Os acidentes humanos e suas implicações fonoaudiológicas: opiniões de docentes e discentes sobre a formação superior

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Skin lesions in envenoming by cnidarians (Portuguese man-of-war and jellyfish): etiology and severity of accidents on the Brazilian coast

This work attempts to establish dermatological identification patterns for Brazilian enidarian species and it probable correlation with envenoming, severity In all observational prospective study, one hundred and twenty-eight patients from the North Coast re-ion of São Paulo State, Brazil were seen between 2002 and 2008. About 80% of these Showed only local effects (erythema, edema, and pain) with small, less than 20 cm, oval or round skin marks and impressions from Small tentacles. Approximately 20% of the victims had long, more than 20 cm, linear and crossed marks with frequent systemic phenomena, such as malaise, vomiting, dyspnea, and tachycardia. The former is compatible with the common hydromedusa from Southeast and Southern Brazil (Olindias sambaquiensis). The long linear marks with intense pain and systemic phenomena are compatible with envenoming, by the box jellyfish Tamoya haplonema and Chiropsalmus quadrumanus and the hydrozoan Portuguese man-of-war (Physalis physalis). There was an association between Skin marks and probable accident etiology. This simple observation rule can be indicative of severity as the Cubozoa Class (box jellyfish) and Portuguese man-of-war cause the most severe accidents. In such cases, medical attention, including intensive care, is important, as the systemic manifestations call be associated with death.

Acidente com material perfurocortante entre profissionais de enfermagem de um hospital universitário

Os riscos ocupacionais a que os profissionais da equipe de enfermagem estão sujeitos no desempenho de suas funções são consideráveis. Assim estabeleceu-se como objetivo deste estudo analisar os acidentes perfurocortantes no período de 2002 a 2006, envolvendo a equipe de enfermagem de um hospital universitário, para compreender o contexto em que ocorrem. A utilização destas informações pode ser ferramenta de prevenção. Estudo descritivo, retrospectivo quantitativo e qualitativo. Na análise quantitativa foi utilizada estatística descritiva e na qualitativa o discurso do sujeito coletivo. Por meio das fichas de notificação do Núcleo de Vigilância Epidemiológica do Hospital, foi possível identificar acidentes do gênero no período pesquisado. Entrevistas foram direcionadas às vítimas de acidentes que tiveram como paciente-fonte portador de Síndrome da Imunodeficiência Adquirida/ Vírus da Imunodeficiência Humana, hepatite B e C. Os achados demonstraram que ainda persiste um grau significativo do desconhecimento ou banalização dos acidentes entre profissionais da saúde.

The HUman MicroNucleus project on eXfoLiated buccal cells (HUMNXL): The role of life-style, host factors, occupational exposures, health status, and assay protocol

The human buccal micronucleus cytome assay (BMCyt) is one of the most widely used techniques to measure genetic damage in human population studies. Reducing protocol variability, assessing the role of confounders, and estimating a range of reference values are research priorities that will be addressed by the HUMNXL, collaborative study. The HUMNXL, project evaluates the impact of host factors, occupation, life-style, disease status, and protocol features on the occurrence of MN in exfoliated buccal cells. In addition, the study will provide a range of reference values for all cytome endpoints. A database of 5424 subjects with buccal MN values obtained from 30 laboratories worldwide was compiled and analyzed to investigate the influence of several conditions affecting MN frequency. Random effects models were mostly used to investigate MN predictors. The estimated spontaneous MN frequency was 0.74 parts per thousand (95% CI 0.52-1.05). Only staining among technical features influenced MN frequency, with an abnormal increase for non-DNA-specific stains. No effect of gender was evident, while the trend for age was highly significant (p < 0.001). Most occupational exposures and a diagnosis of cancer significantly increased MN and other endpoints frequencies. MN frequency increased in heavy smoking (>= 40 cig/day. FR = 1.37:95% CI 1.03-.82) and decreased with daily fruit consumption (FR = 0.68; 95% CI 0.50-0.91). The results of the HUMNXL, project identified priorities for validation studies, increased the basic knowledge of the assay, and contributed to the creation of a laboratory network which in perspective may allow the evaluation of disease risk associated with MN frequency. (C) 2011 Elsevier B.V. All rights reserved.

