Características e fatores associados às quedas atendidas em serviços de emergência

OBJETIVO: Analisar as características dos atendimentos decorrentes de quedas em serviços de urgência e emergência e identificar fatores associados. MÉTODOS: Estudo transversal com 12.617 atendimentos decorrentes de quedas registrados no Sistema de Vigilância de Violências e Acidentes, coletados em 23 capitais e Distrito Federal, de setembro a novembro de 2009, por meio de uma amostra por conglomerado. Foi utilizada a técnica de análise de correspondência, por permitir a observação conjunta de um grande número de variáveis qualitativas. RESULTADOS: A maior parte das vítimas foi do sexo masculino (56,5%), faixa etária de 0 a 19 anos (45,7%) e declarados não brancos (62,2%). A maioria das quedas ocorreu na residência (54,6%) e via pública (17,4%); 14,3% foram relacionadas ao trabalho. Os tipos predominantes foram "queda no mesmo nível" (57,0%) e "queda de escada/degrau" (15,6%). A maioria das lesões foi classificada como entorse, luxação, contusão, corte e laceração (68,3%). Quedas dentre as crianças associaram-se à ocorrência na residência; com os adolescentes na escola; e jovens na prática esportiva. Quedas em adultos estiveram associadas ao local de trabalho, queda de andaimes, telhados, escada/degrau e buracos e uso de álcool. As quedas no mesmo nível resultaram em lesões de menor gravidade, em membros inferiores e superiores, e as quedas de andaime e telhado se associaram com lesões de maior gravidade e internações. CONCLUSÕES: Os resultados mostram que estratégias para a prevenção das quedas devem ser implantadas particularmente em residências, escolas e ambientes de trabalho.

Atendimentos decorrentes de queimaduras em serviços públicos de emergência no Brasil, 2009

O objetivo foi analisar os atendimentos por queimaduras em serviços de emergência, e fatores associados. Estudo transversal de 761 atendimentos coletados pelo Sistema de Vigilância de Violências e Acidentes em 2009. A maioria foi do sexo masculino (58,6%); adultos de 30 a 49 anos (23,1%) e crianças de 0 a 9 anos (23%). A residência foi o local de ocorrência mais frequente (62,1%), especialmente para crianças e mulheres; em seguida comércio, serviços, indústria e construção (19,1%), especialmente entre homens de 20 a 49 anos. Queimaduras no trabalho foram 29,1% do total. Uso de álcool chegou a 5,1%. Agentes causadores em todas as idades: substância quente (43,6%) e fogo/chama (24,2%); na faixa produtiva: substâncias químicas. As queimaduras entre 0 e 14 anos foram associadas com residência, substância e objeto quente e internação hospitalar; entre os de 15 a 49 anos associaram-se com fogo/chama e choque elétrico, via pública e alta da emergência. Estratégias de prevenção para crianças e trabalhadores devem ser implantadas.

Representations of workplace psychological harassment in print news media

OBJECTIVE: To analyze discourses on workplace psychological harassment in print media. METHODOLOGICAL PROCEDURES: Documental study on workplace psychological harassment that analyzed news stories published in three major newspapers of the State of Sao Paulo (southeastern Brazil) between 1990 and 2008. Discourse analysis was performed to identify discursive practices that reflect the phenomenon of psychological harassment in today's society, explanations for its occurrence and impact on workers' health. RESULT ANALYSIS: This theme emerged in the media through the dissemination of books, academic research production and laws. It was initially published in general news then in jobs and/or business sections. Discourses on compensation and precautionary business practices and coping strategies are widespread. Health-related aspects are foregone under the prevailing money-based rationale. Corporate cultures are permissive regarding psychological harassment and conflicts are escalated while working to achieve goals and results. Indifference, embarrassment, ridicule and demean were common in the news stories analyzed. CONCLUSIONS: The causal explanations of workplace harassment tend to have a psychological interpretation with emphasis on individual and behavioral characteristics, and minimizing a collective approach. The discourses analyzed trivialized harassment by creating caricatures of the actors involved. People apprehend its psychological content and stigmatization which contributes to making workplace harassment an accepted practice and trivializing work-related violence.

