Auto-avaliação de saúde entre trabalhadores de uma indústria no sul do BrasilSelf-rated health among industrial workers in Southern Brazil RESUMO OBJETIVO: Analisar a prevalência de auto-avaliação de saúde negativa e seus fatores associados, entre trabalhadores industriais. MÉTODOS:Estudo transversal com amostra probabilística de 482 trabalhadores de indústria metal-mecânica de Joinville, estado de Santa Catarina, em 2005. As informações foram obtidas por meio de questionário auto-administrado e medidas antropométricas. Para estimar a magnitude de associação entre a auto-avaliação e variáveis, foram calculadas as razões de chances (RC) com intervalos de confi ança de 95%. Foram obtidos modelos logísticos múltiplos por meio de análise de regressão logística utilizando um referencial teórico hierárquico. RESULTADOS:A taxa de resposta foi de 98,6%. A auto-avaliação de saúde negativa foi referida por 16,6% dos trabalhadores. A maioria era do sexo masculino (84,8%) e desenvolvia atividades predominantemente ligadas ao setor produtivo (79,4%). A queixa mais comum entre os trabalhadores foi dor nas costas (30,9%). Após modelagem estatística, as seguintes variáveis permaneceram associadas à auto-avaliação negativa de saúde: sexo feminino (RC=3,0; IC 95%: 1,5;6,2), inatividade física (RC=1,8; IC 95%: 1,0;3,4), tensão psicológica (RC=3,0; IC 95%: 1,6;5,6), falta de controle sobre a vida (RC=3,0; IC 95%: 1,5;6,1), referência a uma (RC=3,2; IC 95%: 1,4;7,2) ou duas ou mais doenças crônicas (RC=7,7; IC 95%: 3,4;17,8), licença de saúde de curta duração (RC=2,9; IC 95%: 1,5;5,5) e doença limitante (RC=2,8; IC 95%: 1,2;6,6). CONCLUSÕES:A prevalência de auto-avaliação de saúde negativa esteve associada às dimensões socioeconômica/demográfi ca, estilo de vida, psicossocial e situação de saúde. A variável que mais infl uenciou na auto-avaliação negativa foi a referência a mais de duas doenças crônicas.
Systematic reviews have found no evidence to support a benefit of water fluoridation (WF) to prevent dental caries in adult populations. The aim of this natural experiment was to investigate whether lifetime access to fluoridated water is associated with dental caries experience among adults from Florianópolis, Brazil. The data originated from a population-based cohort study (EpiFloripa Adult) initiated in 2009 (n = 1,720) when participants were aged 20 to 59 years. The second wave was carried out in 2012 (n = 1,140) and included a dental examination and a face-to-face questionnaire. Participants residing at the same address since the age of 7 y or before were included in the primary analyses. Sensitivity analyses were also performed. WF was implemented in the city in 2 different periods of time: 1982 (60% of the population) and 1996. Dental caries was assessed by the decayed, missing, and filled teeth (DMFT) index. A combination of residential status, participant's age, and year of implementation of WF permitted the creation of participants' lifetime access to fluoridated water: >75%, 50% to 75%, and <50% of a participant's lifetime. Covariates included sex, age, socioeconomic mobility, educational attainment, income, pattern of dental attendance, and smoking. Participants who accessed fluoridate water <50% of their lifetime presented a higher mean rate ratio of DMFT (1.39; 95% CI, 1.05-1.84) compared with those living >75% of their lifetime with residential access to fluoridated water. Participants living between 50% and 75% and <50% of their lives in fluoridated areas presented a decayed and filled teeth mean ratio of 1.34 (95% CI, 1.02-1.75) and 1.47 (95% CI, 1.05-2.04) higher than those with residential access to fluoridated water >75% of their lifetime, respectively. Longer residential lifetime access to fluoridated water was associated with less dental caries even in a context of multiple exposures to fluoride.
A insatisfação corporal associa-se a transtornos alimentares, dificuldades de relacionamento interpessoal e ideação suicida. Objetivou-se estimar a prevalência de insatisfação corporal, e verificar sua associação com variáveis infantis e maternas de escolares do 4º e 5º ano de escolas municipais de Itajaí, Santa Catarina. Sorteou-se 737 escolares, de 22 escolas urbanas e rurais. A coleta de dados compreendeu a coleta de dados antropométricos, aplicação de questionários para a criança e para seu responsável. A insatisfação corporal foi identificada, pela diferença entre a percepção da silhueta atual e àquela desejada pelos escolares. Calcularam-se as Razões de Prevalência (RP) e Intervalos de Confiança de 95% (IC 95%). A taxa de resposta foi 81,7% (n = 602). A prevalência de insatisfação corporal foi de 76,9%. Escolares acima do peso, e aqueles com excesso de gordura abdominal apresentaram prevalência 21% e 30%, superiores de insatisfação corporal. Filhos de pais com excesso de peso apresentaram prevalência 12% maior. Tentativas de emagrecer ou engordar foi 23% e 21% maior entre as crianças insatisfeitas com o peso. Após análise ajustada a prevalência foi menor entre as meninas (RP 0,9 IC95% 0,8;1,0) e maior entre crianças com excesso de gordura abdominal e que realizaram tentativas de perder ou ganhar peso (RP 1,2 IC95% 1,1; 1,4). Osresultados indicaram elevada prevalência de insatisfação corporal, principalmente entre os meninos. Aproximadamente metade dos escolares desejou peso inferior, contudo, entre os meninos o desejo de ganhar peso foi maior. A gordura na região abdominal associou-se fortemente à maior prevalência de insatisfação corporal.
