Quality of life is an indicator of how well one perceives that he/she is functioning physically and mentally. The aim of this paper is to determine the health-related quality of life (HRQOL) of artisanal fisherwomen/shellfish gatherers from the Saubara municipality in Bahia, Brazil in comparison to the general population. A structured questionnaire was administered to a sample of 209 artisanal fisherwomen selected at random. The HRQOL questionnaire, known as the 36-Item Short-Form Health Survey version 1 (SF-36v01), was also used, having been translated and verified cross-culturally for the Brazilian population. Sociodemographic, lifestyle and comorbidity information was also collected. Chronic diseases and indicators of musculoskeletal disorders (MSDs) were self-reported. The study population consisted primarily of individuals between 30 and 45 years of age (78%), of self-classified races black or brown (96.2%), with no more than an elementary school education (77%) and married (64.6%). In all the SF-36v01 dimensions, the values in the sample were lower than in the general population of Brazil, which was used as the reference population. In the “Physical Health” domain (Physical Functioning; Physical Role Limitations; Bodily Pain; General Health Perception) a tendency toward a lower health-related quality of life was observed among those who were older, had a lower education level, and had a prevalence of MSDs, hypertension or arthritis. The interference of health conditions linked to the fisherwomen’s work activities may contribute to lower HRQOL in all analyzed aspects, in comparison to the general population. In light of these findings, public health policies must consider these informal workers who contribute greatly to Brazil’s economy and food system.
Resumo Introdução: pescadores são uma das maiores e mais tradicionais categorias de trabalhadores no mundo. Para reduzir lacunas do conhecimento sobre os problemas de saúde relacionados a essa atividade e desenvolver ações com o Sistema Único de Saúde (SUS), em 2006 foram iniciados estudos e ações dirigidos aos trabalhadores da pesca artesanal e mariscagem, envolvendo 13 municípios, na Baía de Todos os Santos, nos estado da Bahia. Objetivo: discutir resultados alcançados em intervenções e estudos realizados, para subsidiar ações de vigilância em saúde do trabalhador (Visat) da pesca. Métodos: foram referidos e discutidos estudos qualitativos e quantitativos desenvolvidos a partir de pesquisa participativa de base comunitária. Resultados: os estudos e intervenções revelaram as condições de trabalho e os riscos ocupacionais dessa atividade, sobretudo a exposição excessiva a movimentos repetitivos, e possibilitaram a quantificação da prevalência das lesões por esforço repetitivo e distúrbio osteomuscular relacionado ao trabalho (LER/Dort). Também contribuíram para analisar a qualidade de vida desses trabalhadores, a organização dos serviços de diagnóstico, a adaptação de protocolo clínico de LER/Dort e a capacitação das Equipes da Estratégia Saúde da Família atuantes em territórios pesqueiros. Conclusão: os estudos e as intervenções indicaram a possibilidade de reprodutibilidade desta experiência no âmbito da Visat no SUS.
The aim is to analyze upper limb functioning and disability, and its association with health-related quality of life among artisanal fisherwomen from Bahia, Brazil. Cross-sectional epidemiological study was conducted with a sample of 209 fisherwomen. Structured questionnaires were used for socio-demographic and comorbidity information, as well as the instruments Disabilities of the Arm, Shoulder and Hand (DASH) and Short-Form Healthy Survey (SF-36) respectively, to evaluate the upper limbs and health-related quality of life. The results demonstrated that the presence of musculoskeletal disorders in the upper limbs directly affects the values of the DASH instrument and the SF-36v01 questionnaire scores, while also generating a negative correlation between the DASH and SF-36v01. The varying functioning abilities, pain and social aspects negatively affect upper limb function, and the daily activities and work of fisherwomen. The presence of chronic disease and the absence of intervention and rehabilitation for these professionals, that could produces, in a long-term, cases of disability.
: Lower back musculoskeletal disorders (MSDs) are an important public health problem and the leading cause of disability worldwide, but with yet unknown prevalence among shellfish gatherers. To investigate the prevalence and work-related factors associated with lower back MSD in a population of female shellfish gatherers, an epidemiological cross-sectional study was carried out in Saubara, Bahia-Brazil, in 2013. The Brazilian version of the Job Content Questionnaire (JCQ) and the Nordic Musculoskeletal Questionnaire (NMQ), in addition to a questionnaire containing the physical demands adapted to the artisanal work, were applied to a random sample of 209 female shellfish gatherers. The prevalence of lower back MSD was 72.7%. Using multivariate logistic regression, the shellfish gatherers who had worked for more than 26 years in the activity showed a prevalence of 1.22 (95% CI: 1.04–1.44) times higher compared to those unexposed. Lower back MSD was 1.24 (95% CI: 1.08–1.42) times higher among those more exposed to work sitting with trunk flexion. Those performed manual handling and muscle force with the arms had a prevalence ratio of 1.18 (95% CI: 1.01–1.39). These results show the need for greater awareness of health and social welfare factors impacting workers in small-scale fisheries and will promote the elaboration of health care policies for this occupational class.
