patología profesional en el sector, profundizar las acciones en seguridad y salud con énfasis en aspectos ergonómicos de la carga física(AU)

This study was carried out under the framework of the research and outreach activities of the Department of Occupational Health of the School of Medicine of the University of the Republic, as an initiative of the workers of its single union of construction and related industries. The objective was to describe the health and disease profile of workers in the sector in order to generate actions to promote their occupational health. The study was descriptive and consisted of a secondary analysis of existing data. Musculoskeletal disorders, traumatic injuries, poisonings and respiratory illnesses were the main cause of sickness absence. Musculoskeletal disorders were the main cause of both work-related and total disability. The cumulative incidence rate of injuries in 2014 was 81.8 per 1000 dues-paying construction workers, and subsequently declined until 2018, to an incidence of 62.2 per 1000 dues-paying workers. Overexertion was the most common mechanism of injury. With respect to fatal accidents, there was a arked decline between 2014 and 2016, followed by a progressive increasein 2018. This study underscores the need to improve the recognition of occupational illness and injury in the construction and related industries sector, and to add depth to safety and health interventions, with an emphasis on ergonomic aspects of physical loads(AU)

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Degenerative spinal disease is the leading cause of low back pain and sciatica in the general population. It is an important cause of absenteeism and increased expenses. Its incidence increases in people subjected to tasks that overload the spine, such as construction workers. Instrumented arthrodesis is a frequent practice with satisfactory results for its resolution. To date, in our country, we haven't found statistical data on this group of work-related patients. Our objective was to evaluate laboral impact generated by instrumented lumbosacral arthrodesis in construction workers. We did a retrospective, descriptive, comparative and monocentric study. Construction workers' patients with degenerative low back pain and instrumented lumbar or lumbosacral arthrodesis who were operated between January 2005 to August 2018 were included. Clinical and imaging evaluation and follow-up for a period of 18 to 24 months. Assessed with the Oswestry Disability Index (IDO) and the Visual Analog Pain Scale (VAS). The sample was analyzed in groups according to the functions at the time of returning to work, retirement or dismissal. We evaluated 139 patients. Mean age 42 years, degenerative spinal disease of the lumbosacral segment, 66.9% of the sample without postoperative complications resumed the same pre-surgical activity. Post-surgical IDO and VAS scores were worse in patients discharged, retired, and/or requalified. Patients under 42 years of age, without postoperative complications who improved more than 1 Oswestry category, returned to their usual tasks with satisfactory results in the medium and long term.

La enfermedad degenerativa del raquis es la causa más frecuente de lumbalgia y ciática en la población general provocando ausentismo, lo que incrementa el gasto en salud de los distintos subsistemas, así como el gasto del empleador quien deberá suplantar al trabajador. Su incidencia aumenta en personas sometidas a tareas de sobrecarga del raquis, como el caso de obreros de la construcción. La artrodesis instrumentada es una práctica frecuente y con resultados satisfactorios para su resolución. No hemos encontrado publicaciones con datos estadísticos locales sobre este tema. El objetivo fue evaluar el impacto laboral que genera la artrodesis lumbosacra instrumentada en trabajadores de la construcción. Realizamos un estudio retrospectivo, descriptivo, comparativo y monocéntrico, entre enero de 2005 y agosto de 2018, de trabajadores de la construcción con artrodesis del segmento lumbosacro por lumbalgia de origen degenerativo con evaluación y seguimiento clínico e imagenológico por un periodo de 18 a 24 meses, utilizando el Índice de Discapacidad de Oswestry (IDO) y la Escala Visual Analógica del Dolor (EVA). Se analizó la muestra en grupos según las funciones al momento del retorno laboral, jubilación o despido. Se evaluaron 139 pacientes (mediana 42 años). El 66.9% de la muestra no tuvo complicaciones postoperatorias y retomó la misma actividad prequirúrgica. Los puntajes de IDO y EVA postquirúrgicos fueron peores en los pacientes despedidos, jubilados y/o recalificados. Los menores de 42 años, sin complicaciones postoperatorias que mejoran más de 1 categoría del Oswestry retomaron sus tareas habituales con resultados satisfactorios a mediano y largo plazo.

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Resumen La enfermedad degenerativa del raquis es la causa más frecuente de lumbalgia y ciática en la población general provocando ausentismo, lo que incrementa el gasto en salud de los distintos subsistemas, así como el gasto del empleador quien deberá suplantar al trabajador. Su incidencia aumenta en personas sometidas a tareas de sobrecarga del raquis, como el caso de obreros de la construcción. La artrodesis instrumentada es una práctica frecuente y con resultados satisfactorios para su resolución. No hemos encon trado publicaciones con datos estadísticos locales sobre este tema. El objetivo fue evaluar el impacto laboral que genera la artrodesis lumbosacra instrumentada en trabajadores de la construcción. Realizamos un estudio retrospectivo, descriptivo, comparativo y monocéntrico, entre enero de 2005 y agosto de 2018, de trabajadores de la construcción con artrodesis del segmento lumbosacro por lumbalgia de origen degenerativo con evaluación y seguimiento clínico e imagenológico por un periodo de 18 a 24 meses, utilizando el Índice de Discapacidad de Oswestry (IDO) y la Escala Visual Analógica del Dolor (EVA). Se analizó la muestra en grupos según las funciones al momento del retorno laboral, jubilación o despido. Se evaluaron 139 pacientes (mediana 42 años). El 66.9% de la muestra no tuvo complicaciones postoperatorias y retomó la misma actividad prequirúrgica. Los puntajes de IDO y EVA postquirúrgicos fueron peores en los pacientes despedidos, jubilados y/o recalificados. Los menores de 42 años, sin complicaciones postoperatorias que mejoran más de 1 categoría del Oswestry retomaron sus tareas habituales con resultados satisfactorios a mediano y largo plazo.

