Gestão ambiental na saúde pública: um estudo sobre a percepção ambiental de gerenciamento de resíduos sólidos de serviços de saúde, dos servidores do Hospital Universitário Onofre Lopes do Rio Grande do Norte

This research has aimed at studying the perception of University Hospital Onofre Lopes (HUOL) s workers on the environmental management plan of RSSS. They have been interviewed 250 workers: doctors, nurses, nursing assistants, and cleaners. It was used an exploratory and descriptive research of the type Survey, which aims at obtaining of data or information on characteristics, actions or opinions of any group of people. The questions of the questionnaire were of the kind objective", formulated in a model "scale", analyzed in according to the positioning of the interviewee. The wastes of health service have high potential for environmental impact in the activities from HUOL. Actions or environmental protective policy can improve the image of HUOL. They have been detected divergences on the rigor in application of law of ANVISA. The HUOL s workers unaware of the law of ANVISA and they have little or no knowledge about the practices of environmental control, public health and, they do not know the Environmental Management System ISO 14001. They have divergent views on the degree of importance of ISO 14001. There is not a Waste Management Plan for Health Service and / or is not disclosed for most of HUOL workers. It has not carried out audits or defined the goals and objectives. Besides, it has not been identified legal requirements, and there has not been communication about the service is performed or has been made a critical analysis and no control of documents the environmental management plan. The HUOL have not had a committee of environmental management. The direction of HUOL has not been organized courses, training and recycling of waste on environmental control of the health service. On a scale from 01 to 05, the level of aware level concerning to the waste management from health services of the workers, so is at the threshold between 01 and 02. For the reversal of this situation, the first and urgent step is the creation and institutionalization the environmental management committee of the University Hospital Onofre Lopes

A saúde ambiental e os resíduos de serviços de saúde nos três níveis de complexidade do Sistema Único de Saúde - SUS

The environmental management in the health establishments is a reality still little explored in the health sector in Brazil, especially concerning its wastes. The management of wastes of health services is established in the valid legislation through the National Council of Environment and Sanitary Vigilance Agency (358/2005 and 304/2004 respectively). The present work is about a descriptive work about the environmental health in the health services. The used criterion was to diagnose the environmental management in twelve establishments of health inserted in the three levels of complexity of the Unique Health System (Sistema Ùnico de Saúde SUS). Among the sub criteria used the waste management is the one of bigger concern. The one referring to the water quality is considered good. The analysis of data reveals that 66% of the establishments got a poor environmental ranking, 17% critical and 17% appropriate, showing that the health establishments in the three levels of complexity of the SUS need urgent structural, environmental and educational interventions

Diagnóstico sócio-produtivo-econômico da comunidade de catadores de resíduos sólidos do município de Codó-MA: um estudo de caso

The research was carried out in the urban area in Codó-MA, a small city the east part of Maranhão, which has 4,228.000 km2 (IBGE, 2000) and population of 113,768 hab. (IBGE, 2008). The city is also inside Codó-MA micro-region. The city is located in one of the lacking area in Brazil, where the Human Development Index (IDH) is approximately 0,558. It does not present an adequate model of management when talking about solid residue collecting. All of the solid residue produced and collected in the city is stored in an open area that they call lixão , which is located in a residence area in the suburbs. Because of that, a problem that involves public health and environmental areas, we understand it is necessary to investigate the way the local government treats and manages the solid residue collecting, as well as, the social, economical and productive reality of those who are directly involved in the collecting itself, its productive chain of the material, including the handling, transportation and its final destiny. It means a social, productive, economical diagnosis, that in a such way,the local society and the organs of inspection can act in a better way to control the problems that include solid urban residue and come from a bad administration. That way, this work proposes to carry out a study that has as result a diagnosis with feasible alternatives on management, taking as basis, social and economical aspects that compound this productive chain. This work can bring great contributions to a better local reality through the introduction of an integrated and supported system of management of solid residue that includes a selective collecting and the creation of a sanitary area. Taking that into consideration, we can contribute to minimize the environmental impacts in Codó Novo, caused by the garbage

Elaboração de um plano de gerenciamento integrado de resíduos sólidos no restaurante universitário da Universidade Federal do Rio Grande do Norte