Health and fitness benefits of a resistance training intervention performed in the workplace

Zavanela, PM, Crewther, BT, Lodo, L, Florindo, AA, Miyabara, EH, and Aoki, MS. Health and fitness benefits of a resistance training intervention performed in the workplace. J Strength Cond Res 26(3): 811-817, 2012-This study examined the effects of a workplace-based resistance training intervention on different health-, fitness-, and work-related measures in untrained men (bus drivers). The subjects were recruited from a bus company and divided into a training (n = 48) and control (n = 48) groups after initial prescreening. The training group performed a 24-week resistance training program, whereas the control group maintained their normal daily activities. Each group was assessed for body composition, blood pressure (BP), pain incidence, muscular endurance, and flexibility before and after the 24-week period. Work absenteeism was also recorded during this period and after a 12-week follow-up phase. In general, no body composition changes were identified in either group. In the training group, a significant reduction in BP and pain incidence, along with improvements in muscle endurance and flexibility were seen after 24 weeks (p < 0.05). There were no changes in these parameters in the control group, and the between-group differences were all significant (p < 0.05). A reduction in worker absenteeism rate was also noted in the training (vs. control) group during both the interventional and follow-up periods (p < 0.05). In conclusion, it was found that a periodized resistance training intervention performed within the workplace improved different aspects of health and fitness in untrained men, thereby potentially providing other work-related benefits. Thus, both employers and employees may benefit from the setup, promotion, and support of a work-based physical activity program involving resistance training.

Analysis of kinematic, kinetic and electromyographic patterns during root canal preparation with rotary and manual instruments

Objective: This study assessed the muscular activity during root canal preparation through kinematics, kinetics, and electromyography (EMG). Material and Methods: The operators prepared one canal with RaCe rotary instruments and another with Flexofiles. The kinematics of the major joints was reconstructed using an optoelectronic system and electromyographic responses of the flexor carpi radial's, extensor carpi radialis, brachioradialis, biceps brachii, triceps brachii, middle deltoid, and upper trapezius were recorded. The joint torques of the shoulder, elbow and wrist were calculated using inverse dynamics. In the kinematic analysis, angular movements of the wrist and elbow were classified as low risk factors for work-related musculoskeletal disorders. With respect to the shoulder, the classification was medium-risk. Results: There was no significant difference revealed by the kinetic reports. The EMG results showed that for the middle deltoid and upper trapezius the rotary instrumentation elicited higher values. The flexor carpi radialis and extensor carpi radialis, as well as the brachioradialis showed a higher value with the manual method. Conclusion: The muscular recruitment for accomplishment of articular movements for root canal preparation with either the rotary or manual techniques is distinct. Nevertheless, the rotary instrument presented less difficulty in the generation of the joint torque in each articulation, thus, presenting a greater uniformity of joint torques.

Irregular working times and metabolic disorders among truck drivers: a review

A number of studies to better understand the complex physiological mechanism involved in regulating body weight have been conducted. More specifically, the hormones related to appetite, leptin and ghrelin, and their association to obesity have been a focus of investigation. Circadian patterns of these hormones are a new target of research. The behaviour of these hormones in individuals subject to atypical working times such as shiftwork remains unclear. Shiftwork is characterized by changes in biological rhythms and cumulative circadian phase changes, being associated with high rates of obesity and metabolic syndrome. Truck drivers, who work irregular shifts, frequently present a high prevalence of obesity, which might be associated with work-related factors and/or lifestyle. In this context, the aim of this paper was to discuss the relationship of body mass index, appetite-related hormones and sleep characteristics in truck drivers who work irregular shifts compared with day workers.

