Objetivo: descrever as principais recomendações sobre ações de prevenção de contágio relacionadas à exposição ocupacional dos profissionais de saúde atuantes frente à COVID-19, disponíveis até março de 2020. Conteúdo: A atual pandemia da doença causada pelo novo coronavírus SARS-CoV-2 tem transmissão favorecida pelo contato próximo e desprotegido com secreções ou excreções de pacientes infectados, principalmente por meio de gotículas salivares. Práticas organizacionais de prevenção devem ser previstas antes da chegada do paciente ao serviço de saúde, reduzindo o fluxo de atendimento, no primeiro atendimento e durante as ações assistenciais, para minimizar a exposição ocupacional ao agente biológico. Profissionais de saúde classificados como grupo de risco devem ser afastados de atividades de risco de contaminação. Aqueles contaminados ou adoecidos devem permanecer em quarentena para minimizar a propagação da COVID-19. Considerações finais: os cuidados para prevenção de contaminação de trabalhadores nesta pandemia pelo novo coronavírus devem ser priorizados, evitando impactos negativos na assistência à população que busca atendimento nos serviços de saúde.ABSTRACTObjective: to describe the main recommended actions on prevention actions related to occupational exposure of health professionals working at COVID-19, available until March 2020. Content: The current pandemic disease caused by the new SARS-CoV-2 coronavirus has its transmission favored by close and unprotected contact with secretions or excretions from infected patients, mainly through salivary droplets. Organizational prevention practices should be prioritized, since patient's arrival at the health service, optimizing the flow of care, the first care and during health care actions, to minimize occupational exposure to the biological agent. Health professionals classified as a risk group should be removed from activities at risk of contamination. Those contaminated or adulterated must remain in quarantine to minimize the spread of COVID-19. Final considerations: care to avoid contamination of workers in this pandemic by the new coronavirus must be prioritized, prevented from affecting the assistance to the population that seeks assistance in health services.RESUMENObjetivo: describir las principales acciones recomendadas sobre acciones de prevención relacionadas con la exposición ocupacional de los profesionales de la salud que trabajan en COVID-19, disponible hasta marzo de 2020. Contenido: La enfermedad pandémica actual causada por el nuevo coronavirus SARS-CoV-2 tiene su transmisión favorecida por contacto cercano y sin protección con secreciones o excreciones de pacientes infectados, principalmente a través de gotas salivales. Se deben priorizar las prácticas de prevención organizacional, desde la llegada del paciente al servicio de salud, optimizando el flujo de atención, la primera atención y durante las acciones de atención de salud, para minimizar la exposición ocupacional al agente biológico. Los profesionales de la salud clasificados como grupo de riesgo deben ser retirados de las actividades en riesgo de contaminación. Las personas contaminadas o adulteradas deben permanecer en cuarentena para minimizar la propagación de COVID-19. Consideraciones finales: se debe priorizar la atención para evitar la contaminación de los trabajadores en esta pandemia por el nuevo coronavirus, evitando que afecte la asistencia a la población que busca asistencia en los servicios de salud.
Introduction: Mental disorders are the third leading cause of social security benefit due to sickness in Brazil. Occupational exposure to psychosocial stressors can affect the workers' mental health. The social security medical experts are responsible for characterizing if those sicknesses are work-related. Objective: To evaluate the factors associated with sick leave due to mental disorders, in particular, the perception of workers on psychosocial factors at work. Methods: This is an analytical study carried out in São Paulo, Brazil, with 131 applicants for sickness benefit due to mental disorders. Questionnaires were applied to assess the sociodemographic data, habits/lifestyle information, and perceived psychosocial factors at work. Results: The most common diagnosis was depressive disorders (40.4%). The medical experts considered 23.7% of all applications as work-related. Most of the participants were female (68.7%), up to 40 years of age (73.3%), married/common-law marriage (51.1%), with educational level greater than or equal to 11 years (80.2%), nonsmokers (80.9%), not alcohol consumers (84%), and practice of physical activities (77.9%). Regarding psychosocial factors, most of the participants informed a high job strain (56.5%), low social support (52.7%), effort-reward imbalance (55.7%), and high overcommitment (87.0%). There was no statistical association between the work-related mental disorders sickness benefits and independent variables. Conclusion: The concession of social security sickness benefits is not associated with sociodemographic data, habits/lifestyle, or psychosocial factors at work. Occupational exposure to unfavorable psychosocial factors was reported by most workers on sick leave due to mental disorders. However, several cases were not recognized by the social security medical experts as work-related, which may have influenced the results of the associations.
