Magnitude da morbidade relacionada ao trabalho no Rio Grande do Norte

Diseases and disorders related to work sets up an important public health problem in Brazil and worldwide. However, the reality of these diseases still constitutes a gap with regard to its characterization and epidemiological situation, especially in Brazil. In this context, this study aims to analyze the magnitude of morbidity related to work from the injuries and illnesses reported by Health the Diseases Notifiable of Health of the State Public River Health Department worker Reference Center Information System services Grande do Norte from 2007 to 2014. It is ecological study, quantitative cross-sectional study in which the analysis unit of the municipalities of Rio Grande do Norte. Data were collected from the state base of Diseases Notifiable Information System Centre of the Secretariat of State Workers' Health Reference Public Health of Rio Grande do Norte, between March and June 2015, after the approval of the Committee of Ethics in Research of the Federal University of Rio Grande do Norte, Opinion 014/2014. The population was represented by the universe of cases of diseases and disorders related to work that were reported and shut down the system from 2007 to 2014. Data were analyzed using descriptive and inferential statistics, presented in tables, graphs, charts and figures. For this, we used the Microsoft Excel 2007 and SPSS version 20.0. To check the significance level we opted for the application of the chi-square or Fisher tests. We adopted the significance level of p <0.05. Of the 10,161 cases of diseases related to the reported work, the biological work accidents had the highest percentage (52.84%) followed by serious occupational accidents (37.49%). For diseases, the highlights were musculoskeletal (4.82%), mental disorders (2.19%) and exogenous intoxication (1.97%). Among men, there was a predominance of major accidents (91.80%), mental disorders (70.00%) and exogenous poisoning (52.84%). Women were most affected by biological accidents (77.50%) and musculoskeletal diseases (64.10%). Among workers who have suffered injuries predominated mulatto (%), mean age of 35.86 years, low education (%) and workers in the formal sector (%). Among the accidents, biological (n = 5,369) accounted for 52.84% of cases occurred predominantly among nursing professionals (48.31%). The percutaneous exposure was the most frequent (73.05%) and the occurrence of circumstances was improper disposal of sharps (45.28%), the needle the most common agent (66.62%) and the organic material was blood (72.99%). Most injured workers were vaccinated against hepatitis B (68.13%), but no information as to the assessment of the vaccine response. In the course of the disease predominated ignored the situation with loss of monitoring of clinical follow-up (55.62%). There was also an increase in the notification of serious industrial accidents predominantly male (91.80%) workers aged 25-44 years (54.3%) and typical accidents (76.3%). The temporary disability was the most common outcome (55.53%) and hand the most affected part (33.00%); the mining and construction industry had the highest number of cases (25.1%) in registered employee (34.2%). The findings of this study show a positive result in relation to increased mandatory reporting of injuries and illnesses related to work together to health services that meet victimized workers, towards the occurrence of knowledge of these accidents for decision making in public plans and policies of health. However, the information system still needs improvement in both the coverage and the quality of the data to demonstrate with greater reliability the magnitude of events to support the planning of workers' health into shares in the state.

Riscos ocupacionais e acidentes de trabalho em um serviço de atendimento móvel de urgência do Rio Grande do Norte

