Submitted by Fabiana Gonçalves Pinto (benf@ndc.uff.br) on 2016-05-17T19:36:39Z No. of bitstreams: 1 Giselle Gomes Borges.pdf: 2928602 bytes, checksum: 0f6004796d06237d4fade7e9f6aaca8d (MD5) / Made available in DSpace on 2016-05-17T19:36:40Z (GMT). No. of bitstreams: 1 Giselle Gomes Borges.pdf: 2928602 bytes, checksum: 0f6004796d06237d4fade7e9f6aaca8d (MD5) Previous issue date: 2015 / Mestrado Profissional em Enfermagem Assistencial / O câncer é um evidente problema de saúde pública mundial. A quimioterapia trouxe uma maior taxa de cura para muitos tumores através da utilização de agentes químicos. Durante o manuseio dos quimioterápicos antineoplásicos (QA) é recomendado que o profissional utilize equipamentos de proteção individual (EPI) já que estes agentes oferecem efeitos indesejados e podem vir a constituir risco ocupacional. Este estudo tem como objeto o risco químico a que estão expostos os enfermeiros que desenvolvem suas atividades laborais em Centrais de Quimioterapia (CQT). Objetivo geral: implantar um manual de boas práticas com a finalidade de minimizar a exposição ao risco químico na CQT. Objetivos específicos: analisar os Conhecimentos, Atitudes e Práticas (CAP) dos enfermeiros a respeito do risco químico na CQT e elaborar um manual de boas práticas para os enfermeiros na CQT sobre a exposição ao risco químico a partir dos resultados do inquérito CAP. Trata-se de uma pesquisa descritiva com abordagem quantitativa, do tipo inquérito CAP. O estudo teve como amostra 26 enfermeiros de duas CQT. Utilizado para a coleta de dados um questionário autoadministrativo sem identificação, misto, contendo perguntas em que se utiliza uma escala de resposta paramétrica tipo Likert. Antecedendo a coleta dos dados o trabalho foi submetido ao Comitê de Ética em Pesquisa (CEP) com aprovação nº 12361613.4.00005274 em 12/09/2014. Resultados: Constatou-se que o conhecimento constituído a respeito do risco químico foi adequado nas duas CQT. Contudo, as atitudes e práticas diante do risco químico não foram coerentes. Dos enfermeiros, 96,2% consideram-se vulneráveis ao risco químico; o uso de EPI é considerado por 76,9% como um cuidado para que ocorra o manuseio seguro dos QA; quanto aos cuidados dispensados pelo Instituto aos que manuseiam QA, 53,8% citam os exames periódicos. O manual foi elaborado a partir dos resultados do inquérito CAP e implantado no Instituto, cenário do estudo, através do sistema Intranet. Para complementar, o manual de boas práticas, foram confeccionados sinalizadores com o intuito de embasar os enfermeiros a minimizarem a exposição ao risco. Conclusão: os profissionais que trabalham em CQT conhecem e consideram-se expostos ao risco químico. São necessárias intervenções para ampliar a adesão às medidas preventivas como o uso de EPI e subsídios com infraestrutura estratégica para a segurança do trabalhador. / Cancer is an obvious problem of global public health. The chemotherapy brought greater cure rate for many tumors through the use of chemical agents. During handling of antineoplastic drugs (QA) is recommended that professionals use personal protective equipament (PPE) as these agents provide unwanted effects and are liable to occupational risk. This paper studied the chemical risk they are exposed to nurses who develop their work activities on Chemotherapy Centers (CQT). Overall objective: to implement a manual of good practices in order to minimize exposure to chemical risk in the CQT. Specific objectives: to analyze the Knowledge, Attitudes and Practices (KAP) of nurses about the chemical risk in the CQT and prepare a manual of good for nurses in CQT on exposure to chemical risk from the KAP survey results. It is a descriptive research with a quantitative approach, the KAP. The study had as sample 26 nurses from two CQT. Used to collect data one auto administrative questionnaire unmarked, mixed, containing questions which uses a parametric response Likert scale. Preceding data collection work was submitted to the Research Ethics Committee (CEP) with approval number 12361613.4.00005274 on 09/12/2014. Results: It was found that knowledge made about chemical risk was adequate in both CQT. Yet attitudes and practices before the chemical risk were not consistent. 96,2% of nurses consider themselves vulnerable to chemical risk; the use of PPE is considered by 76,9% as a caution to occur safe handling of QA; as the care provided by the Institute to handling QA 53,8% cite the periodic examinations. The manual has been prepared from the KAP survey results and implanted in the study setting Institute through the Intranet system. In addition to the manual of good practice were made flags in order to base nurses to minimize exposure to risk. Conclusion: professionals working in CQT know and consider themselves exposed to chemical risk. Interventions are needed to increase the adherence to preventive measures such as the use of PPE and subsidies to strategic infrastructure for worker safety.

