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Pesquisa realizada em um Hospital Universitário do Estado do Rio de Janeiro, através de uma abordagem quantitativa descritiva, com objetivo de identificar os fatores de riscos ambientais presentes nas situações de trabalho dos profissionais de enfermagem, a partir da observação sistemática dos locais de trabalho pelos profissionais de saúde e segurança do trabalho e dos chefes de enfermagem de clínicas de um Hospital Universitário, visando gerar resultados que possam trazer a discussão, os riscos ocupacionais aos quais estão expostos os profissionais de enfermagem, seu conhecimento a respeito destes riscos e sua atuação na identificação e ação sobre os mesmos. A população foi composta por treis profissionais de saúde e segurança no trabalho e trinta enfermeiros chefes de unidade de internação. Para a coleta de dados foi utilizado um questionário fechado proposto no Guia de Avaliação de Riscos nos Locais de Trabalho de Boix e Vogel (1997) e adaptado para aplicação em estabelecimentos de saúde por Mauro (2001). Os dados foram analisados através do software Statical Package for the Social Sciences (SPSS) versão 15.0. Os resultados evidenciaram que os fatores de riscos ocupacionais de maior relevância do estudo foram: os sistemas inadequados de prevenção de incêndio, de saída de emergência e dispositivos e instruções de segurança e manutenção preventiva inadequada, exposição à riscos biológicos, desenho arquitetônico dos locais de trabalho inadequado, distribuição inadequada de pessoal e conhecimento ergonômico insuficiente do trabalhador. Estes fatores atuam de forma direta ou indireta nos locais de trabalho, propiciando aos profissionais um ambiente desfavorável para a realização das atividades, o que pode comprometer a sua saúde e vida profissional. Concluiu-se que os profissionais enfermeiros no cargo de gestores, em sua maioria, não possuem a visibilidade sobre os fatores de riscos aos quais eles próprios e a equipe sob sua gerência encontram-se expostos, mesmo porque desempenham suas tarefas quase em sua integralidade com alto risco de acidentes e doenças. O estudo proporcionou melhor compreensão dos fatores de risco presentes no ambiente, suas repercussões no processo de trabalho de enfermagem e na saúde dos profissionais, da importância da inserção e comprometimento dos gestores sobre os fatores de risco no ambiente de trabalho e da ergonomia participativa na análise e prevenção de riscos ocupacionais. / This research was carried out in a Rio de Janeiro State University Hospital through a descriptive quantitative approach. The aim of this study was to identify environmental risk factors in nursing professionals work situations from the systematic observation of the workplaces by the health and workplace safety professionals and by the head nurses of a University Hospital. Later on, this studys results would lead to a discussion on the occupational risks to which nursing professionals are exposed, on their awareness regarding those risks and on how they proceed to identify and to take measures against them. The population was composed by three health and workplace safety professionals and by thirty head nurses from the hospitalization unit. For data collection a closed questionnaire proposed by Boix e Vogel (1997) in their Risk Assessment at the Workplace and adapted to be applied in health facilities by Mauro (2001) was used. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software version 15.0. The results highlighted the following occupational risk factors as the most relevant in this research: inadequate fire prevention and emergency exit systems, inappropriate preventive maintenance and safety devices and instructions, exposure to biological risks, inadequate workplace architectural designs, irregular staff distribution and professionals insufficient ergonomic awareness. The previous factors can have a direct or an indirect impact on workplaces that may cause an adverse environment for the professionals to perform their activities, and working in such environments may endanger their professional health and life. From this study it was concluded that most of the nursing professionals working as managers are unaware of the risk factors to which their nursing staff and even themselves are exposed, since they carry out their occupational activities mostly with great risk of accident and diseases. This study has provided better understanding on the risk factors that can be found in the environment, on their implications for the nursing work process and for the professionals health, on the importance of managers insertion and commitment to the workplace environment risk factors and on the participative ergonomics during the analysis and prevention process of occupational risks.

Thesis (M.P.H.M (Primary Health Care Management))--Mahidol University, 2005.