Exploratory, descriptive and quantitative study with prospective data, performed in the Mobile Emergency Care Service in the metropolitan region of Natal/RN, in order to identify the knowledge of the multidisciplinary team about the rules of standard precautions and worker safety, to identify occupational hazards peculiar to the activities of this service; characterize work-related accidents (WRA) and know the procedures adopted after each WRA. The population consisted of 162 professionals and data were collected between the months of November and December 2010. As for personal and professional characteristics, of the 162 professional, 12,96% were physicians; 6,79%, nurses; 33,95%, nursing technicians, 46,29%, conductors; 74,70% were male; 43,21% were between 31 and 40 years old; 69,33% lived in Natal/RN, 50,00% had completed high school; 58,64% were married; 69,75% had children, 46,91% were between 1 and 4 years of training; 61,73% had improvement courses; 59,25% had 3 to 4 years of service; 54,32%, with 1-4 years experience in emergency; 44,44% received 1-2 minimum wages; 78,40% received insalubrity premium; 67,28% worked in Basic Support Unit (BSU); 83,95% had journey on SAMU Metropolitano of 31-40 hours per week; 52,47% had other employments. As for knowledge of rules of standard precautions, safety and occupational hazards, 99,38% knew what it was WRA; 62,96% gave incomplete answers; 74,07% knew the rules of prevent WRA; 46,67% acquired this knowledge in lectures; 53,09% knew Personal Protective Equipment (PPE); 71,60% gave incorrect answers about the importance of standard precautions; 45,06% never received an educational intervention on this issue; 89,51% said that educational interventions in the prevention of WRA are very important; 90,12% pointed out this as a very important issue in the workplace; 27,00% suggested guidance on the topic in the workplace; regarding the physical hazards, 34,57% considered noise as the most important; about chemical hazards, 78,40% chose the gases and smoke; for biological hazards, 48,77% reported contact with the blood; for mechanical hazards, 80,86% said that were transport accidents; about ergonomic risks, 40,12% say it is the tension/stress in the care of critically ill, psychiatric and aggressive patients; and there was an average of 4,5 to the feeling of safety in the workplace. Regarding the data on the WRAs occurred, 31,48% experienced at least one accident event; 72,55% did not notify it; 60,98% answered that there was no routine for notification; 56,86% were performing patient transportation; 49,02% were hurt in the Basic Support Unit/Rescue Unit (BSU/RH); 60,78% occurred during the day; 96,08% of professionals were in normal work schedule (24 hours on duty); 31,37% had contusion; 58.82% had damage to members/pelvic girdle; 43,14% had traffic accidents. About the evolution of the WRA, 62,75% did not have to take time away from work; 76,47% had no sequelae; 88,24% did not require rehabilitation; no professional had a change of occupation. And by means of univariate logistic regression, showed that the nurses and male sex were risk factors for the occurrence of WRA. We conclude that there were gaps in the knowledge of staff regarding WRA, emphasizing the need for continuing education in biosafety in the service.

Acidentes por quedas em um grupo específico de idosos

Este estudo objetivou conhecer a incidência do evento queda e identificar a presença de seus principais fatores de risco. Estudo exploratório, realizado de março a novembro/2009, com aplicação de um formulário sobre quedas em um grupo de idosos. Os dados foram analisados por cálculo de frequências, média e desvio-padrão. Participaram 62 idosos, 41,9% relataram queda nos últimos seis meses, a maioria mulheres. Identificou-se ocorrência de agravos concomitantes: visão regular, audição boa, polifarmácia, IMC normal, forte força de preensão palmar e condições dos pés adequadas. Na maioria dos que caiu, o desequilíbrio foi apontado como principal motivo. A queda ocorreu mais no período da manhã, em local de piso áspero e seco, sem degraus, rampas ou tapetes, iluminação adequada e o tipo de calçado mais utilizado foi chinelo de borracha. Percebe-se a alta ocorrência das quedas na população idosa, fato que fundamenta a necessidade de avaliação das condições de risco envolvidas

Alcoolemia em vítimas fatais de acidentes de trânsito no Rio Grande do Norte empregando cromatografia em fase gasosa - head space