Abstract Degenerative spinal disease is the leading cause of low back pain and sciatica in the general population. It is an important cause of absenteeism and increased expenses. Its incidence increases in people subjected to tasks that overload the spine, such as construction workers. Instrumented arthrodesis is a frequent practice with satisfactory results for its resolution. To date, in our country, we haven´t found statistical data on this group of work-related patients. Our objective was to evaluate laboral impact generated by instrumented lumbosacral arthrodesis in construction workers. We did a retrospective, descriptive, comparative and monocentric study. Construction workers' patients with degenerative low back pain and instrumented lumbar or lumbosacral arthrodesis who were operated between January 2005 to August 2018 were included. Clinical and imaging evaluation and follow-up for a period of 18 to 24 months. Assessed with the Oswestry Disability Index (IDO) and the Visual Analog Pain Scale (VAS). The sample was analyzed in groups according to the functions at the time of returning to work, retirement or dismissal. We evaluated 139 patients. Mean age 42 years, degenerative spinal disease of the lumbosacral segment, 66.9% of the sample without postoperative complications resumed the same pre-surgical activity. Post-surgical IDO and VAS scores were worse in patients discharged, retired, and/or requalified. Patients under 42 years of age, without postoperative complications who improved more than 1 Oswestry category, returned to their usual tasks with satisfactory results in the medium and long term.

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Introdução: O espaço de operacionalização da profissão de motorista de ônibus é o trânsito, realidade dinâmica, sistemática, porém surpreendente, neste contexto o estresse é a sensação persistente no dia a dia de trabalho dos motoristas de ônibus. Objetivo: Descrever as percepções dos motoristas de ônibus quanto à vivência no trânsito e fatores estressantes no cotidiano da mobilidade urbana para os motoristas. Métodos: Estudo descritivo fenomenológico pautado no pensamento de Maurice Merleau-Ponty, realizado em uma garagem de ônibus, no período de julho a dezembro de 2017. Foram entrevistados vinte e quatro motoristas de ônibus, com mais de dois anos de profissão, e as perguntas abertas possibilitaram a livre expressão dos significados do trânsito para estes trabalhadores. Resultados: O cotidiano foi considerado estressante e responsável por alterações na saúde e no humor dos motoristas entrevistados. As duas categorias que emergiram foram: O trânsito é surpreendente e O equilíbrio emocional no trabalho é imprescindível. Conclusão: A saúde do motorista é a força motriz para o serviço do transporte e as limitações físicas não são diretamente ligadas à execução desta atividade laboral. É de suma importância lembrar que o sujeito rodoviário necessita das condições positivas para mover a cidade diariamente(AU)

Introducción: El espacio de operación de la profesión de conductor de autobús es el tráfico, la realidad dinámica, sistemática, pero sorprendente, en este contexto el estrés es la sensación persistente en el trabajo diario de los conductores de autobuses. Objetivo: Describir las percepciones de los conductores de autobuses con respecto a la experiencia en el tráfico y factores estresantes en la vida diaria de la movilidad urbana para los conductores. Métodos: Estudio fenomenológico descriptivo basado en el pensamiento de Maurice Merleau-Ponty, realizado en un garaje de autobuses, de julio a diciembre de 2017. Veinticuatro conductores de autobuses, con más de dos años de profesión, fueron entrevistados, y las preguntas abiertas permitieron la libre expresión de los significados del tráfico para estos trabajadores. Resultados: La vida diaria se consideró estresante y responsable de los cambios en la salud y el estado de ánimo de los conductores entrevistados. Las dos categorías que surgieron fueron: el tráfico es sorprendente y el equilibrio emocional en el trabajo es indispensable. Conclusiones: La salud del conductor es la fuerza motriz para el servicio de transporte y las limitaciones físicas no están directamente relacionadas con la ejecución de esta actividad de trabajo. Es de suma importancia recordar que el tema de la carretera necesita las condiciones positivas para mover la ciudad diariamente(AU)