Orientador: Joaquim Gonçalves Machado Neto / Banca: Carlos Alberto Garófalo / Banca: Zilá Luz Paulino Simões / Banca: Antonio Carlos Busoli / Banca: Júlio Cesar Galli / Resumo: O controle de larvas e adultos de Aedes aegypti é a forma disponível para controlar a Dengue. O uso de temefós é importante para o controle de larvas. O controle de adultos é realizado por nebulização de malathion nos imóveis, apresentando riscos ocupacionais aos aplicadores. Objetivou-se avaliar o período residual do temefós em recipientes de diferentes materiais pela validação de método analítico; propor um nível de aceitabilidade de controle de larvas; determinar o período residual de controle (PRC) em recipientes de borracha (pneus); propor um procedimento para monitorar o PRC em Pontos Estratégicos (PEs); avaliar as exposições dérmicas (EDs) e respiratórias (ERs); calcular a necessidade de controle das exposições potenciais (EPs); comparar a eficiência de duas vestimentas de proteção; classificar a segurança das condições de trabalho sem e com o uso das vestimentas; calcular a necessidade de controle das exposições e o tempo de trabalho seguro (TTS) proporcionado pelas vestimentas. O método validado é adequado para determinar a concentração do temefós na água. O material do recipiente afeta a dissipação do temefós. O controle de larvas nos pneus é aceitável (90%) por 22 dias após a aplicação. O procedimento com pneus amostradores é adequado para determinar o PRC de larvas em PEs. As EDs foram muito superiores às ERs. É necessário controlar 91,34 % das EPs. A vestimenta Agro Light é mais eficiente que a da SUCEN e a única em que a atividade foi classificada como segura. A atividade executada com a vestimenta da SUCEN se torna segura se for aumentado o controle da exposição em 11,4 %, ou a redução do tempo de trabalho ao TTS de 1,4 horas / Abstract: Controlling Aedes aegypti larvae and adults is the only possible way to control Dengue. The use of temephos is essential for larvae control. The control of adults is carried out by spraying malathion on buildings, which poses occupational risks to those who apply it. We aimed to evaluate the temephos' residual period in containers made out of different materials through validation of the analytical method; to propose a level of acceptability of larvae control; to determine the residual period of control (PRC) in rubber containers (tires); to propose a procedure to monitor PRC in Strategic Points (PEs); to evaluate dermal (EDs) and respiratory exposure (ERs); to compute the need to control potential exposure (EPs); to compare the efficiency of two protective equipments; to classify the safety of working conditions with and without protective equipments; to calculate the need to control exposure and time of safe work (TTS) provided by the protective equipment. The validated method is suitable to determine the concentration of temephos in water. The material of the container affects temephos degradation. Larvae control in tires is acceptable (90%) for 22 days after application. The procedure with tire samplers is suitable to determine PRC of larvae in PEs. EDs was much higher than ERs. 91.34% of EPs need to be controlled. The Agro Light protective equipment is more efficient than that of SUCEN and activities are considered safe only with its use. Activities performed with the protective equipment provided by SUCEN are considered safe if exposure control is increased by 11.4% or working time is reduced to the TTS of 1.4 hours / Doutor

Pesquisa realizada em um Hospital Universitário do Estado do Rio de Janeiro, através de uma abordagem quantitativa descritiva, com objetivo de identificar os fatores de riscos ambientais presentes nas situações de trabalho dos profissionais de enfermagem, a partir da observação sistemática dos locais de trabalho pelos profissionais de saúde e segurança do trabalho e dos chefes de enfermagem de clínicas de um Hospital Universitário, visando gerar resultados que possam trazer a discussão, os riscos ocupacionais aos quais estão expostos os profissionais de enfermagem, seu conhecimento a respeito destes riscos e sua atuação na identificação e ação sobre os mesmos. A população foi composta por treis profissionais de saúde e segurança no trabalho e trinta enfermeiros chefes de unidade de internação. Para a coleta de dados foi utilizado um questionário fechado proposto no Guia de Avaliação de Riscos nos Locais de Trabalho de Boix e Vogel (1997) e adaptado para aplicação em estabelecimentos de saúde por Mauro (2001). Os dados foram analisados através do software Statical Package for the Social Sciences (SPSS) versão 15.0. Os resultados evidenciaram que os fatores de riscos ocupacionais de maior relevância do estudo foram: os sistemas inadequados de prevenção de incêndio, de saída de emergência e dispositivos e instruções de segurança e manutenção preventiva inadequada, exposição à riscos biológicos, desenho arquitetônico dos locais de trabalho inadequado, distribuição inadequada de pessoal e conhecimento ergonômico insuficiente do trabalhador. Estes fatores atuam de forma direta ou indireta nos locais de trabalho, propiciando aos profissionais um ambiente desfavorável para a realização das atividades, o que pode comprometer a sua saúde e vida profissional. Concluiu-se que os profissionais enfermeiros no cargo de gestores, em sua maioria, não possuem a visibilidade sobre os fatores de riscos aos quais eles próprios e a equipe sob sua gerência encontram-se expostos, mesmo porque desempenham suas tarefas quase em sua integralidade com alto risco de acidentes e doenças. O estudo proporcionou melhor compreensão dos fatores de risco presentes no ambiente, suas repercussões no processo de trabalho de enfermagem e na saúde dos profissionais, da importância da inserção e comprometimento dos gestores sobre os fatores de risco no ambiente de trabalho e da ergonomia participativa na análise e prevenção de riscos ocupacionais. / This research was carried out in a Rio de Janeiro State University Hospital through a descriptive quantitative approach. The aim of this study was to identify environmental risk factors in nursing professionals work situations from the systematic observation of the workplaces by the health and workplace safety professionals and by the head nurses of a University Hospital. Later on, this studys results would lead to a discussion on the occupational risks to which nursing professionals are exposed, on their awareness regarding those risks and on how they proceed to identify and to take measures against them. The population was composed by three health and workplace safety professionals and by thirty head nurses from the hospitalization unit. For data collection a closed questionnaire proposed by Boix e Vogel (1997) in their Risk Assessment at the Workplace and adapted to be applied in health facilities by Mauro (2001) was used. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software version 15.0. The results highlighted the following occupational risk factors as the most relevant in this research: inadequate fire prevention and emergency exit systems, inappropriate preventive maintenance and safety devices and instructions, exposure to biological risks, inadequate workplace architectural designs, irregular staff distribution and professionals insufficient ergonomic awareness. The previous factors can have a direct or an indirect impact on workplaces that may cause an adverse environment for the professionals to perform their activities, and working in such environments may endanger their professional health and life. From this study it was concluded that most of the nursing professionals working as managers are unaware of the risk factors to which their nursing staff and even themselves are exposed, since they carry out their occupational activities mostly with great risk of accident and diseases. This study has provided better understanding on the risk factors that can be found in the environment, on their implications for the nursing work process and for the professionals health, on the importance of managers insertion and commitment to the workplace environment risk factors and on the participative ergonomics during the analysis and prevention process of occupational risks.