Alcohol is one of the few psychotropic drugs that their consumption has admitted legally and sometimes encouraged by the society. Studies show alcohol as the highest consumption of drugs among young people and society in general, probably because of its availability and easy access. The abuse causes public health problems, which was closely related to the violence, socioeconomic problems and the high number of automobile accidents. Transit is one of the main sectors affected by the effects of alcohol, observing a high incidence in the studies. About half of automobile accidents occurs after the consumption of alcoholic beverage, and the vast majority of cases related to high concentrations of alcohol in the bloodstream. The relationship of drunk with traffic accidents is in fact evident everywhere in the world, including Brazil, where studies have shown a high relationship between alcohol consumption and traffic accidents. This study determined the alcohol in fatal victims of traffic accidents in the state of Rio Grande do Norte and established the profile of this population compared with those found in Brazil and other countries. Samples of blood of ethanol added to fulfillment of the standardization of chromatographic conditions and procedures for the analysis, being employed in the determination of alcohol in blood samples of 277 victims of traffic accidents, collected at the Institute of Scientific Technical Police of Rio Grande do North (ITEP) in the year 2007. The blood alcohol level was determined in these samples correlated with the sex, age and marital status of the victim and the location, day of week and month when the accident occurred, is doing a statistical analysis and outlining a profile of the victims of an accident at transit in the state of Rio Grande do Norte. The parameters of standardization studied ensured the quality of the analytical method and, consequently, to obtain reliable laboratory results. Being given the best temperature for injector (150 ºC), detector (250 ºC) and column (50 ºC) with a flow of gas in the column of 2mL/minutos and analysis of time of 12 minutes. The method was linear in the range of 0.01 to 3.2 g / L (r2 = 0.9989) with average recovery of 100.2% and precision with coefficient of variation less than 15%. The analysis carried out on victims of fatal road traffic accidents, ethanol detected in the blood in 66.43% of the victims and these, 96% showed concentration ≥ 0.2 g / L, 87.73% of victims were male, while 12.27% female. The younger age group (1535 years) was the most involved (52,35%) and most single (55.60%). The accidents occurred with greater prevalence in the day on Monday (27%) followed by Sunday (24,19%) and Saturday (15,52%) and it was found that the prevalence of injuries varied between the different months of the year, and in February (14.4%) and April (10.47%) the months that had a higher number of accidents, however this oscillation showed no statistically significant difference. Also no significant difference was observed between the tracks of concentration found in men and women. The standardized method showed to be efficient, given satisfactorily to the goals of this work, and the high levels of alcohol found in victims of fatal road traffic accidents are consistent with several studies of literature, and the profile of the victim also supported by presenting in its most young adults, male and single

Avaliação da gravidade do trauma em condutores de motocicleta vítimas de acidentes de trânsito no Rio Grande do Norte

Descriptive exploratory study, prospective, with quantitative approach, performed on the Monsenhor Walfredo Gurgel Hospital Complex (MWGHC), in Natal/RN, aiming to identify injuries by body area and wound severity on drivers who suffered motorcycle accidents, evaluate the severity of injuries and trauma on these drivers and identify the existence of association between wound and trauma severity and some of the accident s characteristics. The population comprised 371 motorcycle drivers, with data collected between October and December 2007. We used as instruments the Abberviated Injury Scale (AIS), Injury Severity Score (ISS) and the Glasgow Coma Scale (GCE1). The results show that, concerning characterization, there was a predominance of the male gender (88.4%), aged between 18 and 24 years (39.90%), originating from the Natal metropolitan region (55.79%), with fundamental-level instruction (51.48%), catholic (75.78%), married (47.98%). 23.18% work on commerce-related activities and 75.20% have income of up to 2 minimum wages. As for the accident s characteristics, the predominant shift was the afternoon (46.36%), received up to one hour after the event (50.67%), transported by countryside ambulances colleagues and relatives (51.21%), 25.34% had the accident on Sunday; 53.91% suffered falls and vehicle rolls; among the collisions there was a predominance of the motorcycle-automoblie type (28.03%); 52,6% were licensed and among these 50.76% had up to one year of license; 65.50% declared not having suffered previous accidents; 65.77% declared waring helmets in the time of the accident; 57.41% said not to have used drugs, and among those who used, alcohol was the most consumed (98.10%). The lowest score evaluated by GCS1 (3 to 8) was linked to drivers who suffered accidents on Saturday (10.3%), those who were not wearing helmets (14.29%) and the victims of motorcycle-pedestrian/animal crashes (13.33%). The body areas most affected had AIS between 1 and 3 (95.76%) and were: external surface (39.90%) and head/neck (33.20%). As for trauma severity, the highest scores (ISS>25) belonged to those who consumed alcohol (30.73%), suffered falls or vehicle rolls (48.9%) and those attended to 3 hours or longer after the accident (50%). We conclude that for motorcycle drivers who suffered accidents, age, gender, weekday, type of accident, use of drugs and the absence of helmet use signal both to the risk of occurrence of these events, as well as for the greater severity of injuries and trauma.