Introduction: The working space of the bus driver profession is traffic, the dynamic, systematic, but surprising reality. In this setting, stress is the persistent feeling in the daily work of bus drivers. Objective: To describe the perceptions of bus drivers regarding their experience in traffic as well as stressors in the daily life of urban mobility for drivers. Methods: Descriptive phenomenological study based on Maurice Merleau-Ponty's thinking and carried out in a bus garage, from July to December 2017. Twenty-four bus drivers, with more than two years of experience in the job, were interviewed. Open questions allowed the free expression of the meanings of trafficking for these workers. Results: Daily life was considered stressful and responsible for changes in the health and mood of the drivers interviewed. The two categories that emerged were the facts that traffic is surprising and emotional balance at work is essential. Conclusions: The driver's health is the driving force for the transport service. Physical limitations are not directly related to the practice of this work activity. It is of utmost importance to remember that the matter of the road needs positive conditions to move the city on a daily basis(AU)

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Introducción: La hipoacusia es una enfermedad ocupacional frecuente y ocasiona deterioro en la calidad de vida de los trabajadores. Objetivo: Identificar la prevalencia y los factores asociados a hipoacusia inducida por ruido en trabajadores de una empresa metalmecánica. Material y Métodos: Estudio transversal analítico. Se utilizaron datos de historias clínicas ocupacionales para determinar la frecuencia de hipoacusia debido a ruido y sus potenciales factores asociados (edad, sexo, antecedentes personales). Se construyeron modelos de regresión simple y múltiple, estimando razones de prevalencia (RP) utilizando modelos lineales generalizados, familia Poisson y función de enlace log. Resultados: De 1543 trabajadores, la media de edad fue 36,7 años y la mayoría era hombre (93,6%). Solo el 8,2% reportó enfermedad y/o accidente laboral previo a la evaluación ocupacional. El 10,7% presentó hipoacusia debido al ruido. La frecuencia de presentar hipoacusia incrementaba 10% por cada año adicional de edad (RP=1,10, IC95%: 1,09-1,12, p<0,001) y tener el antecedente de enfermedad/accidente laboral incrementaba 75% la frecuencia de presentar hipoacusia (RP=1,75, IC95%: 1,28-2,40, p<0,001). Conclusión: La prevalencia de hipoacusia debido a ruido fue baja, La edad en años y el antecedente de enfermedad/accidente laboral se asociaron de forma positiva a presentar hipoacusia. Se sugiere realizar un seguimiento anual de audiometrías, con especial énfasis en los antecedentes ocupacionales asociados a hipoacusia debido al ruido.

Introduction: Hearing loss is a frequent occupational disease and causes deterioration in the quality of life of workers. The objective was to identify the prevalence and factors associated with noise-induced hearing loss in workers of a metalworking company. Material and Methods: Analytical cross-sectional study. Data from occupational medical records were used to determine the frequency of hearing loss due to noise and its potential associated factors (age, sex, personal history). Simple and multiple regression models were constructed, estimating prevalence ratios (RP) using generalized linear models, Poisson family and log link function. Results: Of 1543 workers, the average age was 36.7 years and the majority were male (93.6%). Only 8.2% reported illness and/or occupational accident prior to the occupational evaluation. 10.7% had hearing loss due to noise. The frequency of presenting hearing loss increased 10% foreach additional year of age (PR = 1.10, 95% CI: 1.09-1.12, p <0.001) and having a history of illness / work accident increased 75% the frequency of presenting hearing loss (RP= 1.75, 95% CI: 1.28-2.40, p <0.001). Conclusion: The prevalence of hearing loss due to noise was low. Age in years and the history of illness / accident were positively associated with hearing loss. It is suggested that annual audiometry follow-up be carried out, with special emphasis on the occupational history associated with hearing loss due to noise.

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Angioedema vibratório é uma forma rara de urticária induzida, que pode ser de caráter familiar ou adquirido. Este artigo descreve um caso clínico de uma mulher, com 33 anos de idade, fisioterapeuta, que iniciou sinais de edema e dor local após atividades de lazer ainda na adolescência e se intensificou posteriormente durante atividades profissionais. Aspectos fisiopatológicos foram discutidos, assim como avaliação laboratorial e testes de provocação. Objetivamos com este relato, ressaltar uma patologia incomum, mas que pode ter grande impacto na qualidade de vida do paciente, necessitando assim de um olhar minucioso do médico na prática clínica. Entendemos que neste caso o angioedema vibratório é efetivamente uma doença ocupacional. Constatamos que de modo geral para urticárias crônicas induzidas e no particular para angioedema vibratório, a história clínica minuciosa é a melhor forma de se obter o diagnóstico.

Vibratory angioedema is a rare form of induced urticaria, which can have a family or acquired etiology. This article describes a clinical case of a 33-year-old, female physiotherapist presenting with signs of edema and local pain after leisure activities that started in her adolescence and intensified during professional activities. Pathophysiological aspects were discussed, as well as laboratory evaluation and provocation tests. With this report, we aim to discuss an unusual disease that can have a major impact on patient's quality of life, thus requiring a detailed look at the physician's clinical practice. We understand that, in the reported case, vibratory angioedema is effectively an occupational disease. We found that in general for chronic induced urticaria and in particular for vibratory angioedema, a thorough clinical history is the best way to obtain the diagnosis.