The concern about preservation of the environment reaches different layers and sections of global society. The environmental prior quality of our planet can only be reached through changes in the attitudes taken in relation due to the waste generated by society, this also lead involving the education sector, in example of the Superior Education Institutions where the concept of ambiental management needs to gain a growing space.In the Federal University of Rio Grande do Norte, can be found the Universitary Restaurant as an example of a Food and Nutrition Unit, it is a restaurant destined to provide services to the academic comunity with the production and distribution of meals. In this operational context the work itself aims subsidies and funds to the search of as minimal generation of residues as possible, applying environmentally correct processes and practices. The work was developed in the period of September to October of 2009 in the Universitary Campus of Federal University of Rio Grande do Norte, in the Universitary Restaurant of the referred institution. The project involved all the employees of the restaurant and used like method the action survey. The produced waste was characterized, arranged according with it s nature (organic or inorganic) classificated following the NBR ISO 14004, adapted by Kinasz (2004) that adjusts the Standards to the specific reality of Food and Nutrition Services being diagnosed an expressive amount of produced waste in the Universitary Restaurant, it can be assured that a culture of wasting is very present and exists, contributing to the rise of solid residues, damaging the environment and consequently reflecting in the costs and expenses of the Unity, a known fact that characterizes and justifies the need of a promoting and active action that leads to positive reflexes in the economic and environmental area, drafting a Plan for Integrate Management of Solid Residues on the Universitary Restaurant of Federal University of Rio Grande do Norte

A incorporação de preceitos ambientais no sistema de gestão de resíduos sólidos do município de João Câmara - RN Brasil

The reality points to the global environmental sustainability as the only viable option for addressing the crisis at hand. The move towards sustainability calls for the generation / evaluation systems in their direction, through the incorporation of environmental requirements and in line with the National Policy on Solid Waste. Therefore, the proposed research supports the importance of social and environmental vision, complementing the technical view, the system for management of solid waste from East London, which is a municipality that has a system whose inadequacies are configured in environmental risk and health. Therefore, by observing, applying the model of sustainability indicators and content analysis of interviews, this research proposes to investigate the principles of sustainability and social participation are presented and what is the perception of risk about the inadequacies in the system. The results confirmed the hypotheses of the study and draw a picture of worrying data, such as very unfavorable indicators of sustainability, lack of channels of participation, uncommitted investments with the management system, devaluation of the collector of waste and differing perceptions about the risk by making actors act in isolation. This worrying situation is eased by the appearance of a series of elements are configured as opportunities for the integration of environmental principles in the system. And despite the inability of managers to participate in the research system, yet it behaves as an opportunity to implement public policies in the area of solid waste such as: the preparation of the municipal waste, the institutionalization of selective collection and organization of cooperative with the support of companies present in the city and educational institutions as the Federal Institute. The research is an opportunity for the implementation of policies in the area of solid waste and will collaborate with the building instruments for the quality of life of residents, for the socioeconomic conditions of collectors and the move towards a sustainable society

Similitudes na gestão dos resíduos sólidos urbanos em países centrais e periféricos

A emergência na necessidade de se manejar os resíduos sólidos urbanos leva as administrações públicas em países centrais e periféricos a utilizarem modelos de gestão de resíduos bastante similares. A gestão dos resíduos nos países centrais é caracterizada pela eficiência na execução dos serviços (limpeza, coleta, transporte e destino final), uso de aparatos tecnológicos na execução de ditos serviços e forte tradição na separação dos materiais recicláveis a ser destinados para a reciclagem. Nos países periféricos, a gestão tradicional (coletar e descartar resíduos em lixões à céu aberto) vem sendo substituída pela gestão moderna, sobressaindo-se o controle dos resíduos em detrimento das estratégias de prevenção. Também, destaca-se a presença de trabalhadores informais que coletam e separam materiais, destinando-os à reciclagem. A partir do levantamento à referência bibliográfica especializada e na consulta a documentos oficiais e produzidos por entidades diversas, o presente artigo analisa as similitudes na gestão dos resíduos sólidos em países centrais e periféricos. A busca pela modernização nos serviços dos resíduos sem levar em conta as recomendações de documentos como a Agenda 21 caracteriza a gestão dos resíduos em países centrais e periféricos pelo ambientalismo econômico, no qual as ações de controle dos resíduos são justificadas pelos aspectos ambientais e sociais dessa gestão

Gestão de resíduos sólidos domiciliares na cidade de Chibuto, província de Gaza Moçambique

