Este trabalho descreve alguns aspectos da qualidade de vida das mulheres trabalhadoras de creche com o objetivo de oferecer subsídios para a melhoria das suas condições de trabalho. Cento e cinquenta e quatro mulheres, constituiram o universo da investigação, funcionárias das 7 creches conveniadas do Bairro Bela Vista com a Prefeitura Municipal de São Paulo, Brasil. Foram realizadas entrevistas, utilizando um formulário em que se consideraram as seguintes variáveis: características sócio-demográficas, opiniões e hábitos pessoais, condições de saúde, acesso a serviços de saúde, ocupação, posse de bens de consumo e nível sócio-econômico, vida profissional, condições e satisfação com o trabalho, escolaridade e ocupação dos maridos, dupla jornada, sindicalização, lazer, conhecimentos, atitudes e práticas no que diz respeito a direitos humanos. Os resultados desse survey mostram que a maioria das trabalhadoras de creche têm baixa escolaridade, isto é, 52,6 por cento frequentaram somente até o ginasial incompleto e 20,1 por cento têm o curso primário incompleto. Têm baixo nível sócio-econômico (classes D e E); 70 por cento têm filhos e 45 por cento são chefes de família. Estão na faixa etária de 18 a 61 anos. Em relação ao salário, 55 por cento recebem apenas de 2 a 3 salários mensais e 25 por cento de 3 a 4 salários. Com relação às moradias, apenas 35 por cento moram no centro da cidade, próximo ao local onde trabalham, as demais dependem de condução para o acesso; 35 por cento possuem casas próprias, 27 por cento moram em pequenos apartamentos e quitinetes e 13 por cento em cortiços. Para atendimento médico, 70 por cento procuram os hospitais localizados na região central por causa do atendimento imediato que oferecem. As Unidades Básicas de Saúde são utilizadas por 61 por cento das mulheres e os Pronto Socorros por 57 por cento . Só 21 por cento possuem convênio médico, principalmente porque os maridos têm direito. O tempo livre das entrevistadas é muito restrito, assim, suas atividades de lazer se resumem principalmente em ouvir rádio e assistir a TV. Com relação à leitura, as revistas foram citadas por mais da metade e os livros por 45 por cento , mas os jornais são lidos raramente. Nos finais de semana, a maioria usa o tempo livre para realizar serviços domésticos. Há muita rotatividade de funcionários nas creches, 49 por cento estão trabalhando há 2 anos ou menos e 24 por cento de 3 a 6 anos. Sessenta por cento trabalham na creche 8 horas/dia, com uma hora de almoço e, em casa, continuam com suas obrigações domésticas (dupla jornada). Quarenta e três por cento (43 por cento ) das mulheres mencionaram não ter feito nenhum curso, reciclagem ou treinamento depois que começaram a trabalhar. Das 944 crianças que frequentavam a creche por ocasião do estudo, só 20 por cento eram filhos dessas trabalhadoras. A opinião das entrevistadas em sua maioria é favorável à creche. Têm poucos conhecimentos em relação a seus direitos de trabalhadora, à aposentadoria, licenças, faltas e outros. Consideram que o Sindicato é importante na luta pelos interesses da categoria, mas a maioria não é associada e nem participa de reuniões ou outros eventos. Conhecem pouco sobre o Estatuto da Criança e do Adolescente. Propuseram, visando a melhoria do trabalho na creche, a realização de cursos de capacitação, aquisição de alguns recursos materiais e humanos, trabalho com os funcionários para aperfeiçoar as relações interpessoais, mudanças no horário e melhor salário. É importante que as opiniões das trabalhadoras, expressas nesta pesquisa, sejam levadas em consideração para a melhoria das suas condições de trabalho. / This work describes some aspects of the quality of life of women working in nurseries. It aims at providing subsidies to improve work conditions in the day care center. The universe of the study consisted of one hundred and fifty four women who worked at the seven nurseries maintained by an agreement between the local Bela Vista District Committee and the São Paulo City Hall, Brazil. The subjects were interviewed by means of a formulary in which the following variables were taken into consideration: social and demographic characteristics, personal habits and opinion, health conditions, access to health services, occupation, possession of consumer goods and social economic level, professional life, work conditions and job satisfaction, schooling and occupation of husbands, necessity of working all day, belonging to labor unions membership, leisure as well as knowledge, attitudes and practices regarding human rights. The results of this survey showed that the majority of the women had low educational, social and economic standards; 52,6 per cent never ended secondary school and 20,1 per cent had not completed primary school. They belonged, moreover, to a low social economic class (classes D and E); 70 per cent had children and 45 per cent were heads of their families. Their ages varied from 18 