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Introducción: la exposición a ruidos forma parte de nuestros hábitos cotidianos, culturales y de ocio. En el entorno de trabajo aparecen diferentes sonidos que puedenser perjudiciales para los oídos. El presente escrito trata de identificar la influencia que existe entre clase social e hipoacusia laboral en trabajadores de la ciudad de Cú-cuta, en edades comprendidas entre los 17 y los 70 años. Métodos: observacional, analítico y transversal; la población estudiada incluyó tra-bajadores del sector público y privado del municipio de Cúcuta, a quienes se les reali-zó un examen audiométrico ocupacional por parte del programa de Fonoaudiología. Resultados: se encontró que la mayoría de los trabajadores, un 54.05%, pertenece a una clase social baja; el 65% se expone a ruido en el trabajo, el 60% no utiliza ele-mentos de protección personal y el 30% presenta hipoacusia.Análisis y discusión: hay una asociación significativa entre la actividad laboral y la actividad extra laboral del grupo etario. Predomina el sexo masculino con una representación del 63%. Esto puede explicarse dado el contexto cultural en el que se realizó el estudio.Conclusiones: en Colombia, existe escasa información sobre la relación entre clase social e hipoacusia laboral. Se debe realizar un análisis de segregación socio-espacial tanto de los hogares como de la enfermedad, para así determinar qué enfermedades se asocian con la actividad laboral

Introduction: exposure to noise is part of our daily, cultural and leisure habits. In the work environment different sounds can be harmful to the ears. The present text tries to identify the influence that exists between social class and work-related hearing loss in the city of Cúcuta, aged between 17 and 70 years Methods: It is observational, analytical and cross-sectional. The studied population consisted of individuals working in the public and private sector of the municipality of Cúcuta. They underwent an occupational audiometric examination by the Speech-Audiology program.Results: It was determined that most of the workers, 54.05%, are members of a low social class; 65% of workers are exposed to noise at work, 60% of workers do not use personal protection elements and 30% of evaluated workers have hearing loss. Analysis and discussion: there is a significant association between work activity and non-work activity of the age group, predominant in males with a representation of 63%, this can be explained given the cultural context in which the study was conducted. Conclusions: in Colombia, there is little information on social class and work-related hearing loss. An analysis of socio-spatial segregation of both households and the disease must be carried out in order to determine which diseases are associated to work activity

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Objetivo: describir la problemática de hombres y mujeres trabajadores que al percibir vulnerado su derecho a la salud en el trabajo por sufrir presuntos o declarados ATEL, buscaron apoyo e interpusieron uno o más recursos constitucionales para lograr su restablecimiento efectivo. Materiales y métodos: estudio mixto. Se aplicó encuesta a 189 trabajadores que sufrieron un presunto o reconocido evento de ATEL y que buscaron apoyo en los servicios de extensión solidaria de la Universidad de Antioquia o en organizaciones de derechos humanos en Medellín. La encuesta captó datos sociodemográficos, de seguridad social, laborales, del SGSST, de los antecedentes, ocurrencia y consecuencias de los ATEL y los recursos interpuestos. Para el abordaje cualitativo se realizó: i) una entrevista en profundidad con un médico laboral y abogado independiente y ii) cuatro grupos focales con trabajadores que sufrieron ATEL, sindicalistas, abogados y médicos representantes de ARL, académicos. Resultados: los trabajadores más vulnerables fueron los más afectados en su derecho. Los agentes que integran el SGRL hacen un abordaje fragmentado de la salud y el trabajo que facilita la vulneración del derecho. Los trabajadores que sufren ATEL deben enfrentar barreras económicas, administrativas y de acceso a salud para restituir su derecho. Conclusiones: el trabajo decente y digno es un horizonte hacia el cual se deben apuntar los esfuerzos para que los trabajadores más vulnerados históricamente conquisten y sostengan una vida plena, digna y saludable. Los recursos como la acción de tutela contribuyen a lograr el cumplimiento del derecho a la salud en el trabajo.

Objective: to describe the problems of working men and women who, when perceiving their right to health at work violated due to alleged or declared workplace accidents or illnesses (ATEL for its acronym in Spanish) sought support and filed one or more constitutional resources to achieve their effective restoration. Materials and methods: Mixed study. A survey was applied to 189 workers who suffered an alleged ATEL event and who sought support in the solidarity extension services at Univesidad de Antioquia or in human rights organizations in the city of Medellin. The survey that captured sociodemographic data, social security data, labor data, the Occupational Health and Safety Management System (SGSST for its acronym in Spanish) data of the background, occurrence and consequences of ATELs and legal resources interposed. For the qualitative approach, an in-depth interview was conducted with an occupational physician and an independent lawyer and four focus groups with workers who suffered ATELs, trade unionists, lawyers and doctors representing the Occupational Risk Administrator (ARL for its acronym in Spanish), and academicians. Results: the most vulnerable workers were the most affected in their right. The agents that make up the General System of Occupational Risks (SGRL by its acronym in Spanish) make a fragmented approach to health and work that facilitates the violation of the right. Workers suffering from ATEL must face economic, administrative and access to health barriers to restore their right. Conclusions: Decent and respectable work is a horizon towards which efforts should be aimed so that the most historically vulnerable workers conquer and sustain full, dignified and healthy life. Resources such as guardianship action contribute to the fulfillment of the right to health at work.