This study analyzes the process of generation and management of solid waste in the Municipality of the City of Chibuto-Mozambique, drawing on the different approaches towards allocation and the socio-environmental implications resulting from this process and waste spatial distribution. To answer these objectives a questionnaire was administered to 367 households distributed in 14 neighborhoods of the city to elicit information on how solid waste is treated and what could be its impact on public health of the residents. From this perspective, the questionnaire gasp information from immigrant residents regarding both their origin, and socio economic condition. Apart from the questionnaire, semi-structured interviews were conducted to staff working on the Sanitation Sector, Urbanization Sector of the Chibuto Municipality, including the Health Service, and Women and Social Affairs. In addition to these data collection methods, for further discussion on the subject, the researcher draw a theoretical framework grounded through literature review, as well as systematic observation of the phenomenon. Research findings revealed that the solid waste collection services provided by the Chibuto Municipality do not follow the procedures laid down in the Regulation on Solid Waste Management, which advocates environmentally safe, sustainable, and complete management of waste. First, the services use open dumps for waste management. Secondly, waste collection does not cover all citizens living in the neighborhoods governed by the municipality, due to financial, technical, and organizational reasons. More importantly, the study found that due to this failure, more than 90% of households surveyed continue to use the traditional methods on waste management which include burning, or the burial techniques. On the other hand, some citizens throw waste on the streets, a method that threatens public health because it increases cases of diseases related to sanitation problems such as (diarrhea and malaria), especially in suburban and peripheral urban areas. Concerning with the above mentioned problems which constitute a real threat to the public health, some ways are proposed for more sustainable and spatially appropriate solid waste management through recycling, waste sorting, composting, reuse, and reduction of solid waste generation.

Inclusão social de catadores de materiais recicláveis: estudo da política nacional de resíduos sólidos e da efetivação do trabalho decente em Natal/RN

The integrated management of municipal solid waste in Brazil is held legally responsible by the city council administration. This is done since the year 2010 with the publication of the National Solid Waste Policy term. According to the policy and law, each city must encourage the implementation of selective collection and the participation of waste picker´s entities aiming social inclusion. However, these actions haven’t yet reached its legal aims. These workers are considered regarding collection actions but are stripped of certain basic labor rights not in conformation with the Decent Work concept. This type of work, according to International Labour Organization, must be seen as work that is properly paid for and must be done regarding conditions of freedom, equity, security and able to provide workers with a dignified life conditions. Thus, this work aims to investigate the implementation process regarding the Solid Waste National Policy in Natal-Rio Grande do Norte in Brazil. This is done considering socio-productive insertion of recyclable material collectors. The research is substantiated by a qualitative approach as well as documental and bibliographical research. A field research considering the cooperatives as well “in locco" observation and semi-structured interviews were carried out between the time span of 2013 and 2014. In order to investigate decent daily working conditions the research emphasized municipal management actions in Natal towards social inclusion that aim to reflect on the progress and difficulties experimented. It is seen that even when these cooperatives receive government support there are still important struggles that need to be overcome. The worker´s tasks are risky, the work environment in not safe or is adequate in terms of health issues. There is the stigma of it being considered an occupational task, the low individual income distancing the activity regarding parameters of the Green Employment and Decent Work concept. On the other hand, the survey showed potential as the relentless pursuit on behalf of the cooperatives that still search better work condition improvement.

Contaminação ambiental e exploração capitalista ao meio ambiente: os resíduos sólidos na sociedade global

O mundo atual passa por uma crise ambiental sem precedentes na história, o que resulta em conseqüências ambientais perceptíveis e preocupantes. Governos e organizações internacionais têm dado maior relevância à variável ambiental como um dos principais eixos de definição das políticas de crescimento/desenvolvimento econômico, como o intuito de adequar as demandas sociais aos limites naturais. Como consequências dessa forma perdulária de produção e consumo da sociedade global temos a contaminação ambiental ampliada e diversificada. O presente artigo discute a acumulação capitalista no setor dos resíduos sólidos, partindo da hipótese da impossibilidade de se diminuir a geração ampliada dos resíduos, sendo necessário que se crie estratégias de gestão e tratamento para os resíduos baseados na atividade da reciclagem dos materiais. A parte final expõe os paradigmas da questão dos resíduos sólidos na sociedade global.