This dissertation focuses on occupational risk communication created by grantees of the Occupational Safety and Health Administration\'s Susan Harwood Training Grant (SHTG) Program. Although the SHTG program is aimed at workers in most high-hazard industries, I focus on occupational risk communication developed for residential construction workers, who remain the most at-risk for on-the-job injuries and fatalities. In 2011 (the most recent year for which statistics are available), 721 construction workers died in work-related accidents (Bureau of Labor Statistics, 2012). In this study, I relied primarily on two research methods: context-sensitive text analysis of deliverables created by twelve SHTG program grantees from 2006-2009 and interviews with representatives of four of these twelve grantees. The findings from this research illustrate the complexity of creating occupational risk communication in grant-related institutional settings. Although the process might seem straightforward, it is composed of twelve milestones, each of which can result in difficulties for the final deliverables. Grantees are asked to create safety training deliverables that includes principles of active workplace learning; however, qualitative analysis of these deliverables indicates that such principles are rarely enacted. Instead, the deliverables are marked by an emphasis on technical language, as well as by death-focused justification strategies that scare trainees into following the guidelines being presented. Each of these characteristics can alienate audiences of varied linguistic and cultural backgrounds, such as those found in the construction industry. / Ph. D.

Tiriamojo darbo tikslas. Ištirti stacionarioje sveikatos priežiūros įstaigoje dirbančių slaugytojų sveikatą įtakojančius psichosocialinius rizikos veiksnius ir įvertinti jų valdymo galimybę. Uždaviniai: Nustatyti slaugytojų nuomonę apie psichosocialinių rizikos veiksnius ir jų realų valdymą; Tyrimo metodika. 2011 m. rugpjūčio mėn. atliktas kiekybinis ir kokybinis tyrimas. Apklausti 284 VšĮ Respublikinės Šiaulių ligoninės bendrosios praktikos slaugytojai bei interviu metu apklausti 9 informantai. Rezultatai. Nustatyta nepakankamas apsaugos pirštinių naudojimas (p = 0,000). Daug darbo užduočių, nepriklausančių slaugytojo veiklai (p = 0,002), laiko trūkumas užduotims atlikti (p = 0,008), nepakankamai sudaromos sąlygos profesinei kvalifikacijai kelti ( p = 0,050). Organizavimo veiksniai: naktinis darbas (p = 0,035), nepakankamas darbo užmokestis (p = 0,035). Turinio veiksniai: didelė atsakomybė už atliekamus slaugos veiksmus (p = 0,042), įtakos savo darbui trūkumas (p = 0,027). Darbo santykių veiksniai: bloga skyriaus atmosfera (p = 0,018), nėra bendravimo (p = 0,017), paramos iš skyriaus administracijos trūkumas (p = 0,029), paramos iš įstaigos vadovybės trūkumas (p = 0,000), blogas vadovavimas įstaigai (p = 0,001). Visi šie veiksniai yra statistiškai reikšmingai susiję su slaugytojų amžiumi, jų šeimynine padėtimi, slaugytojų darbo stažu dabartinėje darbo vietoje bei bendru medicininiu darbo stažu. Negatyvus elgesį kasdien ir kas savaitę patirdavo: 2,2 % slaugytojų gaudavo... [toliau žr. visą tekstą] / Aim of study: to investigate the psychosocial risk factors for health among nurses working at in-patient health care setting and evaluate the potential for management of such factors. Objectives: to evaluate the attitudes of nurses towards psychosocial risk factors and actual management of such factors. Material and methods: the qualitative and quantitative study was conducted in August 2011. In total, 284 general practice nurses from Siauliai Hospital were enrolled to study, 9 of them underwent the interview. Results. There were following identified risk factors: insufficient use of hospital gloves (p<0.001), abundance of tasks not related with nursing (p=0.002), lack of time for accomplishing the tasks (p=0.008), and scarce conditions for improvement of professional qualification (p=0.050). Organizational factors: work at night (p=0.035) and low salary (p=0.035). Content-related