Objetivo: descrever a problemática de homens e mulheres trabalhadores que ao perceber vulnerado seu direito à saúde no trabalho por sofrer presuntos ou declarados ATEL, procuraram apoio e interpuseram um ou mais recursos constitucionais para lograr seu restabelecimento efetivo. Materiais e métodos: estudo misto. Aplicou se enquete a 189 trabalhadores que sofreram um presunto ou reconhecido evento de ATEL e que buscaram apoio nos serviços de extensão solidaria da Universidade de Antioquia ou em organizações de diretos humanos em Medellín. A enquete captou dados sócios demográficos, de segurança social, laborais, do SGSST, dos antecedentes, ocorrência e consequências dos ATEL e os recursos interpostos. Para a abordagem qualitativa se realizou: i) uma entrevista em profundidade com um médico laboral e advogado independente e ii) quatro grupos focais com trabalhadores que sofreram ATEL, sindicalistas, advogados e médicos representantes de ARL, acadêmicos. Resultados: os trabalhadores mais vulneráveis foram os mais afetados em seu direito. Os agentes que integram o SGRL fazem uma abordagem fragmentada da saúde e o trabalho que facilita a vulneração do direito. Os trabalhadores que sofrem ATEL devem enfrentar barreiras econômicas, administrativas e de aceso a saúde para restituir seu direito. Conclusões: o trabalho decente e digno é um horizonte para o qual se devem apontar os esforços para que os trabalhadores mais vulnerados historicamente conquistem e sustenham uma vida plena, digna e saudável. Os recursos como a ação de mandato de segurança que contribui a obter o cumprimento do direito à saúde no trabalho.

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Introduction: Pleural mesothelioma is a rare tumor with a high degree of malignancy. It is considered an occupational disease that has developed in parallel with the industrial use of asbestos. In Argentina, the asbestos was prohibited in 2003. The objective of this study is to know the clinical and diagnostic characteristics and treatment of pleural mesothelioma and to determine the characteristics of asbestos exposure in 40 cases of mesothelioma in different regions of the Argentine Republic. Materials and Methods: It is a descriptive, multicenter study. Hospitals from Buenos Aires, Tucumán, Córdoba and Rosario participated in this study from January 2013 until January 2015. Clinical data were recorded in a Medical Form, and history of environmental, domestic and occupational exposure was recorded in an Exposure Form. Each participant was classified as: exposed, not exposed or unknown. The patient was considered as "exposed" if he/she identified at least one of the three types of exposure: occupational, environmental or domestic. Results: 40 cases of pleural mesothelioma were analyzed, 55% of which were male. We found reference of at least one exposure to asbestos in 75% of the cases; 7.5% denied every possible type of exposure and in 17.5% exposure was unknown. The probability of exposure was: 57.5% environmental, 60% domestic and 37% occupational. There was a greater statistically significant proportion of men with occupational exposure. Conclusion: The contribution of this work relies on the information about the different types of asbestos exposure in cases of pleural mesothelioma in the Argentine Republic.

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The aims of the current study were to investigate the prevalence of bovine brucellosis, to correlate laboratory results of serum reactive samples to the serology of animals presenting serous pouches, and to identify possible risk factors for the development of the disease. In order to do so, 1,265 bovine blood samples were collected from male and female animals bred in different counties in Maranhão state, Brazil, and in other regions of the country. The animals were slaughtered in two slaughterhouses controlled by the Federal Inspection Service (FIS), and in two others controlled by the Municipal Inspection Service (MIS), of regions such as Açailândia and Imperatriz. Samples were tested for specific antibodies by using buffered acidified antigen (BAA) and 2-mercaptoethanol in combination with slow serum agglutination (2-ME + SSA). Additionally, an epidemiological questionnaire was applied to 100 owners, who provided animals to the slaughterhouses, to enable investigating the risk factors for bovine brucellosis. Fifteen serous pouches of animals presenting this lesion were also collected at slaughter time. Thirty-nine out of the analyzed samples were reacted to BAA, whereas 15 reacted to the 2-ME + SSA test; only one male was reagent and it resulted in 1.19% prevalence. One out of the 15 collected serous pouches reacted to the 2-ME + SSA test. The risk factors identified in this study were: the incidence of miscarriages, the sale of animals without previous examination, and the failure in testing the animals before introducing them in herds and before slaughter. It was possible to conclude that the animals slaughtered in the herein evaluated slaughterhouses were infected with Brucella abortus, as well as that this infection prevailed in females.(AU)

