Masculinidades e fatores sociais de risco para a saúde: um retrato nacional

O objetivo geral deste artigo é analisar os fatores de ordem social que influenciam a saúde dos homens portugueses, em particular os comportamentos que se associam à construção das masculinidades. Para satisfazer o objetivo da pesquisa proceder‑se‑á à análise de alguns indicadores estatísticos produzidos por fontes oficiais, de natureza amostral ou administrativa, como o INE ou o EUROSTAT. O modelo de masculinidade que emerge da análise dos indicadores nacionais apresentados remete para um ideário de género muito associado a estilos de vida e desempenho de profissões com impacto negativo na esperança média de vida dos homens portugueses. Tendo como referência as mulheres, destaca‑se no caso dos homens: maior taxa de acidentes de viação; consumo de álcool e tabaco mais acentuado e prematuro; mais mortes associadas ao consumo de drogas; mais mortes autoprovocadas intencionalmente; maior incidência da SIDA; maior número de acidentes de trabalho. ABSTRACT - The purpose of this article is to analyze the social factors that influence the health of Portuguese men, namely the behaviors that can be associated to the construction of masculinities. To satisfy this objective we will analyze some statistical indicators produced by official sources like INE or EUROSTAT. The model of masculinity that emerges from national indicators analysis is associated to behaviors and consumptions with a negative impact in Portuguese men health and life expectancy. In this article we highlight some of these behaviors: biggest rate of transport accidents; larger and early alcohol and tobacco consumption; more deaths associated to the consumption of drugs; more auto provoked deaths; bigger AIDS incidence; more occupational accidents.

Contributo da análise ergonómica do trabalho para o estudo de acidentes de trabalho em enfermeiros no serviço de urgência

Mestrado em Segurança e Higiene no Trabalho.

Task-based occupational exposure assessment and particle number concentration: two important data resources to perform risk assessment for occupational exposure to particles

Environment monitoring has an important role in occupational exposure assessment. However, due to several factors is done with insufficient frequency and normally don´t give the necessary information to choose the most adequate safety measures to avoid or control exposure. Identifying all the tasks developed in each workplace and conducting a task-based exposure assessment help to refine the exposure characterization and reduce assessment errors. A task-based assessment can provide also a better evaluation of exposure variability, instead of assessing personal exposures using continuous 8-hour time weighted average measurements. Health effects related with exposure to particles have mainly been investigated with mass-measuring instruments or gravimetric analysis. However, more recently, there are some studies that support that size distribution and particle number concentration may have advantages over particle mass concentration for assessing the health effects of airborne particles. Several exposure assessments were performed in different occupational settings (bakery, grill house, cork industry and horse stable) and were applied these two resources: task-based exposure assessment and particle number concentration by size. The results showed interesting results: task-based approach applied permitted to identify the tasks with higher exposure to the smaller particles (0.3 μm) in the different occupational settings. The data obtained allow more concrete and effective risk assessment and the identification of priorities for safety investments.

Fungal contamination in swine: a potential occupational health threat

Poor air quality in a pig-confinement building may potentially place farmers at higher health risk than other workers for exposure to airborne pollutants that may reach infectious levels. The aim of this study was to assess worker exposure to fungi in indoor environments in Portuguese swine buildings. Air samples from 7 swine farms were collected at a flow rate of 140 L/min, at 1 m height, onto malt extract agar supplemented with chloramphenicol (MEA). Surfaces samples of the same indoor sites were obtained by swabbing the surfaces. Samples from the floor covering were also collected from four of seven swine farms. All collected samples were incubated at 27°C for 5-7 days. After lab processing and incubation of obtained samples, quantitative colony-forming units (CFU)/m(3), CFU/cm(2), and CFU/g and qualitative results were determined with identification of isolated fungal species. Aspergillus versicolor was the most frequent species found in air (21%), followed by Scopulariopsis brevicaulis (17%) and Penicillium sp. (14%). Aspergillus versicolor was also the most frequent species noted on surfaces (26.6%), followed by Cladosporium sp. (22.4%) and Scopulariopsis brevicaulis (17.5%). Chrysosporium was the most frequently found genera in the new floor covering (38.5%), while Mucor was the most prevalent genera (25.1%) in used floor covering. Our findings corroborate a potential occupational health threat due to fungi exposure and suggest the need for a preventive strategy.