to 61 years. As regards income, 55.0 per cent earned 2 to 3 minimum wages per month and 25.0 per cent earned from 3 to 4. As to their dwellings, 35.0 per cent lived downtown, near their workplaces and others depended on transportation to get to work. 35.0 per cent of the subjects owned their homes; 27.0 per cent lived in small apartments and 13.0 per cent in slums. Health centers were used by 61.0 per cent of the women and 57.0 per cent used Emergency Units; 21.0 per cent were enrolled in the health insurance plan of their husbands. In relation to medicai care, 70.0 per cent prefered to report to the downtown hospitals due to the prompt attention offered by those units. Their spare time was scarce and was mostly used for leisure by listening to the radio or watching TV. As to reading activities, more than half of the subjects mentioned reading magazines and 45.0 per cent books, but newspapers were hardly read at all. On newspapers most of the women used their time in housework activities. There was a high turnover of employees in the studied nurseries; as much as 49.0 per cent of the subjects had been working for only two years or even less and 24.0 per cent from 3 to 6 years. As much as 60.0 per cent of the subjects worked 8 hours a day besides the lunch hour and once home got their housework under way. As regards courses, 43.0 per cent of the women mentioned not having attended any at all or even participated in training programmes after having started to work. Only 20.0 per cent of the 944 children of the nurseries at the time of this study belonged to the interviewed subjects. Most of the subjects expressed themselves highly as regards the nurseries. They had scant knowledge about their rights as employees in reference to\' retirement, sick-leaves, abscences and so on. They considered the labour unions important in striving for better conditions but most of them were not members and did not even participate in their meetings or other events. They knew very little about The Child and the Adolescent Bylaw. Some measures were proposed by the interviewed subjects in order to improve job quality in the nurseries such as: in-service courses, acquisition of human and material resources, activies aiming at improving employees\' interpersonal relationships, timetable changes and better wages. It is important that the employees\' opinions presented in this study be taken into account by the administrators so as to improve their job conditions.

Este trabalho descreve alguns aspectos da qualidade de vida das mulheres trabalhadoras de creche com o objetivo de oferecer subsídios para a melhoria das suas condições de trabalho. Cento e cinquenta e quatro mulheres, constituiram o universo da investigação, funcionárias das 7 creches conveniadas do Bairro Bela Vista com a Prefeitura Municipal de São Paulo, Brasil. Foram realizadas entrevistas, utilizando um formulário em que se consideraram as seguintes variáveis: características sócio-demográficas, opiniões e hábitos pessoais, condições de saúde, acesso a serviços de saúde, ocupação, posse de bens de consumo e nível sócio-econômico, vida profissional, condições e satisfação com o trabalho, escolaridade e ocupação dos maridos, dupla jornada, sindicalização, lazer, conhecimentos, atitudes e práticas no que diz respeito a direitos humanos. Os resultados desse survey mostram que a maioria das trabalhadoras de creche têm baixa escolaridade, isto é, 52,6 por cento frequentaram somente até o ginasial incompleto e 20,1 por cento têm o curso primário incompleto. Têm baixo nível sócio-econômico (classes D e E); 70 por cento têm filhos e 45 por cento são chefes de família. Estão na faixa etária de 18 a 61 anos. Em relação ao salário, 55 por cento recebem apenas de 2 a 3 salários mensais e 25 por cento de 3 a 4 salários. Com relação às moradias, apenas 35 por cento moram no centro da cidade, próximo ao local onde trabalham, as demais dependem de condução para o acesso; 35 por cento possuem casas próprias, 27 por cento moram em pequenos apartamentos e quitinetes e 13 por cento em cortiços. Para atendimento médico, 70 por cento procuram os hospitais localizados na região central por causa do atendimento imediato que oferecem. As Unidades Básicas de Saúde são utilizadas por 61 por cento das mulheres e os Pronto Socorros por 57 por cento . Só 21 por cento possuem convênio médico, principalmente porque os maridos têm direito. O tempo livre das entrevistadas é muito restrito, assim, suas atividades de lazer se resumem principalmente em ouvir rádio e assistir a TV. Com relação à leitura, as revistas foram citadas por mais da metade e os livros por 45 por cento , mas os jornais são lidos raramente. Nos finais de semana, a maioria usa o tempo livre para realizar serviços domésticos. Há muita rotatividade de funcionários nas creches, 49 por cento estão trabalhando há 2 anos ou menos e 24 por cento de 3 a 6 anos. Sessenta por cento trabalham na creche 8 