Os objetivos do estudo foram determinar a prevalência da brucelose bovina, relacionar resultados laboratoriais de amostras séricas reagentes com a sorologia de animais que apresentavam bursites e, ainda, identificar possíveis fatores de risco para a enfermidade. Para isso, no abate foram coletadas 1.265 amostras de sangue bovino, entre machos e fêmeas, procedentes de diferentes municípios maranhenses e de outras regiões do Brasil, abatidos em dois frigoríficos com Serviço de Inspeção Federal e dois com Serviço de Inspeção Municipal, nas regionais de Açailândia e Imperatriz. As amostras foram testadas para a presença de anticorpos específicos pelos testes do antígeno acidificado tamponado e 2-mercaptoetanol combinado à soroaglutinação lenta (2-ME + SAL). Para realizar o estudo dos fatores de risco, adicionalmente aplicou-se um questionário epidemiológico com 100 proprietários que forneceram animais aos frigoríficos. Foram também coletadas 15 amostras de material de bursite de animais que apresentaram a referida lesão no momento do abate. Do total de amostras analisadas, 39 foram reagentes ao antígeno acidificado tamponado e 15 foram confirmadas no 2-ME + SAL. Apenas um macho foi reagente, o que resultou em prevalência de 1,19%. Das 15 amostras de material de bursites coletadas, uma foi reagente no teste 2-ME + SAL. Os fatores de risco identificados no estudo foram: ocorrência de abortamentos, venda de animais sem exames e não realização de exames que atestem os animais antes da inclusão nos rebanhos para abate. Concluiu-se que a infecção por Brucella abortus em animais abatidos nos frigoríficos avaliados está presente e ocorre com maior frequência em fêmeas.(AU)

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The aims of the current study were to investigate the prevalence of bovine brucellosis, to correlate laboratory results of serum reactive samples to the serology of animals presenting serous pouches, and to identify possible risk factors for the development of the disease. In order to do so, 1,265 bovine blood samples were collected from male and female animals bred in different counties in Maranhão state, Brazil, and in other regions of the country. The animals were slaughtered in two slaughterhouses controlled by the Federal Inspection Service (FIS), and in two others controlled by the Municipal Inspection Service (MIS), of regions such as Açailândia and Imperatriz. Samples were tested for specific antibodies by using buffered acidified antigen (BAA) and 2-mercaptoethanol in combination with slow serum agglutination (2-ME + SSA). Additionally, an epidemiological questionnaire was applied to 100 owners, who provided animals to the slaughterhouses, to enable investigating the risk factors for bovine brucellosis. Fifteen serous pouches of animals presenting this lesion were also collected at slaughter time. Thirty-nine out of the analyzed samples were reacted to BAA, whereas 15 reacted to the 2-ME + SSA test; only one male was reagent and it resulted in 1.19% prevalence. One out of the 15 collected serous pouches reacted to the 2-ME + SSA test. The risk factors identified in this study were: the incidence of miscarriages, the sale of animals without previous examination, and the failure in testing the animals before introducing them in herds and before slaughter. It was possible to conclude that the animals slaughtered in the herein evaluated slaughterhouses were infected with Brucella abortus, as well as that this infection prevailed in females.(AU)

Os objetivos do estudo foram determinar a prevalência da brucelose bovina, relacionar resultados laboratoriais de amostras séricas reagentes com a sorologia de animais que apresentavam bursites e, ainda, identificar possíveis fatores de risco para a enfermidade. Para isso, no abate foram coletadas 1.265 amostras de sangue bovino, entre machos e fêmeas, procedentes de diferentes municípios maranhenses e de outras regiões do Brasil, abatidos em dois frigoríficos com Serviço de Inspeção Federal e dois com Serviço de Inspeção Municipal, nas regionais de Açailândia e Imperatriz. As amostras foram testadas para a presença de anticorpos específicos pelos testes do antígeno acidificado tamponado e 2-mercaptoetanol combinado à soroaglutinação lenta (2-ME + SAL). Para realizar o estudo dos fatores de risco, adicionalmente aplicou-se um questionário epidemiológico com 100 proprietários que forneceram animais aos frigoríficos. Foram também coletadas 15 amostras de material de bursite de animais que apresentaram a referida lesão no momento do abate. Do total de amostras analisadas, 39 foram reagentes ao antígeno acidificado tamponado e 15 foram confirmadas no 2-ME + SAL. Apenas um macho foi reagente, o que resultou em prevalência de 1,19%. Das 15 amostras de material de bursites coletadas, uma foi reagente no teste 2-ME + SAL. Os fatores de risco identificados no estudo foram: ocorrência de abortamentos, venda de animais sem exames e não realização de exames que atestem os animais antes da inclusão nos rebanhos para abate. Concluiu-se que a infecção por Brucella abortus em animais abatidos nos frigoríficos avaliados está presente e ocorre com maior frequência em fêmeas.(AU)

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Objetivo: Avaliar se a disfunção temporomandibular (DTM) crônica esteve associada ao absenteísmo laboral. Métodos: O estudo foi realizado com dados secundários de um ensaio clínico randomizado conduzido em um centro de referência terciária. Foram selecionados os pacientes que apresentaram diagnóstico de DTM segundo o Research Diagnostic Criteria/Temporomandibular Disorders (RDC/TMD), e que exerciam atividade profissional. O grau de dor crônica foi relacionado com o absenteísmo laboral relatado. Resultados: Dos 106 pacientes selecionados, a maioria registrou níveis altos de intensidade da dor e baixos de interferência na capacidade de trabalhar. Entretanto, quanto maior a classificação do grau de dor crônica, mais dias de falta ao trabalho foram relatados (p<0,001). Houve ainda uma correlação positiva de média a forte entre ausência do trabalho, a interferência nas atividades diárias e a mudança na capacidade laboral. Conclusão: A dor crônica por DTM esteve associada ao absenteísmo laboral, e os pacientes com maior grau de dor crônica relataram mais dias de ausência ao trabalho.