This dissertation addresses the complex challenge of communicating knowledge about environmental risks from toxic chemicals. Modern environmental risks are often invisible and technically complex, making the management of these risks highly dependent on data and information. Reliance on risk knowledge necessitates effective dissemination and communication by government agencies, yet the public's engagement with this information remains unclear due to limited real-world studies. This dissertation is comprised of three standalone papers bridging this gap. Each focuses on different aspects of risk knowledge communication using news dialogues as data sources. The first paper investigates the communication of location-specific risk information through a case study of the Radford Army Ammunition Plant (RAAP). Using content analysis and logistic regression, the study examines how scientific information about local environmental issues is presented in news articles and what factors influence its inclusion. Findings highlight the varying capacities among different stakeholder groups to access and utilize scientific information, underscoring the need for governmental and research support for less-resourced groups. The second paper explores chemical-specific risk knowledge, focusing on the environmental risks associated with per- and polyfluoroalkyl substances (PFAS). Employing a structural topic model (STM) and multinomial logistic regression, the study assesses the impact of the United States Environmental Protection Agency (US EPA)'s Draft Toxicity Assessment for GenX, one of the PFAS chemicals, on news topics. Results indicate that the influence of new risk knowledge on news topics varies depending on community context, with significant impacts observed when communities are ready for governmental action or legislation using the new assessment. The third paper examines the use of the US EPA's Toxics Release Inventory (TRI) database in news media. Through exploratory analysis, it reveals how different stakeholders use TRI data to make claims about environmental risks, highlighting that environmental organizations are primary users who often reconstruct TRI data to make it more relevant to the public. This suggests their potential role as intermediaries in risk knowledge communication. This dissertation provides empirical evidence of the limited news coverage of environmental risk knowledge, the dominance of government sources, and the significant role of intermediary groups. The findings suggest policy implications for government agencies and other organizations, highlighting the need to improve the conveyance and communication of risk knowledge. Recommendations include providing more contextual information and training for communities and intermediary groups on interpreting and utilizing risk data and information. These aim to bolster public comprehension and responsiveness to environmental risks, thereby protecting public safety and health. / Doctor of Philosophy / Toxic chemicals in our environment pose serious risks, but these dangers are often invisible and complex, making them hard to understand and manage without data and information about them. This dissertation explores how information about these risks is shared with the public through printed and online news coverage, aiming to enhance communication and our understanding of these environmental threats. This dissertation presents findings from three studies, each focusing on different types of risk information. The first looks at scientific information about local environmental risks at the Radford Army Ammunition Plant communicated in the news. It shows that not all groups have the same ability to access and use scientific data, and people tend to or feel compelled to bring up scientific information when they claim that risks exist, while the same level of scientific proof is not deemed necessary when denying the risks. The second study identifies topics in the news coverage of a specific chemical risk, per- and polyfluoroalkyl substances (PFAS) contamination across the United States. This study also reveals how the publication of a new risk assessment for GenX – one type of PFAS chemical that was found to be more harmful than previously thought – changes the topics covered in the news. It finds that the impact of the new risk assessment depends on the readiness of communities to engage with the information and take action. The third study examines how a broad database of toxic chemical releases – the United States Environmental Protection Agency's Toxics Release Inventory – is used by various groups speaking in the news. It finds that environmental organizations play a crucial role in making complex data understandable and relevant to the public. Overall, this dissertation highlights the challenges and importance of effectively sharing information about toxic chemicals. It suggests ways for government agencies and other organizations to improve how they communicate these risk data and information, such as providing more context and training for those who advocate or report on these issues. By doing so, we can help the public better understand and respond to environmental risks, ultimately protecting our health and the planet.