horas/dia, com uma hora de almoço e, em casa, continuam com suas obrigações domésticas (dupla jornada). Quarenta e três por cento (43 por cento ) das mulheres mencionaram não ter feito nenhum curso, reciclagem ou treinamento depois que começaram a trabalhar. Das 944 crianças que frequentavam a creche por ocasião do estudo, só 20 por cento eram filhos dessas trabalhadoras. A opinião das entrevistadas em sua maioria é favorável à creche. Têm poucos conhecimentos em relação a seus direitos de trabalhadora, à aposentadoria, licenças, faltas e outros. Consideram que o Sindicato é importante na luta pelos interesses da categoria, mas a maioria não é associada e nem participa de reuniões ou outros eventos. Conhecem pouco sobre o Estatuto da Criança e do Adolescente. Propuseram, visando a melhoria do trabalho na creche, a realização de cursos de capacitação, aquisição de alguns recursos materiais e humanos, trabalho com os funcionários para aperfeiçoar as relações interpessoais, mudanças no horário e melhor salário. É importante que as opiniões das trabalhadoras, expressas nesta pesquisa, sejam levadas em consideração para a melhoria das suas condições de trabalho. / This work describes some aspects of the quality of life of women working in nurseries. It aims at providing subsidies to improve work conditions in the day care center. The universe of the study consisted of one hundred and fifty four women who worked at the seven nurseries maintained by an agreement between the local Bela Vista District Committee and the São Paulo City Hall, Brazil. The subjects were interviewed by means of a formulary in which the following variables were taken into consideration: social and demographic characteristics, personal habits and opinion, health conditions, access to health services, occupation, possession of consumer goods and social economic level, professional life, work conditions and job satisfaction, schooling and occupation of husbands, necessity of working all day, belonging to labor unions membership, leisure as well as knowledge, attitudes and practices regarding human rights. The results of this survey showed that the majority of the women had low educational, social and economic standards; 52,6 per cent never ended secondary school and 20,1 per cent had not completed primary school. They belonged, moreover, to a low social economic class (classes D and E); 70 per cent had children and 45 per cent were heads of their families. Their ages varied from 18 to 61 years. As regards income, 55.0 per cent earned 2 to 3 minimum wages per month and 25.0 per cent earned from 3 to 4. As to their dwellings, 35.0 per cent lived downtown, near their workplaces and others depended on transportation to get to work. 35.0 per cent of the subjects owned their homes; 27.0 per cent lived in small apartments and 13.0 per cent in slums. Health centers were used by 61.0 per cent of the women and 57.0 per cent used Emergency Units; 21.0 per cent were enrolled in the health insurance plan of their husbands. In relation to medicai care, 70.0 per cent prefered to report to the downtown hospitals due to the prompt attention offered by those units. Their spare time was scarce and was mostly used for leisure by listening to the radio or watching TV. As to reading activities, more than half of the subjects mentioned reading magazines and 45.0 per cent books, but newspapers were hardly read at all. On newspapers most of the women used their time in housework activities. There was a high turnover of employees in the studied nurseries; as much as 49.0 per cent of the subjects had been working for only two years or even less and 24.0 per cent from 3 to 6 years. As much as 60.0 per cent of the subjects worked 8 hours a day besides the lunch hour and once home got their housework under way. As regards courses, 43.0 per cent of the women mentioned not having attended any at all or even participated in training programmes after having started to work. Only 20.0 per cent of the 944 children of the nurseries at the time of this study belonged to the interviewed subjects. Most of the subjects expressed themselves highly as regards the nurseries. They had scant knowledge about their rights as employees in reference to\' retirement, sick-leaves, abscences and so on. They considered the labour unions important in striving for better conditions but most of them were not members and did not even participate in their meetings or other events. They knew very little about The Child and the Adolescent Bylaw. Some measures were proposed by the interviewed subjects in order to improve job quality in the nurseries such as: in-service courses, acquisition of human and material resources, activies aiming at improving employees\' interpersonal relationships, timetable changes and better wages. It is important that the employees\' opinions presented in this study be taken into account by the administrators so as to improve their job conditions.