Saúde da família: uma estratégia de mudança no processo de produção dos serviços de saúde

The purpose of this study is to analyze, from the point of view of nurses, changes that took place in the process of providing health services after the introduction of the Family Health Program (FHP). It is na investigation of qualitative nature that uses semi-structured interviews as a main empirical approach tool. Six nurses from the city of Caicó, Rio Grande do Norte, who were working with basic care before the introduction of the FHP, within basic care, were: adscription and ties with the community; hospitality and the humanizacion of care-giving; decrease in cases of inpatient treatment; strengthening of the prevention of injuries and health promotion; improvemente of health indicatiors, finally, actions that point towads meeting the principles of wholeness, equity and universality as a declaration of the Brazilian National Health Care System (SUS). Nevertheless, in spite of all recognizable positive aspects, the FHP has some weaknesses, such as: the difficulty posed by colletive work; the mismatch between professional education and the demands of the current health standard; a poor physical infrastructure of the Basic Health Units; a high heath staff turnover and precarious work conditions. In addition to this, some strategies that can be used to help improve the process of providing health services have been pointed out, such as, coordination between sectors, continuous education, making work conditions less precarious and improving the means whereby heathy service management is conveyed,Tthus, finally, we understand that the FHP does bring forward meaningful changes to the process of provinding health services to strengthen the Brasilian National Health Care System (SUS), in spite of the fact that it lies within a scenario of adversities that can be overcome through the collective endeavor of the several social actors

Diagnóstico e avaliação das áreas de destino final dos resíduos sólidos urbanos no estado do rio grande do norte

This work aims to present the diagnosis and the evaluation of areas of final destination of urban solid waste in Rio Grande do Norte (RN) state. The survey was based on the experience of the State of São Paulo, which made its first inventory in 1997, through its Companhia de Tecnologia de Saneamento Ambiental CETESB. The methodology for the structuring of diagnosis was the Índice de Qualidade de Aterros de Resíduo -- IQR, developed by the Institute for Technological Research of São Paulo (ITRP). The calculation is based on the completion of a matrix that contains information about the main features of the site, infrastructure and operating conditions of the area of waste disposal. This study intends to subsidize the state government of Rio Grande do Norte through its State Secretariat of Environment and Water Resources and the Instituto de Desenvolvimento Sustentável e Meio Ambiente do RN (IDEMA), as well as federal, state and municipal authorities, in the definition of public policies for integrated management of municipal solid wastes to take account of environmental preservation and improvement of sanitary conditions of Natal-RN population.

Diagnóstico Socioambiental da disposição final dos resíduos sólidos no distrito de Guajiru São Gonçalo do Amarante/RN, ressaltando a situação socioeconômica dos catadores

One of the concerns of this century is with the handling and the final destination of urban solid waste (RSU), where depending on the form as they will be made use, they can cause diverse problems, they are of ambient or social order, being able to generate the loss of the quality of life and illnesses to the population, of direct or indirect form. The objective of the present work was to diagnosis the environmental partner situation of the Final Destination of the urban solid residues in the District of Guajiru, city of São Gonçalo do Amarante/RN, standing out the partner-economic situation of the scavengers. The research was carried through in the period of March of 2008 the October of 2009, with a methodology developed through analyzes them of documents made available for the state ambient agency, the Air base of Christmas and managing agencies of the city. For collection of the date, it was used directly application of the questionnaire with 20 existing scavengers in points of destination of residues, evaluation of the old place of final destination through the use of the spread sheet of the IQR (Index of Quality of the Residues), developed for the CETESB, identification of the matter dump and photographic register. For effect of treatment of the data, a descriptive analysis with regard to the answers of the interviewed scavengers was carried through. The acquired date, Scale had been according to tabulated and analyzed in Excel 2003, where they had been generated graphical to observe the behavior of the data. The results show that of the twenty interviewed scavengers, 35% possess age between 20 and 30 years; 75% possess incomplete basic education; 60% inhabit in houses of waal or huts (cardboard or wood); 55% do not make use of system of water supply and system of sanitary exhaustion; with regard to income monthly for scavengers, 35% had presented income between R$ 200,00 and R$300,00 and 20% possess income above of R$ 500,00 for possessing another source of income; 80% of the interviewed ones, use some type of equipment of individual protection; In the year of 2009, confirming what it was informed by the State agency of Environment, during the field visit, we evidence that the city of Is Gonçalo do Amarante, currently, destines its residues in Sanitary landfill of São Region Metropolitan of Natal in the District of Massaranduba in the city of Ceará-Mirim, after some interventions of the State Public prosecution service. However, in the district of Guajiru some diggings still exist that today are used as final destination of RCD' s (Residues of Construction and Demolition) of the cities of Natal and São Gonçalo do Amarante, as well as private dumps that are used by scavengers that deviate the final destination (Sanitary landfill) of the residues of the great generators (supermarkets, shopping Center and hotels), with presence of urubus, generating a new ambient problem for the city and the aeroportuária security. Ahead of this scene, the study it suggests viable alternatives for the elimination of the private dumps and for the social situation of the escavengers, aiming at to improve its quality of life and 10 to minimize the ambient impacts caused by the inadequate destination of the solid waste in the community of Guajiru, São Gonçalo do Amarante/RN, being able to contribute so that the public managers carry through action in the handling and the control of the final destination of the urban solid waste