Musculoskeletal reported symptoms among aircraft assembly workers: a multifactorial approach

The aim of this study was to evaluate factors associated with reported work-related musculoskeletal symptoms among aircraft assembly workers. Population consisted of 552 (491 men/61 women) workers who performed tasks related to the work of aircraft assembly. Participants completed a comprehensive questionnaire, including socio-demographic information, habits/lifestyles, working conditions, and work organization. Workers also answered the Nordic Musculoskeletal Questionnaire to obtain data on musculoskeletal symptoms. Multivariate logistic regression was performed to analyze factors associated with musculoskeletal reported symptoms. Results showed that body regions with the highest prevalence of reported musculoskeletal symptoms were similar when referred the past twelve months and the past seven days. Significant factors associated with musculoskeletal symptoms included variables related to conflicts at work, sleep problems, mental fatigue, and lack of time for personal care and recovery. Working time in the industry was associated only with reports for the last seven days and regular physical activity off-work seems to be a positive factor in preventing musculoskeletal symptoms for the past twelve months. The results highlight the multi-factorial nature of the problem. Actions to prevent musculoskeletal diseases at the aircraft assembly work should consider multiple interventions that would promote better recovery between work shifts.

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.

Study of postures in sugarcane cutters in the Pontal of Paranapanema-SP, Brazil

The expansion of sugarcane monoculture in Brazil in the last decades has pointed out to the necessity of considering the question of sugarcane cutters occupational health. In this work we present a cross-sectional study aiming to examine the occupational posture of a group of sugarcane cutters, which work in a cane field located in the region of Pontal do Paranapanema-SP, Brazil. The study was made using the Ergonomic Analysis of Work - EAW methodology and the postural analysis method by Win-OWAS. Through the obtained records of postures, it was observed that during a workday the sugarcane cutters remain standing erect on two legs or in one leg 66% of the time and that their trunk remain tilted and in rotation, according to 63% of the positions categorized. It was also observed that the sugarcane cutter trunk performs repetitive and boundless movements during his routine of work, which can expose this individual to additional wear of their musculoskeletal functions. The activities in which the individual engages have favorable or adverse influence on his posture. The repetitive movements involved in specialized occupations are equivalent to repeated exercises, thus may be responsible for the excessive development of certain muscle groups. The study suggests that the postures adopted by sugarcane cutters can overload their musculoskeletal system and predispose the cutters to work-related musculoskeletal diseases.

O adoecer pelo trabalho na enfermagem: uma revisão integrativa

A busca incessante pela realização de diferentes atividades provoca no homem um aumento das cargas laborais, levando ao aparecimento de doenças físicas, psíquicas e emocionais. Resolveu-se buscar evidências científicas sobre as formas de adoecimento pelo trabalho da enfermagem, bem como as formas para o enfrentamento e prevenção ao adoecimento e acidentes de trabalho. Utilizou-se a revisão Integrativa e a pesquisa foi realizada em bases de dados eletrônicas na área da saúde. Os descritores utilizados foram: doença ocupacional, prevenção ocupacional, trabalhador da enfermagem. Encontrou-se 27 artigos. Percebeu-se que os trabalhadores da enfermagem apresentam dores lombares, injúrias músculo-esqueléticas, sofrem acidentes com material pérfuro-cortante, estresse e tensão no trabalho, sofrem com poluição ambiental e dermatites.

Distúrbios osteomusculares relacionados ao trabalho em profissionais de enfermagem: revisão integrativa da literatura

OBJETIVO: Avaliar as evidências sobre o adoecimento de trabalhadores de enfermagem pelos Distúrbios Osteomusculares Relacionados ao Trabalho (DORT). MÉTODOS: Revisão integrativa da literatura utilizando as bases: Biblioteca Virtual em Saúde (BVS), BVS Enfermagem, Scopus e Banco de Teses da Universidade de São Paulo (USP) obtendo-se 17 estudos. RESULTADOS: Evidenciou-se que os DORT acometem os profissionais de enfermagem e relacionam-se às condições inadequadas dos ambientes de trabalho, à organização e estrutura do trabalho. CONCLUSÃO: É necessário investir em programas preventivos, capacitações, educação em saúde, estratégias de intervenção e organização dos serviços existentes.