Background: Although infectious diseases are less common in high-income countries compared to low-income countries, they should still be seriously considered as a relevant public health issue. Some professions, such as healthcare workers, laboratory workers, and care providers may be at a particularly high risk of acquiring infections. In Germany, work-related infectious diseases are after skin diseases, the most common cause of occupational diseases reported to the Institution for Statutory Social Accident Insurance and Prevention in the Health Care and Welfare Services (BGW). An occupational disease, as defined by the WHO, is “any disease contracted primarily as a result of an exposure to risk factors arising from work activity”, although this definition varies between countries. In order for infections to be recognized as an occupational disease, either the identification of an index case is needed or it must be shown that the likelihood in which a particular case of illness was attributable to the occupation: the probability of causation must be greater than 50% (the “more-likely-than-not” rule). A general “rule-of-thumb” is to equate the probability of causation of 50% with a relative risk of disease equal to two (the “doubling of the risk”). This principle is used by many countries for the recognition of an occupational disease. Few studies have concentrated on the risk of infectious disease in daycare workers, who may be at higher risk than the general population due to their frequent and close contact to young children. Research questions: The primary aim of this review was to summarize the evidence on the relationship between being a daycare worker working with children and the possible increased risk for infections not preventable by vaccines. Furthermore, research gaps were to be identified. Finally, the implications for practice and health policy based on the evidence were to be described. Methods: For the systematic reviews with meta-analysis, the Medline and Embase databases were searched using search strings defined according to the Population, Exposure, Comparison, and Outcomes (PECO) applicable to the research questions in order to find studies on vaccine non-preventable infections in daycare workers published since 2000. The search hits were evaluated using predefined inclusion and exclusion criteria by two independent reviewers. A separate manual search was performed by reviewing the reference lists of key articles and systematic reviews. The “citation tracking factor” by Google scholar was used to find additional relevant studies. The resulting studies were extracted and were assessed in eight risk of bias domains for the judgement of study quality. With a meta-analysis, the pooled risk of infections for daycare workers compared to the general or a reference population was calculated. The quality of evidence was assessed by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Results: After evaluating the 6879 records, ten methodologically adequate studies were identified regarding parvovirus B19 infection (four studies) and cytomegalovirus (CMV) infection (six studies). No adequate studies on other infections were found. For parvovirus B19 infection, three cross-sectional studies and one retrospective cohort study were identified. The pooled parvovirus B19 seroprevalence in daycare workers was 70.3% (95% CI 59.5-80.4). Of three studies investigating the relative risk (RR) of parvovirus B19 infection on daycare workers, only one study evaluated seroconversion rates. There was an indication for an increased risk of parvovirus B19 infection for daycare workers compared to the unexposed population (RR = 1.12, 95% CI 0.98–1.27) using prevalence estimators. Furthermore, daycare workers had a higher parvovirus B19 seroconversion rate compared to the unexposed population (RR = 2.63, 95% CI 1.27–5.45) in the low risk of bias study. For CMV infection, five cross-sectional studies and one cohort study were included. The pooled CMV seroprevalence of daycare workers was 59.3% (95% CI 47.6-70.9). The four studies investigating risk of infection indicated an increased seroprevalence for daycare workers compared to a reference population (prevalence ratio, RR=1.54, 95% CI 1.33-1.77). No study evaluated CMV seroconversions for daycare workers. Conclusions: The findings suggest higher parvovirus B19 and cytomegalovirus seroprevalence for daycare workers compared to the general population. There is a need for longitudinal and higher-quality studies regarding infections not preventable by vaccines in daycare workers, as well as a need to study other infections for which daycare workers may be at higher risk. Nonetheless, when the actual occupational seroconversion risk is considered by taking into account the pre-occupational seroprevalences, the pooled relative risks for both parvovirus B19 and CMV infection are compatible with a doubled seroconversion risk corresponding to a probability of causation due to the occupation of at least 50%. Preventative efforts in the workplace are needed based on the legally required risk assessment at the workplace. Moreover, it is important to raise awareness of the potential risk of infection in women trying to conceive or during pregnancy. Recommendations to prevent infections in the day care center include using gloves and frequent handwashing after exposure to young children’s bodily fluids, cleaning surfaces, and avoiding intimate contact with young children if pregnant, although these measures alone may not completely protect the daycare worker from infection. Currently, in Germany, an employment ban for pregnant daycare workers depends on the federal state. To avoid occupational risks for pregnant daycare workers, scientific-based guidelines should be developed and applied consistently.