This cross-sectional study with 1,249 workers from all 49 municipal primary health care centers was conducted in Florianópolis, Santa Catarina State, Brazil, with the objective of investigating the prevalence of poor self-rated health and its association with working conditions and other factors. Multivariate statistical analyses were conducted using Poisson regression. The prevalence of poor self-rated health was 21.86% (95%CI: 19.56%-24.15%). The largest prevalence was found among dental assistants (35.71%), and the lowest among physicians (10.66%). In the adjusted analysis, the outcome was associated with female gender (PR = 1.48; 95%CI: 1.03-2.14), older age (PR = 1.29; 95%CI: 1.05-1.59), higher education (PR = 0.69; 95%CI: 0.55-0.87), more time working at the primary care center (PR = 1.57; 95%CI: 1.29-1.98), higher workload score (PR = 1.67; 95%CI: 1.35-2.05), obesity (PR = 1.74; 95%CI: 1.37-2.21), and often or always experiencing musculoskeletal symptoms (PR = 2.69; 95%CI: 1.90-3.83). A higher workload score remained associated with the outcome, suggesting an association between working conditions and self-rated health.
ResumoO estudo teve como objetivo avaliar a qualidade da alimentação e fatores associados em escolares do primeiro ao quinto ano de uma escola municipal de Itajaí, Santa Catarina. A qualidade da dieta foi analisada por meio de um índice que conferia pontuação a cada item alimentar conforme sua frequência de consumo. Variáveis socioeconômicas, demográficas e comportamentos relacionados à saúde foram identificados por questionário. Foram calculadas razões de prevalência (RP) brutas e ajustadas, e respectivos intervalos de confiança de 95% (IC95%) por meio da Regressão de Poisson. Avaliaram-se 523 crianças (88,9% da amostra calculada), 52,6% (IC95%: 48,3-56,9%) tiveram sua dieta classificada como inadequada, com pontuação média de 6,97, variando de -9 a +17 pontos. O sexo feminino (RP=0,81, IC95%: 0,66-0,98) e a menor escolaridade (RP=1,35, IC95%: 1,04-1,75) do responsável estiveram associados ao desfecho. Crianças com obesidade abdominal e que realizavam refeições em frente à televisão tiveram dieta de pior qualidade. Sabe-se que o consumo alimentar em frente à televisão é associado a maiores volumes de ingestão. Variáveis infantis e do responsável estiveram relacionadas à pior qualidade da alimentação. Desta forma, atividades para melhorar a qualidade da dieta devem envolver crianças e seus cuidadores.Palavras-chave: criança; comportamento alimentar; estado nutricional; saúde escolar; hábitos alimentares. AbstractThe study aimed to evaluate quality of diet and associated factors in schoolchildren from first to fifth grade in a public school in Itajaí, Santa Catarina. The quality of the diet was analyzed using an index that gave to each food item a score as their frequency of consumption. Socioeconomic, demographic, and health-related behaviors were identified by questionnaire. Crude, adjusted prevalence ratios (PR), and theirs 95% confidence intervals were calculated (95%CI) through Poisson regression. Were evaluated 523 children (88.9% of the calculated sample) and 52.6% (95%CI: 48.3-56.9%) had their diet rated as poor, with a mean score of 6.97 ranging from -9 to +17 points. Female gender (PR=0.81, 95%CI: 0.66-0.98) and lower education (PR=1.35, 95%CI: 1.04-1.75) were associated with the outcome. Children with abdominal obesity and who took meals in front of the TV had poorer diet quality, it is known that food consumption in front of television is associated with larger volumes of intake. Children and caregivers variables were related with worse diet quality. Thus, activities to improve the quality of the diet should involve children and their caregivers.
OBJECTIVE The objective of this study was to analyze whether socioeconomic conditions and the period of availability of fluoridated water are associated with the number of teeth present.METHODSThis cross-sectional study analyzed data from 1,720 adults between 20 and 59 years of age who resided in Florianópolis, SC, Southern Brazil, in 2009. The outcome investigated was the self-reported number of teeth present. The individual independent variables included gender, age range, skin color, number of years of schooling, and per capita household income. The duration of residence was used as a control variable. The contextual exposures included the period of availability of fluoridated water to the households and the socioeconomic variable for the census tracts, which was created from factor analysis of the tract’s mean income, education level, and percentage of households with treated water. Multilevel logistic regression was performed and inter-level interactions were tested.RESULTS Residents in intermediate and poorer areas and those with fluoridated water available for less time exhibited the presence of fewer teeth compared with those in better socioeconomic conditions and who had fluoridated water available for a longer period (OR = 1.02; 95%CI 1.01;1.02). There was an association between the period of availability of fluoridated water, per capita household income and number of years of education. The proportion of individuals in the poorer and less-educated stratum, which had fewer teeth present, was higher in regions where fluoridated water had been available for less time.CONCLUSIONS Poor socioeconomic conditions and a shorter period of availability of fluoridated water were associated with the probability of having fewer teeth in adulthood. Public policies aimed at reducing socioeconomic inequalities and increasing access to health services such as fluoridation of the water supply may help to reduce tooth loss in the future.
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