Fungal burden in waste industry: an occupational risk to be solved

High loads of fungi have been reported in different types of waste management plants. This study intends to assess fungal contamination in one waste-sorting plant before and after cleaning procedures in order to analyze their effectiveness. Air samples of 50 L were collected through an impaction method, while surface samples, taken at the same time, were collected by the swabbing method and subject to further macro- and microscopic observations. In addition, we collected air samples of 250 L using the impinger Coriolis μ air sampler (Bertin Technologies) at 300 L/min airflow rate in order to perform real-time quantitative PCR (qPCR) amplification of genes from specific fungal species, namely Aspergillus fumigatus and Aspergillus flavus complexes, as well as Stachybotrys chartarum species. Fungal quantification in the air ranged from 180 to 5,280 CFU m−3 before cleaning and from 220 to 2,460 CFU m−3 after cleaning procedures. Surfaces presented results that ranged from 29 × 104 to 109 × 104 CFU m−2 before cleaning and from 11 × 104 to 89 × 104 CFU m−2 after cleaning. Statistically significant differences regarding fungal load were not detected between before and after cleaning procedures. Toxigenic strains from A. flavus complex and S. chartarum were not detected by qPCR. Conversely, the A. fumigatus species was successfully detected by qPCR and interestingly it was amplified in two samples where no detection by conventional methods was observed. Overall, these results reveal the inefficacy of the cleaning procedures and that it is important to determine fungal burden in order to carry out risk assessment.

Occupational exposure to aflatoxin B1 and ochratoxin A: co-exposure in swine production

The most common scenario in occupational settings is the co-exposure to several risk factors. This aspect has to be considered in the risk assessment process because can alter the toxicity and the health effects when dealing with a co-exposure to two or more chemical agents. A study was developed aiming to elucidate if there is occupational co-exposure to aflatoxin B1 (AFB1) and ochratoxin (OTA) in Portuguese swine production. To assess occupational exposure to both mycotoxins, a biomarker of internal dose was used. The same blood samples from workers of seven swine farms and controls were consider to measure AFB1 and OTA. Twenty one workers (75%) showed detectable levels of AFB1 with values ranging from <1 ng/ml to 8.94 ng/ml and with significantly higher concentration when compared with controls. In the case of OTA, there wasn't found a statistical difference between workers and controls and the values for workers group ranged from 0.34 ng/ml to 3.12 ng/ml and 1.76 ng/ml to 3.42 ng/ml for control group. The results suggest that occupational exposure to AFB1 occurs. However, in the case of OTA results, seems that food consumption plays an important role in both groups exposure. The results claim attention for the possible implications on health of this co-exposure.

Occupational exposure to aflatoxin B1: new (old) occupational risk!

Contrary to fungi, exposure to mycotoxins is not usually identified as a risk factor present in occupational settings. This is probably due to the inexistence of limits regarding concentration of airborne mycotoxins, and also due to the fact that these compounds are rarely monitored in occupational environments. Aflatoxin B1 (AFB1) is the most prevalent aflatoxin and is associated with carcinogenicity, teratogenicity, genotoxicity and immunotoxicity but only a few studies examined exposure in occupational settings. Workers can be exposed to high airborne levels during certain operations in specific occupational settings. Aim of study: The study aimed to assess exposure to AFB1 in three settings: poultry, swine production and waste management.

Climate changes influence in occupational exposure to fungi and mycotoxins

Climate changes and their effects on fungal distribution and activity are aspects of concern regarding the human exposure to mycotoxins. An exhaustive search was made for papers available in scientific databases reposrting the influence that climate cchange has on fungi and mycotoxins. Also a review regarding fungal burden, collected between 2010 and 2015 in different settings, was done to support the discussion about future fungi and mycotoxins ocuupational exposure. A. flavus complex, E. graminerarum complex and F. verticilliodes were the most reported to be influenced by climate changes. We noted also that the analyzed Portuguese settings presented already an occupational problem due to their fungal burden. It will be important to know future climate changes to select what complexes/species and strains, and consequently the mycotoxins, we should consider as indicators of an occupational problem. In addition, epidemiologic studies are needed to increase knowledge about potential health effects related with the exposure to both risk factors.

Climate changes and mycotoxins: two risk factors associated!

Many species of fungi produce bioactive compounds called mycotoxins. These compounds are produced by filamentous fungi and can contaminate food, feeds and specific indoor environments resulting in high economic losses. Severe health problems and death have been related with mycotoxins exposure through the consumption of several food commodities. There are many factors involved in mycotoxin production by fungi but climate is the most important. Thus, when changes in the weather occur, mycotoxins production will be affected. We looked for articles that were available in scientific databases, written in English and that mention in the title and/or abstract the combined terms fungi and climate change and also mycotoxins and climate change.