Resumo O presente artigo tem como objetivo identificar os fatores associados com os distúrbios musculoesqueléticos (DME) em pescoço/ombro e membros superiores distais em pescadoras artesanais/marisqueiras em Saubara, Bahia, Brasil. Trata-se de um estudo de corte transversal realizado com 209 pescadoras artesanais/marisqueiras. Foram utilizados para este estudo a versão brasileira do questionário de conteúdo do trabalho e do questionário nórdico e um questionário das demandas físicas para o trabalho. As análises multivariadas foram feitas de acordo com os principais fatores de risco para DME. Algumas demandas físicas agrupadas, nas etapas da coleta dos mariscos e na cata, se associaram, respectivamente, com DME em pescoço ou ombro [Razão de Prevalência - RP: 1,28 (IC95%: 1,09-1,49)] e DME em membros superiores distais [RP: 1,38 (IC95%: 1,05-1,83)], no modelo final ajustado. As RP ajustadas para DME em membros superiores distais foram de 1,26 (IC95%: 1,07-1,47), de acordo com as horas diárias dedicadas ao trabalho como marisqueira, e 0,74 (IC95%: 0,57-0,96) de acordo com o desenvolvimento de outro trabalho atualmente. O modo em que é desenvolvido o trabalho da marisqueira é importante para ocorrência dos DME.
Resumo Objetivo: aferir o grau de implantação do Protocolo de Vigilância e Atenção à Saúde de ex-trabalhadores e da população expostos a chumbo, cádmio, cobre e zinco em Santo Amaro, Bahia, no período de 2010 a 2015. Métodos: foram elaborados modelo lógico de avaliação e instrumentos de coleta de dados a fim de avaliar a estrutura, o processo e o resultado da implantação do Protocolo. O método Delphi adaptado foi utilizado como técnica de consenso para garantir a validade do conteúdo e da matriz de julgamento. Resultados: o escore final da avaliação foi de 22,3%, considerado insatisfatório, segundo a escala adotada. A “estrutura” obteve 38 pontos do total de 100; o “processo”, baseado na dimensão “organização e execução das atividades previstas no Protocolo”, obteve 25 pontos de 100; e a abordagem “resultados” alcançou 4 pontos de 100. Apenas 2,5% da população prevista pelo Protocolo teve as fichas de atendimento preenchidas, porém com falhas no atendimento, na realização de exames e nas notificações ao Sistema de Informação de Agravos de Notificação. Conclusão: o processo de implantação do Protocolo necessita de maior empenho da gestão pública de saúde, e de melhoria na infraestrutura, nas estratégias de orientação das equipes de saúde e na participação do usuário.
Musculoskeletal disorders (MSDs) can be characterized from their occupational etiology and their occurrence; their chronicity generates negative repercussions for the health of workers, especially of artisanal fishing. To investigate the prevalence of generalized musculoskeletal disorders by body region and self-reported pain in a fishing population of northeastern Brazil, an epidemiological cross-sectional study was carried out in Santiago do Iguape, Bahia-Brazil, in 2017. The Brazilian version of the Nordic Musculoskeletal Questionnaire (NMQ), in addition to a questionnaire containing the socio-demographic and labor conditions were applied to a random stratified sample of 248 artisanal fisheries. There were 170 female shellfish gatherers and 78 fishermen, with a mean age of 36.7 years (SD = 10.5 years) and 43.3 years (SD = 11.8 years), respectively. The beginning of the labor activity was initiated at approximately 11 years of age. The average weekly income varied from 17.64 USD to 29.10 USD. The prevalence of MSD independent of occupation occurred in at least one body region in 93.5% and the presence of musculoskeletal pain/discomfort over the last seven days in 95.2% of the fishing workers. The highest prevalence of MSD was found in shellfish gatherers in: lower back (86.4%), wrist and hand (73.5%), and upper back (66.8%). In relation to the presence of pain in the last year, the frequency of pain was greater in the fishermen compared to the shellfish gatherers. The generalized severity of the MSD in 93.5% of this community of fishermen is evident, with emphasis in the following regions: lower back, wrist and hand and upper back in both groups, with occurrence of pain in more than one body region at the same time.
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