Association between distressing non-work-related events and occupational injuries

The following is a report on a case-control study whose objective was to investigate the association between distressing non-work-related events and occupational injures. Ninety three injured workers (cases) were matched with 372 non-injured controls in a large metallurgical factory in southeastern Brazil. Exposure to distressing non-work-related events was measured through a questionnaire focusing on situations pertaining to personal problems unrelated to work activities. The data were analyzed by adjusting a conditional logistic regression model, where occurrence of the work injury was the dependent dichotomous variable and answers from the questionnaire were independent continuous variables. The analysis showed an association between some distressing non-work-related events and occupational injuries. These findings imply expanding the horizon of preventive measures used in targeting. work injuries which have traditionally been focused on the control of strictly workplace risks.

Estudo da evolução dos acidentes do trabalho registrados pela Previdência Social no período de 1995 a 1999, em Botucatu, São Paulo

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Trajetória da análise de acidentes: o paradigma tradicional e os primórdios da ampliação da análise

A abordagem tradicional de acidentes pressupõe que a obediência a procedimentos e normas protege o sistema contra acidentes e que esses eventos decorrem de comportamentos faltosos dos trabalhadores, originados, em parte, de aspectos de suas personalidades. A identificação desses comportamentos baseia-se em comparação com o padrão que toma por base o jeito seguro de fazer, conhecido por antecipação pelos especialistas em segurança. Nas últimas décadas, surgem visões alternativas à abordagem tradicional, ampliando o perímetro das análises de acidentes e abrindo caminho para questionamentos de seus pressupostos relativos às concepções de ser humano e de trabalho. Os novos enfoques ajudam a evidenciar os resultados estéreis das práticas tradicionais: culpar e punir as vítimas, recomendar treinamentos e normas mantendo inalterados os sistemas em que ocorreram os acidentes. As novas abordagens sugerem o esgotamento do enfoque tradicional e ressaltam a importância da contribuição dos operadores para a segurança dos sistemas.

Novas tecnologias e saúde do trabalhador: a mecanização do corte da cana-de-açúcar

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Mortality rate in children caused by traffic accidents according to geographical regions : Brazil, 1997 - 2005

Lesões fatais em crianças causadas por acidentes de trânsito representam um problema em muitos países. Este estudo analisou a taxa de mortalidade em crianças passageiras de automóveis menores de 10 anos de idade no Brasil, entre 1997 e 2005. Para isso, o número de mortes foi obtido diretamente no banco de dados do Sistema de Informação sobre Mortalidade (SIM) e os dados da população são projeções intercensitárias a partir censo demográfico do Instituto Brasileiro de Geografia e Estatística (IBGE) disponíveis pelo site do DATASUS. Foram calculadas, para os triênios compreendidos no período em estudo, as taxas de mortalidade por acidente de trânsito entre crianças passageiras de automóveis segundo faixa etária (menor que 1 ano, 1 a 4 e 5 a 9) e região geográfica. Os resultados mostraram taxas de mortalidade de 5,68, 7,32 e 6,78 (por 1.000.000), respectivamente, para os períodos 1997-1999, 2000-2002 e 2003-2005 para todo o Brasil. Crianças menores de 1 ano de idade apresentam taxa de mortalidade de 10,18 (por 1,000,000), maior que as observadas para as outras faixas etárias. Para o período 1997-2005, as maiores taxas foram observadas nas regiões Centro-Oeste e Sul, representando, respectivamente, 13,88 e 11,47 (por 1.000.000). Tais resultados mostram a situação de risco da criança em relação a acidentes de trânsito como passageiras de automóveis e contribuem para a elaboração de campanhas educativas de prevenção de lesões.

Venomous mollusks: the risks of human accidents by conus snails (gastropoda: conidae) in Brazil

Os moluscos do gênero Conus apresentam um aparato venenoso composto de uma rádula quitinosa ligada a glândulas de peçonha, causando envenenamentos humanos graves e mesmo óbitos pela ação neurotóxica indutora do bloqueio de vários receptores e paralisia muscular. Não há casos descritos de envenenamento no país, mas determinadas populações correm risco de acidentes.