Purpose: Evaluate if TMD chronic pain had been associated to work absenteeism. Methods: A study using secondary data obtained from a randomized clinical trial of patients seeking for TMD treatment at a tertiary center. Worker patients with TMD according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were selected. Mean degree of chronic pain severity was compared with number of days of work absenteeism. Results: Of 106 selected patients, majority reported high levels of pain intensity and low disability. However, the greater pain severity degree, the greater the number of days of sick leave reported (p<0,001). There was also a positive correlation between work absenteeism, disability and daily activities impairment. Conclusion: TMD chronic pain has been associated to work absenteeism, and patients with severe degree of chronic pain reported more days of sick leave.

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Leptospirosis is an important socioeconomic disease in humans, as well as in domestic and wild animals, being caused by Leptospira spp. Bovine animals are considered reservoirs of this disease, because they intermittently disseminate the bacteria into the environment through their urine. In this way, the cattle an important source of Leptospira infection. The objective of this study was to detect Leptospira spp. antibodies and DNA in bovine females from two refrigerated slaughterhouses in the microregion of Umuarama, Paraná, Brazil. In particular, blood and urine samples from 52 crossbred bovine females older than 36 months from the two slaughterhouses were used. The microscopic agglutination test (MAT) was used to detect leptospiral antibodies, and the polymerase chain reaction (PCR) and subsequent sequencing were used to detect Leptospira DNA. The MAT yielded 22 (42.3%) serum samples considered reagent, while the nested PCR test resulted in one amplified sample (1.9%)of 289 bp. This single sample was then amplified again using primers for the SecY gene (549 bp). Sequencing of this gene characterized the bacteria as L. borgpetersenii that were similar to the serovar Hardjo of the genotype Hardjobovis. This is the first molecular confirmation of Hardjobovis-like L.borgpetersenii in the urine of crossbred bovine females older than 36 months from slaughterhouses in the microregion of Umuarama. This studys results show that it is important to combine serological and molecular diagnosis in the detection of Leptospira spp. Therefore, both methods were used to improve our understanding of the epidemiology of this disease in bovine animals from the microregion of Umuarama. In addition, the analysis informed the subsequent adoption of preventive measures and educational One Health actions to prevent economic losses related to the herd, as well as social losses related to workers and the environment.(AU)

A leptospirose é uma importante doença sócio-econômica acarretada pela Leptospira spp. que afeta homens e animais domésticos ou selvagens. Os bovinos são considerados reservatórios desta enfermidade, sendo importante fonte de infecção por eliminar a bactéria pela urina de forma intermitente no meio ambiente. O objetivo deste trabalho foi detectar anticorpos e DNA de Leptospira spp. em fêmeas bovinas provenientes de dois matadouro-frigoríficos da microrregião de Umuarama, Paraná, Brasil. Neste trabalho foram utilizadas amostras de sangue e urina de 52 fêmeas bovinas mestiças com idade superior a 36 meses provenientes de dois matadouros-frigoríficos. Para detecção de anticorpo anti-Leptospira spp. foi realizada a prova de Soroaglutinação Microscópica (SAM), e para a detecção de DNA foi realizada a reação em cadeia pela polimerase (PCR) e posterior sequenciamento. Na SAM,22 (42,30%) amostras de soro foram consideradas reagentes e na nested PCR uma (1,92%) amostra amplificou 289 pb, e posteriormente, a mesma amostra amplificada novamente para o gene sec Y com 549pb. O sequenciamento do gene Sec Y caracterizou o produto obtido como L. borgpetersenii semelhante ao sorovar Hardjo genótipo Hardjobovis. Esta é a primeira confirmação molecular semelhante ao genótipo Hardjobovis pertencente à espécie L. borgpetersenii em urina de fêmeas bovinas mestiças com idade superior a 36 meses proveniente de matadouros-frigoríficos localizados na microrregião de Umuarama no estado do Paraná. Os resultados deste trabalho evidenciam a importância da associação do diagnostico sorológico e molecular para a detecção de Leptospira spp. Isto é importante para o entendimento da epidemiologia desta enfermidade em bovinos da microrregião de Umuarama e adoção de medidas de prevenção e ações de educação em saúde na esfera da Saúde Única, evitando assim perdas econômicas relacionado ao rebanho e sociais relacionadas a trabalhadores e meio ambiente.(AU)