AimsSickness absence is a socioeconomic global burden. In Brazil, mental disorders are the third leading cause of social security benefits payments. The aim of the present study was to compare factors associated with long-term sickness absence between workers who claimed social benefits due to mental disorders or by other causes. We investigated individual features and occupational characteristics. In addition, we evaluated psychosocial factors at work assessed by the Demand-Control-Support (DCS) and Effort-Reward Imbalance (ERI) models, and whether they were associated with long-term sickness absence due to mental disorders (LTSA-MD).MethodsThe present case-control study was conducted in São Paulo, Brazil. The sample (n = 385) included workers on sick leave for more than 15 days. Cases were the participants with disabling psychiatric illnesses, and controls were the ones with other disabling diseases. Interviews were conducted to assess individual features (sociodemographic data, health habits/lifestyle, health conditions) and occupational characteristics. The participants' perception of exposure to dimensions of the DCS and ERI models was also recorded. Multiple logistic regressions were performed to evaluate the association between independent variables and LTSA-MD.ResultsAll the regression analyses showed that LTSA-MD was associated with female sex, self-reported white skin color, higher education level, high tobacco consumption, high alcohol intake, two or more comorbidities, exposure to violence at work, high job strain and low social support at work, effort-reward imbalance and high overcommitment to work. LTSA-MD was associated with separate and combined DCS and ERI stress models.ConclusionsIndividual features and work conditions were associated with LTSA-MD. Combined analysis of stress models showed that psychosocial factors at work were significantly associated with LTSA-MD. Resourceful use of this information may contribute to the implementation of preventive actions and strategies to facilitate return to work targeting the populations most susceptible to mental disorders.
This communication aimed to analyze the profile variation of disability benefits due to mental disorders. Secondary data published by Brazilian Social Security between 2008 and 2011 were evaluated. Mean annual variation rates over the period were calculated for the economically active population, as were the number insured, paid out overall sickness benefits and for mental and behavioral disorders. Mental disorders are the third most common reason for disability benefits. There was an average annual increase of 0.3% in new benefit claims, with a 2.5% fall in mean annual incidence. Work-related disease was identified in 6.2% of cases, most of it due to mood disorders. The government should use the data from the Social Security Institute to support a debate of public policies regarding mental health.
This paper presents the main messages of a South American expert roundtable (ERT) on the unintended side effects (unseens) of digital transformation. The input of the ERT comprised 39 propositions from 20 experts representing 11 different perspectives. The two-day ERT discussed the main drivers and challenges as well as vulnerabilities or unseens and provided suggestions for: (i) the mechanisms underlying major unseens; (ii) understanding possible ways in which rebound effects of digital transformation may become the subject of overarching research in three main categories of impact: development factors, society, and individuals; and (iii) a set of potential action domains for transdisciplinary follow-up processes, including a case study in Brazil. A content analysis of the propositions and related mechanisms provided insights in the genesis of unseens by identifying 15 interrelated causal mechanisms related to critical issues/concerns. Additionally, a cluster analysis (CLA) was applied to structure the challenges and critical developments in South America. The discussion elaborated the genesis, dynamics, and impacts of (groups of) unseens such as the digital divide (that affects most countries that are not included in the development of digital business, management, production, etc. tools) or the challenge of restructuring small- and medium-sized enterprises (whose service is digitally substituted by digital devices). We identify specific issues and effects (for most South American countries) such as lack of governmental structure, challenging geographical structures (e.g., inclusion in high-performance transmission power), or the digital readiness of (wide parts) of society. One scientific contribution of the paper is related to the presented methodology that provides insights into the phenomena, the causal chains underlying “wanted/positive” and “unwanted/negative” effects, and the processes and mechanisms of societal changes caused by digitalization.