Anthropotechnological analysis of industrial accidents in Brazil

The Brazilian Ministry of Labour has been attempting to modify the norms used to analyse industrial accidents in the country. For this purpose, in 1994 it tried to make compulsory use of the causal tree approach to accident analysis, an approach developed in France during the 1970s,without having previously determined whether it is suitable for use under the industrial safety conditions that prevail in most Brazilian firms. In addition, apposition from Brazilian employers has blocked the proposed changes to the norms. The present study employed anthropotechnology to analyse experimental application of the causal tree method to work-related accidents in industrial firms in the region of Botucatu, São Paulo. Three work-related accidents were examined in three industrial firms representative of local, national and multinational companies. on the basis of the accidents analysed in this study, the rationale for the use of the causal tree method in Brazil can be summarized for each type of firm as follows:the method is redundant if there is a predominance of the type of risk whose elimination or neutralization requires adoption of conventional industrial safety measures (firm representative of local enterprises); the method is worth while if the company's specific technical risks have already largely been eliminated (firm representative of national enterprises); and the method is particularly appropriate if the firm has a good safety record and the causes of accidents are primarily related to industrial organization and management (multinational enterprise).

Forum: social network for the surveillance and prevention of workplace accidents

In 2008, academic researchers and public service officials created a university extension studies platform based on online and on-site meetings denominated "Work-Related Accidents Forum: Analysis, Prevention, and Other Relevant Aspects. Its aim was to help public agents and social partners to propagate a systemic approach that would be helpful in the surveillance and prevention of work-related accidents. This article describes and analyses such a platform. Online access is free and structured to: support dissemination of updated concepts; support on-site meetings and capacity to build educational activities; and keep a permanent space for debate among the registered participants. The desired result is the propagation of a social-technical-systemic view of work-related accidents that replaces the current traditional view that emphasizes human error and results in blaming the victims. The Forum uses an educational approach known as permanent health education, which is based on the experience and needs of workers and encourages debate among participants. The forum adopts a problematizing pedagogy that starts from the requirements and experiences of the social actors and stimulates support and discussions among them in line with an ongoing health educational approach. The current challenge is to turn the platform into a social networking website in order to broaden its links with society.

Sleep apnea and automobile accidents: Review of regulation for drivers

Several studies show a crescent association between sleep-disordered breathing, excessive sleepiness and automobile accidents. Many countries already discussed about specific regulations for drivers with these conditions, including questionnaire and/or investigation by a qualified specialist. In Brazil, these discussions have barely begun. In view of that, we suggest some items to be included in our traffic law.

Subnotificação de acidentes do trabalho não fatais em Botucatu, SP, 2002

Objective: The implementation of work-related injury prevention policies has been hindered by underreporting of incidents among formal workers, and substantial underreporting among informal workforce. This study aimed at estimating the underreporting of work-related injury in a median-sized city. Methods: A random survey was carried out among residences in the urban area of Brazil. Residents were interviewed about the occurrence of work-related injury to people aged more than nine years in the last 90 days. All incidents reported were double checked in the National Social Security Institute (INSS) records. Results: There were 9,626 residences visited. It was estimated 79.5% (CI 95%: 78.8%-80.3%) of underreporting of work-related injury. Conclusions: Work-related injury reporting is poor in the study location and this may be occurring in other cities. Data suggest the need to build up information systems on Brazilian workers' health. It should incorporate methods, materials and human recourses necessary to recognize, store, analyze, and spread information support injury prevention policies and promote workers' health programs.

Occupational exposure to paint solvents and particulate material in car repair shops

Aims: We evaluated solvents and total particulates exposures in auto body repair shops together with a search of painter's related complaints. Methods: 26 painters exposures were evaluated by pumped personal sampling; solvents were retained in charcoal sorbent tubes and the particulates in PVC filters. Painter's personal habits and their work characteristics were obtained through a questionnaire, applied in a private interview. For the symptoms the Q16 questionnaire was used, added of questions about complaints during the painting. Results: High exposures were detected during spray painting. For solvents, the TLV-STEL adjusted for the mixtures was surpassed in six evaluations. However, as repaint is a short-term operation, it makes the average concentrations weighed for the work shift lower than the TLV-TWA adjusted for the mixtures. Total particulate concentrations had surpassed the TLV-TWA in four of the evaluations. Symptoms frequency in the Q16 questionnaire was higher for painters than for the controls (Mann-Whitney test U=193; p=0.008), and they showed positive correlations with the age (Spearman r=0.354, t=1.85, p=0.076), the number of years in the profession (Spearman r=0.433, t=2.35, p=0.027) and the alcoholic beverage consumption (Spearman r=0.457, t=2.516, p=0.019). Conclusions: The painting work done at car repair shops can result in high solvent and particulate exposures, although they are short-term operations. Their acute and chronic effects for the painters do not have been clearly evidenced in the present study, continuing deserving multidisciplinary attention.