Acidentes de Trabalho : análise em profissionais de enfermagem que atuam nas unidades de terapia intensiva e urgência Natal/RN

It is a descriptive-exploratory research, with a quantitative approach, aiming to characterize typical occupational accident suffered by the professionals from nursery group, in the Intensive Care Units and Emergency in a hospital in Natal-RN, trying to identify the factors that contribute to those accidents; to identify some information taken by those professionals related to the accident risks; to know the procedures taken after each accident. This sample is composed by 176 professionals that are 44 nurses and 132 nursing technicians/auxiliaries, collected from March to April 2010. The results related to the personal characterization of the nursery group showed that 31 (18.61%) are between the 36-40 years of age; 148 (84.09%) females and 96 (55.68%) had finished High School. Related to the professional characterization, 53 (30.11%) are nurses, and 123 (69.88%) nursing technicians and auxiliaries; 44 (25.00%) are working as nurses, and 132 (75.00%) as nursing technicians and auxiliaries; 45 (25.56%) are working in the nursery area between 15 to 20 years and 11 months; 53 (30.11%) are in this institution between 10 to 14 years and 11 months; 79 (44.88%) work in the ICU; 55 (31.25%) are working in this area from 1 to 4 years and 11 months; 110 (62.50%) like to work in this area; 161 (91.47%) work 30 to 40 hours per week; 90 (51,13%) have another employment. Related to knowledge about typical occupational accident, 167 (94.88%) said they know about it; 96 (54.54%) know the accident rules; 103 (58.52%) think it is important to talk about this subject in the nursery courses; 92 (52.27%) said this subject is important to be discussed in the work and 372 (87.73%) think education is necessary to reduce accident. Related to the data about accidents, 104 (59.09%) have suffered typical occupational accident, among them 69 (39.20%) have suffered it once; 47 (36.19%) did not register any accident; 60 (57.69%) were caring some patient during the accident; 47 (45.19%) of them occurred in the ICU; 50 (48.07%) professionals were working during the night period; 69 (66.34%) have suffered perforation; 86 (82.69%) had upper limbs affected; 64 (61.53%) were affected by needle; about the reason of the accident, 89 (60.54%) said it occurred due to carelessness. Related to the accident evolution, 88 (85.57%) did not need to remain off work after accident; 13 (81.25%) remained off work during 15 days; 87 (83.65%) had no sequelae and for 101 (97.11%) it was not necessary rehabilitation. We conclude that typical occupational accident can occur with young workers who admit a knowledge about the subject, however they do almost nothing to prevent it. We believe this research has contributed to the characterization of this kind of accident suffered by the nursery group of a public hospital in Natal, and it can stimulate the creation and reformulation of personal protection against typical occupational accident suffered by nursery professionals

Os profissionais de saúde diante da violência :mapeando o processo de implantaçãoda notificação na rede básica de saúde em Natal/RN

Violence is a complex and multifarious phenomenon that has convoked the government to think about strategies to face the question. This work is about one of these strategies proposed by brazilian Health Minister: the Individual notification/investigation Card - Domestic Violence, Sexual and/or others Interpersonal Violences . This instrument is a notification protocol which is been implanted in all of the country. This process is in course in Natal/RN. This work is a report of one research realized in five units of basic health care network of Natal/RN concerning this process about the implementation of the violence notification card. The study aims to cartography all the process of card implantation, discussing the used strategies, the drawn course, difficulties and possibilities as well as how the researcher intended to map subjective process involved at health professional acting at violence case and the propose to use the card. Meetings were held at each unit and a daily fieldwork report was used as research instrument. In this investigation it was observed that notifying violence involves a complexity that is not present in other kinds of notification as consequence of the phenomenon characteristic and health workers are invited to act in different perspective that knowledge and instruments of traditional health fieldwork available does not work. It was observed that the notification card, as a possible instrument of intervention, are considered important detectors from process of work at health basic care and health policies. Depending the way the instrument is used, it may incentive different discussions and manners to offer health care or in other way it can reproduce control and vigilance logics. Consequently it is necessary to consider some factors pointed out at this experience, implanting instruments like this, thinking about these limits and possibilities

Indicadores associados a acidentes de trânsito envolvendo motoristas de ônibus da cidade de Natal

