OBJECTIVE:To estimate the contribution of work-related diseases to sick leaves due to general and occupational health problems. METHODS:Sociodemographic, occupational and health data from 29,658 records of temporary disability benefits, granted on account of health problems by the Instituto Nacional do Seguro Social (National Institute of Social Security) in the state of Bahia (Northeastern Brazil), were analyzed. All constant ICD-10 clinical diagnoses were taken into consideration, except for those referring to external causes and factors that infl uence contact with health services. The link between diagnosis and occupation was based on the ICD-10 code and whether the type of compensation was due to a "work-related accident/disease" or not. RESULTS:From all the benefi ts, 3.1% were granted due to work-related diseases: 70% were musculoskeletal system and connective tissue diseases, while 14.5% were related to the nervous system. In general, benefi ts granted at more than two times the expected frequency were as follows: tenosynovitis in the manufacturing sector (Proportion Ratio-PR=2.70), carpal tunnel syndrome in the fi nancial intermediation sector (PR=2.43), and lumbar disc degeneration in the transportation, postal service and telecommunications sectors (PR=2.17). However, no causal connection could be established for these diseases, in these activity sectors, in a signifi cant percentage of benefi ts. CONCLUSIONS:Results suggest the existence of possible occupational risk factors for diseases in these fi elds of activity, as well as the underreporting of the link between diseases and work, thus disguising the responsibility of companies and the perspective of prevention through work reorganization.
OBJECTIVE:To analyze factors associated with the duration of disability benefi ts due to work-related upper-limb musculoskeletal disorders. METHODS:Ambispective cohort study conducted with 563 insured workers from the General Social Security System who received temporary disability benefi ts due to work-related upper-limb musculoskeletal disorders in the city of Salvador, Northeastern Brazil, in 2008. The data came from an inquiry performed by the Regional Audit of the National Social Security Institute and from administrative records. Sociodemographic and work-related variables were analyzed, as well as characteristics of the health problem and aspects related to social security. Factors associated with time until the cessation of the benefi t were identifi ed through survival analysis techniques. RESULTS:Low socioeconomic position (RR=1.29; 95%CI 1.02; 1.64), age below 39 years (RR=1.23;95%CI 1.03; 1.47), income replacement by the National Social Security Institute ≤ 100% (RR=1.24; 95%CI 1.04; 1.47) and high expectation of returning to work (RR=1.20; 95%CI 1.00; 1.44) are the categories related to higher rate of cessation of the benefi t and with its shorter duration. CONCLUSIONS:Factors that are not strictly medical, like socioeconomic position, age, expectation of returning to work and level of income replacement by the National Social Security Institute, seem to infl uence the benefi t's duration. These hypotheses need to be tested with further confi rmatory studies in order to improve the understanding of the process of determining incapacity for work.
This study focused on the annual cumulative incidence (ACI) of disabling work-related musculoskeletal disorders affecting the neck and/or upper limbs (ULMSD) among workers covered by the National Social Insurance System in the city of Salvador, Bahia State, Brazil. Cases were workers who received disability compensation benefits when unable to work due to ULMSD, during the year 2008. The data were obtained from the administrative systems of the National Social Insurance Institute and Ministry of Labor and Employment. ACI was 15 per 10,000 workers. Increased ACI of ULMSD was associated with female gender, lower income, and work in financial activities or manufacturing. Women earning the minimum wage (US$ 64.00 per month) or less had the highest ACI of ULMSD (123 per 10,000), suggesting inequalities in the occurrence of these disorders. The study indicates the need to prioritize preventive actions focusing on ergonomics and work organization, early diagnosis, treatment, and rehabilitation.
Posição socioeconômica e duração do benefício por incapacidade devido a doenças musculoesqueléticas relacionadas ao trabalho Socioeconomic position and duration of disability benefi t due to work-related musculoskeletal disorders
This article discusses new uses of interpretative repertoires of risk, especially those related to adventure. The author argues that the language of risk as adventure has multiple uses, as both a hedge against de-traditionalizing processes typical of late modernity and a figure of speech for new sensitivities stemming from the imperative of coping with the imponderability and volatility of modern risks. The article begins with an overview of the historical meanings of risk, seeking to argue that, as language in use, risk is a useful vantage point for understanding the transformations currently under way in the forms of social control, suggesting that we are experiencing a transition from disciplinary society, typical of classic modernity, to risk society. The discussion then focuses on recent transformations in images of risk, with special emphasis on the trend to use risk-adventure as a metaphor for late modernity.
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