Exposure and risk assessment in occupational exposure to fungi: aspects to consider in highly contaminated settings

Although a clear correlation between levels of fungi in the air and health impacts has not been shown in epidemiological studies, fungi must be regarded as potential occupational health hazards. Fungi can have an impact on human health in four different ways: (1) they can infect humans, (2) they may act as allergens, (3) they can be toxigenic, or (4) they may cause inflammatory reactions. Fungi of concern in occupational hygiene are mostly non-pathogenic or facultative pathogenic (opportunistic) species, but are relevant as allergens and mycotoxins producers. It is known that the exclusive use of conventional methods for fungal quantification (fungal culture) may underestimate the results due to different reasons. The incubation temperature chosen will not be the most suitable for every fungal species, resulting in the inhibition of some species and the favouring of others. Differences in fungi growth rates may also result in data underestimation, since the fungal species with higher growth rates may inhibit others species’ growth. Finally, underestimated data can result from non-viable fungal particles that may have been collected or fungal species that do not grow in the culture media used, although these species may have clinical relevance in the context. Due to these constraints occupational exposure assessment, in setings with high fungal contamination levels, should follow these steps: Apply conventional methods to obtain fungal load information (air and surfaces) regarding the most critical scenario previously selected; Guideline comparation aplying or legal requirements or suggested limits by scientific and/or technical organizations. We should also compare our results with others from the same setting (if there is any); Select the most suitable indicators for each setting and apply conventional-culture methods and also molecular tools. These methodology will ensure a more real characterization of fungal burden in each setting and, consequently, permits to identify further measures regarding assessment of fungal metabolites, and also a more adequate workers health surveillance. The methodology applied to characterize fungal burden in several occupational environments, focused in Aspergillus spp. prevalence, will be present and discussed.

Occupational exposure to mycotoxins: aspects to consider for the aggregate and cumulative risk assessment

Mycotoxins are an important group of naturally occurring substances known to contaminate a huge variety of agricultural products, feed and food commodities. The main concern is their widespread presence and toxic effects on humans and animals as they have been described as cytotoxic, nephrotoxic, hepatotoxic, teratogenic, immunosuppressive, mutagenic and/or carcinogenic. However, until now, risk assessments and regulations have usually been performed on individual mycotoxins despite humans and animals are being frequently exposed to a multitude of mycotoxins simultaneously. Moreover, even though some exposures through inhalation and dermal contact may potentially occur, only oral ingestion has been considered as the sole route of exposure in all the evaluations. However, more recent studies have also demonstrated airborne exposure to mycotoxins in different occupational settings with emphasis on agricultural professions. In these cases, skin contact with mold-infested substrates and inhalation of spore-borne toxins are the most important sources of exposure. Still, mycotoxins are not normally recongnize as na occupational hazard and exposure is different from the one ocurring by food intake. In this case, exposure is charaterized to be acute and simultaneous to other mycotoxins and also to fungi and dust. All these features increase the challenge implicated in the risk assessment process. Some topics will be presented and discussed in detailed such as: What occupational settings should be consider in this case; possible exposure routes; exposure characterization; how to assess exposure; co-exposure; aggregate exposure and cumulative risk assessment.

Risk assessment in occupational exposure to formaldehyde: differences between anatomy and pathology laboratories and formaldehyde-resins production

Formaldehyde (CH2O), the most simple and reactive of all aldehydes, is colorless, and readily polymerizing gas at normal temperature. The most extensive use is in production of resins and has an important application as a disinfectant and preservative, reason why relevant workplace exposure may also occur in pathology and anatomy laboratories and in mortuaries. A study was carried out in Portugal, in a formaldehyde production resins factory and in 10 pathology and anatomy laboratories. It was applied a risk assessment methodology based on Queensland University proposal that permitted to perform risk assessment for each activity developed in a work station. This methodology was applied in 83 different activities developed in the laboratories and in 18 activities of the factory. Also, Micronucleus Test was performed in lymphocytes from 30 factory workers and 50 laboratories workers.

Occupational exposure to aflatoxin (AFB1) in poultry production

Aflatoxin B1 (AFB1) has been recognized to cause cancer in the humans liver. Epidemiological and laboratory evidence also point towards the respiratory system as target for carcinogenesis. Exposure occurs mainly through food chain but inhalation represent an additional route of exposure. Agricultural workers have the greatest risk of occupational exposure due to their exposition to airborne aflatoxin through inhalation of dust.

Prevalência de sintomas de lesões músculo-esqueléticas ligadas ao trabalho: contributos para a intervenção centrada no trabalhador

Mestrado em Intervenção Sócio-Organizacional na Saúde - Área de especialização: Qualidade e Tecnologias da Saúde.

Estudo da prevalência de sintomas de lesões músculoesqueléticas ligadas ao trabalho nos profissionais de educação de infância: educadores de infância e auxiliares de acção educativa

Mestrado em Segurança e Higiene no Trabalho.