Gestão dos resíduos sólidos das contruções prediais na cidade do Natal-RN

The present work has the objective of presenting an investigation about the quantification, classification and destination of the waste of construction and demolition (RCD) in the city of Natal - RN, focusing the aspects of the environmental impacts and the strategic importance of the environmental administration in the earnings of productivity of the companies. Of the environmental point of view the research intends to identify and to quantify the monthly and annual production of RCD in the city, as well as to know the places of deposition of those residues. To reach the objectives of the study, an exploratory and descriptive research was accomplished, using a questionnaire with closed subjects and an open one, applied in 25 entrepreneurs of the branch of the building site, being 21 builders and 4 entrepreneurs of collection companies and removal dumps. As form of analysis of the data, the descriptive analysis was used and of crossing. The production engineering considers important the insert of best production practices and administration of the product in the companies, with views to the increase of your competitiveness, productivity earnings and improvement of the environmental aspects with views to the consumer's satisfaction, in that case the buyer of immobile. The principal results of the investigation demonstrate that there was not great variability of answers with relationship to the interviewees opinion in what he refers to the environmental practices. In your majority the building site interviewees entrepreneurs evidenced the absence of the public power, particularly the city hall of Natal, in the control, fiscalization and creation of mechanisms for a correct destination of RCD, as well as for your reuse and recycle. On the other hand also it was evident that the recycle or the reuse of RCD on the part of the companies is a rare practice and a lot of times inexistent, although the entrepreneurs' of the building site section great majority recognizes that would have won of productivity with the correct and intensive use of such measures

Fatores que afetam a satisfação de pacientes em serviços de saúde :um estudo em setor ambulatorial de hospital

This thesis shows concepts and models related to customer satisfaction measurement, focusing in detail on patients satisfaction evaluations in a policlinic sector of a hospital located in Natal RN. To reach this aim, two hundred and fifty one patients of this hospital were interviewed. The methodology approach includes a theoretical basis through a review and study of previous research on the topic, governmental initiatives and management systems which deal with excellence and need more reports concerning customers perceptions about satisfaction. Furthermore, it was included some models of nationals index about customer satisfaction. The Norwegian model was used in this thesis. The use of this approache, together with a multiple regression analysis, led to results that shows the factors which affect patients satisfaction in a policlinic sector. They are four as following: The evaluation of physician attendance; its results; simplicity of accessibility when health services are needed; and both support and tranquility given by the hospital. The study results can support researches of a conceptual model to determinate the aspects which affect the patient s satisfaction and could be a contribution to a development of a national costumer satisfaction index

Gerenciamento de resíduos sólidos recicláveis: estudo de caso das cooperativas do município de Natal/RN

This dissertation conducted in the years 2011 and 2012, an analysis of cooperatives waste pickers in the city of Natal, Rio Grande do Norte, aiming to identify improvements to be implemented to assist the management of waste from the municipality as well as to improve the living conditions of the workers who perform the selective collection, the environmental perspective. This analysis was performed by means of an investigation of the reality in which they live cooperatives and their local representation, using also the law. The research is characterized as a case study of an applied nature, documentary, consultations with the institutions related to the issue of solid waste in the national and local levels; exploratory and descriptive, the main methodological tools technical visits and structured interviews. From these methods was possible to obtain data regarding the organization of cooperatives, environmental perception of the collector of recyclable materials, among other issues. For the analysis of data matrices were used to include comments and method GUT, from which it was possible to identify numerous difficulties faced by recycling cooperatives, and develop proposals for possible improvements in various aspects of their operation, such as infrastructure and production process , which can improve both the waste management and the quality of life of workers involved in the selective collection system city