OBJECTIVETo describe the translation and early stages of cross-cultural adaptation of the questionnaire Verwachtingen over werken (or “Return-to-work self-efficacy”) for workers in sick leave due to mental disorders, from the original in Dutch to the Brazilian Portuguese language.METHODSA panel gathering experts was formed to determine the questionnaire conceptual and item equivalence. For semantic equivalence, the Dutch-Portuguese Brazilian translations were consolidated and consensus meetings were held to structure versions of the instrument. Each version was back-translated from Brazilian Portuguese to Dutch and evaluated by one of the authors of the original version. The final version was submitted to two pre-tests for operational equivalence.RESULTSThe original questionnaire in Dutch was translated twice to Brazilian Portuguese. During the process, four consensus meetings of the experts’ panel were performed to create the versions. Each version was back-translated to Dutch. One of the authors of the original questionnaire performed an evaluation on the first three versions until the definition of the final one, which was titled Expectativas sobre o trabalho (Expectations about work). Pre-tests’ participants did not reported problems to fill the questionnaire.CONCLUSIONSResults indicate that the Brazilian Portuguese cross-culturally adapted version maintains the original meaning of the questionnaire, while including characteristics peculiar to the Brazilian reality. Measurement and functional equivalence of this version must still be evaluated before its application can be recommended for workers who have been absent from work due to mental disorders.
Objective To analyze the factors associated with mental distress among health workers who cared for patients with a suspected or confirmed diagnosis of coronavirus disease 2019 (COVID-19). Methods A cross-sectional analytical study of national scope, carried out between in the second quarter of 2020. A total of 437 health professionals, who filled out an electronic form about sociodemographic data, occupational aspects, psychosocial characteristics of work and mental distress. Multiple logistic regression was performed to analyze the covariables associated with mental distress. Results There was a predominance of workers on the nursing team (65.0%), female (71.0%), from Southeastern region of the country (68.6%) and with no morbidities (36.2%). The prevalence of mental distress was 61.6%. Job strain was reported by 24% of participants, and the perception of low support from coworkers was described by 52.9%. The final multiple regression model showed that mental distress was associated with females (odds ratio - OR: 1.93; 95%CI: 1.22-3.07), age up to 40 years (OR: 1.64; 95%CI: 1.07-2.52), weekly working hours equal or over 60 hours (OR: 1.87; 95%CI: 1.15-3.11), job strain (OR: 2.45; 95%CI: 1.41-4.40) and low support from co-workers (OR: 3.47; 95%CI: 2.26-5.38). Conclusion Six out of ten participants presented mental distress, which was associated to both individual characteristics and factors related to the work carried out during the pandemic. There is an urgent need to map services that have such characteristics, to outline actions to promote mental health and prevent emotional distress at different levels of health care.
The 2030 United Nations Goal 8 for sustainable development focuses on decent work. There is utility in identifying the occupational safety and health aspects of Goal 8, as they pertain to the four pillars of decent work: job creation, social protection, rights of workers, and social dialogue. A workgroup of the International Commission on Occupational Health and collaborators addressed the issue of decent work and occupational safety and health (OSH) with the objective of elaborating a framework for guidance for practitioners, researchers, employers, workers, and authorities. This article presents that framework, which is based on an examination of the literature and the perspectives of the workgroup. The framework encompasses the intersection of the pillars of decent (employment creation, social protection, rights of workers, and social dialogue) work with new and emerging hazards and risks related to various selected determinants: new technologies and new forms of work; demographics (aging and gender); globalization; informal work; migration; pandemics; and OSH policies and climate change. The OSH field will need an expanded focus to address the future of decent work. This focus should incorporate the needs of workers and workforces in terms of their well-being. The framework identifies a starting point for the OSH community to begin to promote decent work.
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