The purpose of this study was to investigate indicators of urban bus drivers involvement in transit accidents. We analyzed their involvement in accidents in relation to several indicators suggested by the literature, including the temporal dimension of those bus drivers, as expressed in Zimbardo's Time Perspective Inventory (ZTPI), for previous studies have shown that people more present time oriented revealed greater tendency to engage in risk driving. A questionnaire was applied to 457 bus drivers of the city of Natal, RN, Brazil, with questions about participants socio-demographic information, their professional performance and items on time perspective, presented in a five points Likert type scale. Among the indicators analyzed, the best predictors of traffic accidents were: worried about not being on schedule, family problems, and falling asleep; to work overtime, passengers complaints, work while on vacations and medical leaves. In regard to drivers' time perspective, the sub-scale of "combined present" showed a positive relationship with involvement in transit accidents, while the future scale a negative one, in both cases in accordance with the expect direction, even though the effects have not been statistically significant. The selected predictive variable indicate that traffic accidents are mainly associated to situational factors, that could be prevented through the betterment of work conditions of the bus drivers and other organizational and public policies, since transit accidents should be part of initiatives in the areas of health and safety

Os acidentes de trabalho e os valores humanos em operadores de uma fábrica de calçados

The study present analyzes the relation between work accident and human values. It was developed with the sample of 156 operators of a factory, through to an application of structured questionnaires. The data were submitted to quantitative analyses (for example, analyses of frequency distributions, Chi-Square, test t). It was verified that 27 employees that filled out the questionnaires suffered work accidents. The results evidence that there aren´t significant differences between the people s values that suffered work accidents and those that did not suffer. The employees presented a hierarchy of different values comparing with the others Brazilian studies. It was observed that the work accidents varies for organizational sectors. So, we get the conclusion, the occurrence of the work accidents is not associated to the values, but they are probably associated to work conditions

Percepção de cuidadores de crianças acerca da prevenção de acidentes domésticos infantis: análise à luz do modelo de crenças em saúde

This study aimed to analyze the perception of home caregivers of children from zero to five years-old on child domestic accidents and their influence in preventing these events. Exploratory and descriptive study with a qualitative approach, conducted with 20 caregivers attended at the Family Health Unit of Cidade Nova in Natal/Rio Grande do Norte, Brazil. The participants should have age less than 18 years-old, being a caregiver of at least a five year-old child and living in the area ascribed of Family Health Unit in the neighborhood Cidade Nova. Data collection occurred between March and April 2013 and a semistructured interview script was used. This stage was preceded by the acquiescence of the director of health institution where the research was developed, the Health Department of the Municipality of Natal as well as the Ethics Committee in Research of Universidade Federal do Rio Grande do Norte under Opinion nº 219 872 and CAAE nº 12236013.7.0000.5537. It is noted that respondents were asked to formal authorization by the Term of Consent. The data were treated according to the technique of the Collective Subject Discourse and analyzed based on three dimensions of the Health Belief Model, relating to perceptions of susceptibility to infant domestic accidents, self-efficacy to prevent infant and indicia domestic accidents for action of preventing domestic accidents in childhood. The results revealed that all the respondents were women, who, in their majority, they are mothers of the children they care, and predominantly they are aged between 18 and 30 years-old, full high school education and unemployed. Concerning the perception of susceptibility, it was unveiled understanding of deponents on various types of accidents, which are considered preventable. For this purpose, it was highlighted that the constant surveillance of the children is essential, keeping in view their high degree of curiosity and immaturity. On the perceived selfefficacy, the participants reported adopting preventive measures; however, they reported experiencing falls, burns, electric shocks and dog bites. In regard to the meaning attributed to experienced accidents they highlighted their feelings of guilt and despair, particularly about the cases understood as serious. Regarding the last dimension analyzed, related to indications for action, family, friends and television were the main source of information about household accidents and their prevention methods; however, health professionals were rarely cited as issuers of such knowledge. It is concluded that there is a widespread perception of women about prevention of domestic accidents and the weakness in the view of health professionals, including nurses, as disseminators of this information. This suggests the need to strengthen the dialogue on the issue and encouraging the participation of caregivers actively in the prevention of child domestic accidents

Avaliação do acesso aos serviços de reabilitação física para vítimas de acidentes de trânsito: caminhos para melhoria da qualidade do sistema de saúde