Qualidade de vida no trabalho e distúrbios osteomusculares relacionados ao trabalho entre profissionais de enfermagem

OBJETIVO: Avaliar a associação de Qualidade de Vida no Trabalho (QVT) com os distúrbios osteomusculares (DORT) entre profissionais de enfermagem que trabalham em bloco cirúrgico. MÉTODOS: Estudo de abordagem quantitativa, descritivo, transversal e correlacional, do qual participaram 211 trabalhadores de Enfermagem de 11 hospitais de Londrina-PR, Brasil. Para coleta de dados, foram utilizados três instrumentos: caracterização sociodemográfica e profissional, Escala Visual Analógica e o Questionário Nórdico. RESULTADOS: A maioria dos participantes era de auxiliares de enfermagem (62,6%), do sexo feminino (87,1%), casados (54,5%), com idade média de 40 anos. Dentre os participantes, 38,9% apresentavam queixas osteomusculares na região inferior das costas e 37,9%, na região dos ombros. Neste estudo, a QVT obteve associação estatisticamente significante com os distúrbios osteomusculares na região lombar e dos ombros nos últimos 12 meses (p=0,00). CONCLUSÃO: A ausência de lombalgia contribuiu significativamente para elevar a medida de QVT (p=0,010), embora o modelo final de regressão tenha explicado, apenas 22,6% da variância da medida de QVT.

La sicurezza delle strade esistenti: il caso dell'intersezione GUASTALLA - LOSI - MANZONI nel Comune di Carpi

La presente tesi tratta delle analisi di sicurezza delle intersezioni sia esistenti, sia di nuova progettazione. Nel primo capitolo vengono definite le intersezioni secondo il D.M. 19-04-06 “Norme funzionali e geometriche per la costruzione delle intersezioni stradali”. Sono descritte le manovre possibili, le problematiche ed i punti di conflitto che si vengono a creare durante l’attraversamento, definendo le varie tipologie. Successivamente si affronta una classificazione tipologica delle intersezioni rappresentando per mezzo di una matrice simbolica tutti i possibili nodi. Questi vengono suddivisi in base alla possibilità di connessione. Ampio spazio è dato alla descrizione dell’intersezione a raso dove vengono esaminate le caratteristiche geometriche tra cui le configurazioni delle corsie e le tipologie di isole divisionali. Vengono esaminate le particolarità dell’intersezione semaforizzata definendo il ciclo semaforico e gli elementi che lo compongono, la fasatura, il livello di servizio (LOS), il ritardo, definendo gli elementi che lo compongono per mezzo di formule empiriche. Nella seconda parte del capitolo viene descritta l’intersezione a rotatoria in base al D.M. 19-04-06. Inizialmente si introduce l’argomento con nozioni storiche a carattere informativo, quindi si da una classificazione generale degli elementi che la caratterizzano. Viene descritta l’isola divisionale spiegandone la tipologia costruttiva e rappresentando i parametri di classificazione geometrica. A titolo di esempio sono state inserite varie rappresentazioni di rotatorie suddivise per tipologie costruttive. Nell’ultima parte viene affrontato l’elemento rotatoria definendo la distanza di visibilità e i criteri per il calcolo della capacità. Il secondo capitolo parla delle analisi di sicurezza delle intersezioni. Inizialmente viene descritta la circolare 3699 “Linee guida per le analisi di sicurezza delle strade” definendo il concetto di analisi di sicurezza ed esaminando le differenze tra le due tipologie di analisi: Road safety review e Road safety audit. In seguito si descrivono gli obbiettivi dell’analisi di sicurezza, vantaggi e svantaggi e la valutazione dell’approccio concettuale. Viene descritta più approfonditamente la tipologia del Road safety review evidenziando l’utilità, gli elementi che la caratterizzano, le figure professionali che prendono parte a queste analisi con le azioni che devono seguire. Dopo si analizzano i criteri per affrontare gli studi sulla sicurezza e le fasi per le procedure di analisi. Si procede con la descrizione di una tipologia di ispezione, analizzando le problematiche e la stesura del rapporto di analisi con la descrizione dei tempi di attuazione. Nella parte centrale del capitolo viene descritta la direttiva del parlamento europeo e del consiglio sulla gestione della sicurezza delle infrastrutture stradali con i relativi obbiettivi che si prefigge. Vengono riportati i 13 articoli che si compone con i relativi 4 allegati inerenti a: - Valutazione di impatto sulla sicurezza; - Audit della sicurezza stradale; - Gestione dei tratti stradali ad alto rischio, gestione della sicurezza della rete e ispezione di sicurezza; - Dati che devono figurare nelle relazioni di incidenti. L’ultimo argomento preso in esame riguarda le norme per gli interventi di adeguamento delle strade esistenti. Vengono descritte le categorie di intervento e gli obbiettivi da raggiungere distinguendoli in obbiettivi prestazionali, di funzionalità operativa e sicurezza della circolazione. Vengono affrontate le caratteristiche e le differenze tra interventi strutturali e non strutturali con i relativi obbiettivi valutando gli effetti che si ottengono dall’adeguamento delle strade. Successivamente vengono descritte le campagne di monitoraggio con le relative procedure e tempistiche. Infine si valutano le responsabilità degli interventi. Nel capitolo 3 viene descritta l’analisi dello stato di fatto. Si è proceduto con la classificazione della infrastruttura descrivendo i tratti di strada interessati dall’intervento ed utilizzando delle foto per individuare alcune problematiche emerse nell’intersezione. Utilizzando l’elaborato “azzonamento del territorio comunale di Carpi” è stata descritta la zona oggetto di studio. Poi con la macroclassificazione del territorio con scala 1:10000 viene mostrato graficamente il territorio urbanizzato, in corso di urbanizzazione e a destinazione urbana. L’ultimo elaborato preso in esame riguarda la classificazione acustica del territorio. Infine si è proceduto con l’analisi del traffico e di incidentalità. Utilizzando i dati rilevati dalla polizia municipale del comune di Carpi sono stati costruiti i grafici e studiati gli andamenti nel periodo di tempo di riferimento dal 2000 al 2008. Utilizzando poi i dati dei flussi di traffico si sono analizzati le tipologie e i volumi di traffico nell’intersezione. Nell’ultimo capitolo viene studiato il Road safety review dell’intersezione. Si procede con una descrizione generale dell’intersezione, e si prosegue poi con l’individuazione delle problematiche lungo il tracciato. Inizialmente sono state scattate numerose foto nella zona interessata poi sono state divise per tipologia di problema. Per ogni problema si è cercato una soluzione descrivendo e motivando la scelta. Nelle conclusioni si sono descritti i risultati ottenuti nell’analisi di sicurezza elencando le principali raccomandazioni emerse dall’analisi.