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Resumen Objetivos Realizar una caracterización sociodemográfica y laboral de la población que acudió por lumbalgia al Área de Medicina de Rehabilitación del Hospital Central Militar. Material y métodos Estudio retrospectivo, transversal y descriptivo que consideró como variables el género, la edad, el peso y el potencial origen de la lumbalgia. El análisis estadístico incluyó medidas de tendencia central, de dispersión y desviación estándar. Resultados Se evaluaron 1,952 expedientes; 938 cumplieron con los criterios de ingreso; 578 pertenecieron al sexo femenino y 360 al masculino. Las causas de los padecimientos más comunes fueron de tipo mecanopostural, postquirúrgico y postraumático; el número de militares en el activo fue de 276 pacientes, con una mayor preferencia para el Servicio de Sanidad (20.9%), Infantería (14.5%), y la Fuerza Aérea (11.4%). Conclusiones La lumbalgia se muestra con mayor afección para el sexo femenino que para su contraparte; hubo un mayor número de valoraciones médico-asistenciales a la población derechohabiente, seguida por la militar; se evidenció el origen mecanopostural, postquirúrgico y postraumático con mayor frecuencia, afectando principalmente a los servicios y armas como sigue: Servicio de Sanidad, Infantería y Fuerza Aérea. Se recomienda hacer énfasis en los factores mencionados a fin de incidir en el tratamiento de la lumbalgia.

Abstract Objective To identify the risk factors, demographic and laboral characteristics of the population that is treated for low back pain in the Rehabilitation Center of the Military Central Hospital. Material and methods Retrospective, cross-sectional and descriptive study. Study variables: gender, age, weight, potential origin of the low back pain. The statistical analysis included: measures of central tendency, dispersion and standard deviation. Results 1,952 clinical records were evaluated; 938 fulfilled the admission criteria, 578 belonged to female patients and 360 to male ones. The most common etiologies were mechanopostural, post-surgical and post-traumatic; the number of military personnel in the active service was 276, with a greater preference for the Health Service (20.9%), Infantry (14.5%), and Air Force (11.4%). Conclusion The female sex is more affected by low back pain. The greater number of medical assessments were done to non-military population. The mechanopostural, post-surgical and post-traumatic etiologies showed a greater frequency, mainly affecting the following services: Health Service, Infantry, and Air Force. We recommend to emphasize the factors mentioned in order to influence the treatment of low back pain.

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Introduction Noise-induced hearing loss (NIHL), which is one of the most common occupational diseases among industrialized populations, is associated with longstanding exposure to high levels of noise. The pathogenesis of NIHL is not clear, but some genes and their activity at the tissue level have been investigated. Hypercholesterolemia, which can disturb the microcirculation, can be one of the underlying pathologies in hearing loss. Objective To investigate the relationship between NIHL and hypercholesterolemia. Methods The study group was selected among workers who had an occupational exposure of 85 dB of noise for at least 10 years. The audiologic assessment was recorded at seven frequencies (500 Hz, 1,000 Hz, 2,000 Hz, 3,000 Hz, 4,000 Hz, 6,000 Hz and 8,000 Hz). A total of 456 workers were included in the study and divided into two groups: the control group (252 patients) and the NIHL group (204 patients). After the audiologic measurement, blood samples were taken and investigated for blood cholesterol levels. According to these results, the groups were compared. Results Both groups were similarly distributed regarding age and occupational exposure time ( p > 0.05). We could not detect any association between cholesterol levels and noise-induced hearing loss ( p < 0.05). According to logistic regression analyses, the odds ratios are not significant for both hypercholesterolemia and hypertriglyceridemia ( p > 0.05). Conclusion Noise-induced hearing loss is still a common occupational problem that can be prevented by hearing conservation programs and occupational health and safety training. Still, we know little about the relationship between NIHL and hypercholesterolemia. According to our findings, we cannot detect any relationship. Controlled studies and studies with human individuals can be made possible in the future with diagnostic innovations in tissue imaging and tissue microcircular sampling.

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Abstract Introduction Noise-induced hearing loss (NIHL), which is one of the most common occupational diseases among industrialized populations, is associated with longstanding exposure to high levels of noise. The pathogenesis of NIHL is not clear, but some genes and their activity at the tissue level have been investigated. Hypercholesterolemia, which can disturb the microcirculation, can be one of the underlying pathologies in hearing loss. Objective To investigate the relationship between NIHL and hypercholesterolemia. Methods The study group was selected among workers who had an occupational exposure of 85 dB of noise for at least 10 years. The audiologic assessment was recorded at seven frequencies (500 Hz, 1,000 Hz, 2,000 Hz, 3,000 Hz, 4,000 Hz, 6,000 Hz and 8,000 Hz). A total of 456 workers were included in the study and divided into two groups: the control group (252 patients) and the NIHL group (204 patients). After the audiologic measurement, blood samples were taken and investigated for blood cholesterol levels. According to these results, the groups were compared. Results Both groups were similarly distributed regarding age and occupational exposure time (p > 0.05). We could not detect any association between cholesterol levels and noise-induced hearing loss (p < 0.05). According to logistic regression analyses, the odds ratios are not significant for both hypercholesterolemia and hypertriglyceridemia (p > 0.05). Conclusion Noise-induced hearing loss is still a common occupational problem that can be prevented by hearing conservation programs and occupational health and safety training. Still, we know little about the relationship between NIHL and hypercholesterolemia. According to our findings, we cannot detect any relationship. Controlled studies and studies with human individuals can be made possible in the future with diagnostic innovations in tissue imaging and tissuemicrocircular sampling.