The Physical Rehabilitation services (PR) are of fundamental importance in combating the global epidemic of Traffic Accidents (TA). Considering the numerous physical and social consequences of the survivors, quality problems in access to PR are a hazard to recovery of victims. It is necessary to improve the management of quality of services, assessing priority dimensions and intervening in their causes, to ensure rehabilitation available in time and suitable conditions. This study aimed to identify barriers to access to rehabilitation considering the perception of TA victims and professionals. The aim is also to estimate the access to rehabilitation and their associated factors. This is a qualitative and quantitative study of exploratory nature developed in Natal / RN with semi-structured interviews with 19 health professionals and telephone survey to 155 victims of traffic accidents. To explore barriers to access the speeches were transcribed and analyzed using the Alceste software (version 4.9). During the interviews used the following guiding question: “What barriers hinder or prevent access to physical rehabilitation for victims of traffic accidents?”. The names of classes and axes resulting from Alceste was performed by ad hoc query to three external researchers with subsequent consensus of the most representative name of analysis. We conducted multivariate analysis of the influence of the variables of the accident, sociodemographic, clinical and assistance on access to rehabilitation. Associations with p <0.20 in the bivariate analysis were submitted to logistic regression, step by step, with p <0.05 and confidence interval (CI) of 95%. The main barriers identified were: “Bureaucratic regulation”, “Long time to start rehabilitation”, “No post-surgery referral” and “inefficiency of public services”. These barriers were divided into a theoretical model built from the cause-effect diagram, in which we observed that insufficient access to rehabilitation is the product of causes related to organizational structure, work processes, professional and patients. Was constructed two logistic regression models: “General access to rehabilitation” and “Access to rehabilitation to public service”. 51.6% of patients had access to rehabilitation, and 32.9% in public and 17.9% in the private sector. The regression model “General access to rehabilitation” included the variables Income (OR:3.7), Informal Employment (OR:0.11), Unemployment (OR:0.15), Perceived Need for PR (OR:10) and Referral (OR: 27.5). The model “Access to rehabilitation in the public service” was represented by the “Referral to Public Service” (OR: 23.0) and “Private Health Plan” (OR: 0.07). Despite the known influence of social determinants on access to health services, a situation difficult to control by the public administration, this study found that the organizational and bureaucratic procedures established in health care greatly determine access to rehabilitation. Access difficulties show the seriousness of the problem and the factors suggest the need for improvements in comprehensive care for TA survivors and avoid unnecessary prolongation of the suffering of the victims of this epidemic.

Acidentes por quedas em um grupo específico de idosos

Este estudo objetivou conhecer a incidência do evento queda e identificar a presença de seus principais fatores de risco. Estudo exploratório, realizado de março a novembro/2009, com aplicação de um formulário sobre quedas em um grupo de idosos. Os dados foram analisados por cálculo de frequências, média e desvio-padrão. Participaram 62 idosos, 41,9% relataram queda nos últimos seis meses, a maioria mulheres. Identificou-se ocorrência de agravos concomitantes: visão regular, audição boa, polifarmácia, IMC normal, forte força de preensão palmar e condições dos pés adequadas. Na maioria dos que caiu, o desequilíbrio foi apontado como principal motivo. A queda ocorreu mais no período da manhã, em local de piso áspero e seco, sem degraus, rampas ou tapetes, iluminação adequada e o tipo de calçado mais utilizado foi chinelo de borracha. Percebe-se a alta ocorrência das quedas na população idosa, fato que fundamenta a necessidade de avaliação das condições de risco envolvidas

Definições para o resultado de enfermagem comportamento de prevenção de quedas: uma revisão integrativa

Devido à necessidade de mensurar o risco de quedas em concordância à linguagem padronizada de enfermagem, foi selecionado o resultado de enfermagem Comportamento para Prevenção de Quedas da Nursing Outcomes Classification (NOC), com objetivo de identificar evidências sobre seus elementos, mensuração, comparação com indicadores existentes e construir definições constitutivas. Foi efetuada revisão integrativa entre abril e novembro de 2009, mediante identificação da questão, estabelecimento de critérios de inclusão/exclusão, extração das informações, avaliação, interpretação e síntese. Destacaram-se pesquisas transversais e perspectivas de especialistas. Os indicadores Uso de recursos de correção da visão e Uso de sapatos amarrados e do tamanho adequado foram considerados insuficientes para avaliar fatores de risco como déficits sensoriais e roupas/calçados inadequados. Percebe-se que algumas definições precisam ser melhor desenvolvidas e que esse resultado de enfermagem merece refinamento sobretudo referente aos indicadores. Foram identificados 22 indicadores e definições foram propostas baseadas nas evidências da literatura