Resumo Objetivo: discutir desafios para a elaboração e implementação de planos de resposta e prontidão estratégica contra a COVID-19. Métodos: partindo de recomendações da Organização Mundial da Saúde, que enfatiza três grupos de objetivos a serem buscados nesses planos, defende-se a inclusão do tema da proteção à saúde dos trabalhadores da Saúde no âmbito de seu terceiro objetivo: “Minimizar o impacto da epidemia sobre sistemas de saúde”. Discussão: a ênfase dada ao uso de EPI, medidas de etiqueta social e higiene é discutida como potencialmente minimizadora da importância de medidas de controle de engenharia e de controles administrativos para a prevenção da doença. Destaque é dado à necessidade de treinamentos que formem trabalhadores para o reconhecimento de situações de risco associadas às dificuldades das novas atividades surgidas na pandemia, com ênfase em novas interações entre colegas e entre trabalhadores, assim como em novos instrumentos e contextos dela decorrentes. Os custos a serem pagos na forma de impactos na saúde dos trabalhadores tendem a crescer em contextos de degradação de situações de trabalho associados à rápida evolução da doença. Um dos desafios dos programas de resposta é o de reconhecer e responder com rapidez às mudanças que criam novos riscos.
This article analyzes reports and data from the investigation of severe and fatal work-related accidents by the Regional Institute of Criminology in Piracicaba, São Paulo State, Brazil. Some 71 accident investigation reports were analyzed from 1998, 1999, and 2000. Accidents involving machinery represented 38.0% of the total, followed by high falls (15.5%), and electric shocks (11.3%). The reports conclude that 80.0% of the accidents are caused by "unsafe acts" committed by workers themselves, while the lack of safety or "unsafe conditions" account for only 15.5% of cases. Victims are blamed even in situations involving high risk in which not even minimum safety conditions are adopted, thus favoring employers' interests. Such conclusions reflect traditional reductionist explanatory models, in which accidents are viewed as simple, unicausal phenomena, generally focused on slipups and errors by the workers themselves. Despite criticism in recent decades from the technical and academic community, this concept is still hegemonic, thus jeopardizing the development of preventive policies and the improvement of work conditions.
Da vigilância para prevenção de acidentes de trabalho: contribuição da ergonomia da atividadeFrom surveillance to work-related accident prevention: the contribution of the ergonomics of the activity
Trata-se de estudo qualitativo feito em hospital universitário, cujo objetivo foi analisar o trabalho de auxiliares e técnicos de enfermagem, categoria mais numerosa entre os profissionais de saúde e mais sujeita à incidência de acidentes de trabalho. Este hospital conta com um pouco mais de 2.000 profissionais de enfermagem. Foram utilizados dois métodos de análise. 1) A Análise Coletiva do Trabalho (ACT), que consiste em reuniões com pequenos grupos de trabalhadores explicando seu trabalho. Foram realizadas quatro reuniões, com 34 participantes, quase todos do sexo feminino; 2) O Modelo de Análise e Prevenção de Acidentes (MAPA), que foi utilizado para compreender um acidente ocorrido em uma das clínicas do hospital, com um acidentado que aceitou participar do estudo. Os resultados revelaram que as rotinas de trabalho caracterizam-se por rol de tarefas de cuidados aos pacientes, marcado por grande variabilidade no cotidiano de suas atividades constantemente interrompidas com sobreposição de tarefas decorrentes de demandas urgentes, além de problemas em aspectos organizacionais na situação que originou o acidente, bem como, a fragilidade do sistema de gestão de segurança do trabalho no hospital.
The traditional approach to accidents assumes that compliance with procedures and norms protects the system from accidents and that these events are caused by the faulty behavior of workers, which results partly from personality aspects. Identification of these behaviors can be based on comparing them with the standard "safe working practices", which safety experts are aware of ahead of time. In recent decades, new alternative views have expanded the perimeters of accident analyses and opened the way to questioning the assumption of the traditional approach to the concepts of the human being and work. These new approaches help to highlight the sterile results of traditional practices: blaming and punishing victims, recommending training, and proposing norms without changing the systems in which the accidents took place. The new approaches suggest that the traditional approach is totally worn out and emphasize the importance of operator contribution for system safety.
The analysis of work-related accidents is important for accident surveillance and prevention. Current methods of analysis seek to overcome reductionist views that see these occurrences as simple events explained by operator error. The objective of this paper is to analyze the Model of Analysis and Prevention of Accidents (MAPA) and its use in monitoring interventions, duly highlighting aspects experienced in the use of the tool. The descriptive analytical method was used, introducing the steps of the model. To illustrate contributions and or difficulties, cases where the tool was used in the context of service were selected. MAPA integrates theoretical approaches that have already been tried in studies of accidents by providing useful conceptual support from the data collection stage until conclusion and intervention stages. Besides revealing weaknesses of the traditional approach, it helps identify organizational determinants, such as management failings, system design and safety management involved in the accident. The main challenges lie in the grasp of concepts by users, in exploring organizational aspects upstream in the chain of decisions or at higher levels of the hierarchy, as well as the intervention to change the determinants of these events.
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