Laboratory verification of predicted permanent deformation in asphalt materials following climate change.

In the past a change in temperature of 5°C most often occurred over intervals of thousands of years. According to estimates by the IPCC, in the XXI century is expected an increase in average temperatures in Europe between 1.8 and 4.0°C in the best case caused by emissions of carbon dioxide and other GHG from human activities. As well as on the environment and economic context, global warming will have effects even on road safety. Several studies have already shown how increasing temperature may cause a worsening of some types of road surface damages, especially rutting, a permanent deformation of the road structures consisting in the formation of a longitudinal depression in the wheelpath, mostly due to the rheological behavior of bitumen. This deformation evolves during the hot season because of the heating capacity of the asphalt layers, in fact, the road surface temperature is up to 24°C higher than air. In this thesis, through the use of Wheeltrack test, it was studied the behavior of some types of asphalt concrete mixtures subjected to fatigue testing at different temperatures. The objectives of this study are: to determine the strain variation of different bituminous mixture subjected to fatigue testing at different temperature conditions; to investigate the effect of aggregates, bitumen and mixtures’ characteristics on rutting. Samples were made in the laboratory mostly using an already prepared mixtures, the others preparing the asphalt concrete from the grading curve and bitumen content. The same procedure was performed for each specimen: preparation, compaction using the roller compactor, cooling and heating before the test. The tests were carried out at 40 - 50 - 60°C in order to obtain the evolution of deformation with temperature variation, except some mixtures for which the tests were carried out only at 50°C. In the elaboration of the results were considered testing parameters, component properties and the characteristics of the mixture. Among the testing parameters, temperature was varied for each sample. The mixtures responded to this variation with a different behavior (linear logarithmic and exponential) not directly correlated with the asphalt characteristics; the others parameters as load, passage frequency and test condition were kept constant. According to the results obtained, the main contribution to deformation is due to the type of binder used, it was found that the modified bitumen have a better response than the same mixtures containing traditional bitumen; to the porosity which affects negatively the behavior of the samples and to the homogeneity ceteris paribus. The granulometric composition did not seem to have interfered with the results. Overall has emerged at working temperature, a decisive importance of bitumen composition, than the other characteristics of the mixture, that tends to disappear with heating in favor of increased dependence of rutting resistance from the granulometric composition of the sample considered. In particular it is essential, rather than the mechanical characteristics of the binder, its chemical properties given by the polymeric modification. To confirm some considered results, the maximum bulk density and the air voids content were determined. Tests have been conducted in the laboratories of the Civil Engineering Department at NTNU in Trondheim according to European Standards.

Der Einfluss von daily hassles auf Aspekte der Arbeitssituation im internationalen Vergleich

Die Literatur zu Arbeitszufriedenheit zeigt, dass die Bedeutung verschiedener Komponenten der Arbeitszufriedenheit zwischen einzelnen Kulturkreisen schwankt. Um diese unterschiedlichen Befunde zu erklären, bietet die "Affective Events Theory" einen Erklärungsrahmen an, der den Einfluss affektiver Erlebnisse auf verschiedene Einstellungskomponenten abbildet. Diese Studie hatte zum Ziel, bei Beschäftigten mit unterschiedlichen kulturellen Hintergründen, den Einfluss von "daily hassles" auf Empfindungen und verschiedene Komponenten der Arbeitszufriedenheit zu untersuchen. Da sich bei Mitgliedern independenter und interdependenter Kulturen verschiedene Interpretationen der gleichen Situationen finden, die anschließend zu unterschiedlichen affektiven und kognitive Reaktionen führen, wurden insgesamt 244 Beschäftigte aus Deutschland (independent) und Japan (interdependent) befragt. Sie erinnerten selbst erlebte, berufliche "daily hassles" hinsichtlich der kognitiven Dimensionen "Verursacher" und "Kontrollierbarkeit" und gaben ihre Reaktionen auf Fragebögen an. Allgemeine Arbeitszufriedenheit wurde als Konstrukt konzipiert, das aus einer affektiven und einer kognitiven Komponente besteht. Es wurde vermutet, dass die Befragten abhängig vom kulturellen Hintergrund und der kognitiven Struktur der "daily hassles" unterschiedliche Empfindungen zeigen, die die affektiven und kognitiven Komponenten der Arbeitszufriedenheit unterschiedlich beeinflussen. Zudem wurde angenommen, dass allgemeine Arbeitszufriedenheit im jeweiligen Kulturkreis durch diese beiden Komponenten unterschiedlich stark beeinflusst wird. Die Ergebnisse der Regressionsanalysen eines grafischen Kettenmodells konnten diese Annahmen zum großen Teil bestätigen: in independenten Kulturkreisen erweist sich allgemeine Arbeitszufriedenheit als ein aus zwei Komponenten bestehendes Konstrukt mit einer kognitiven und einer affektiven Komponente; in interdependenten Kulturen hingegen entspricht allgemeine Arbeitszufriedenheit vornehmlich einer affektiven Komponente. Es zeigte sich, dass die affektive Komponente in beiden Kulturkreisen durch unterschiedliche Empfindungen beeinflusst wird. Auf den ersten Blick gleiche, berufliche Ereignisse werden abhängig vom kulturellen Hintergrund unterschiedlich interpretiert und lösen differierende Empfindungen aus. Diese beeinflussen ihrerseits verschiedene Komponenten der Arbeitszufriedenheit unterschiedlich. Entgegen dem aktuellen Stand der Literatur spiegeln Angaben zu allgemeiner Arbeitszufriedenheit somit nicht ein universell einheitliches (kognitives) Phänomen wider sondern sind abhängig vom kulturellen Hintergrund unterschiedlich stark affektiv besetzt.