factors: high responsibility for nursing actions (p=0.042) and lack of influence on own work (p=0.027). Relationships at work: poor internal climate at work (p=0.018), lack of communication (p=0.017), lack of support by department authorities (p=0.029), lack of support by hospital authorities (p<0.001), and poor hospital management (p=0.001). All abovementioned factors were statistically significantly associated with nurses ‘age, family status, work experience in current workplace, and general medical work experience. Daily or weekly negative behaviour towards nurses was reported by 2.2 % in form... [to full text]

Introduction: The building sector is one of the most dangerous. It was measured the risk perception possessed by construction workers. Culture can affect risk perception. Objectives: Show the risk perceived by construction workers in Spain and Peru, compare and discuss the similarities and differences between countries. Materials and methods: An exploratory, cross sectional study. Two samples of workers were used: Spanish (N=204) and Peruvian (N=210), obtained in building works, civil works and training centers. The quantification method used is the psychometric paradigm and its adaptation to the Portell & Solé's occupational safety in the NPT of INSHT from Spain. Were used 9 qualitative attributes of risk and a global quantitative attribute. These attributes are measured by Likert scale from 1 to 7 points, while the global quantitative attribute is measured on a scale of 1 to 100. Results: Workers in environments with potential hazards or heavy machinery have a high perception of risk. Workers in both countries considered that have knowledge enough about safety at work. Spanish workers consider their health and safety managers do not have enough knowledge, being better rated in Peru. The probability of incident obtained low score. The global quantitative measure of risk did not obtain statistically significant difference between the two countries. Conclusions: perceived risk in construction should be studied to improve the health of their workers. / irgarzon@ugr.es / Introducción: El sector de la construcción es uno de los más peligrosos. Se midió la percepción del riesgo que poseen los trabajadores de la construcción. La cultura puede afectar la percepción del riesgo. Objetivos: Dar a conocer el riesgo que perciben los trabajadores de la construcción en España y Perú, comparar y discutir las similitudes y diferencias entre países. Materiales y métodos: Estudio de carácter exploratorio transversal. Se utilizaron dos muestras de trabajadores: Españoles (N=204) y Peruanos (N=210) obtenidas en obras de edificación, obras civiles y centros de formación. El método de cuantificación es el paradigma psicométrico y su adaptación a la seguridad ocupacional de Portell & Solé en la NTP 578 del INSHT de España. Se utilizaron 9 atributos cualitativos del riesgo y un atributo cuantitativo global. Estos atributos se miden mediante escalas Likert de 1 a 7 puntos, mientras que el atributo cuantitativo global se mide mediante una escala de 1 a 100. Resultados: Los trabajadores de ambientes con riesgos potenciales o con maquinaria pesada tienen una percepción alta del riesgo. Los trabajadores de ambos países consideran que poseen suficiente conocimiento sobre la seguridad en el trabajo. Los trabajadores españoles consideran que sus responsables de seguridad y salud no poseen suficiente conocimiento, siendo mejor puntuados en Perú. La probabilidad de ocurrencia obtuvo baja puntuación. La medida cuantitativa global del riesgo no obtuvo diferencia estadísticamente significativa entre ambos países. Conclusiones: se debe estudiar el riesgo percibido en la construcción para mejorar las condiciones de salud de sus trabajadores.

Introduction: Firefighters are workers who usually live with risks inherent with their profession. Objectives: To delve about the concept of perceived risk as a tool for managing occupational risk. Materials and methods: The model used for risk quantification was the psychometric paradigm. Thus, anonymous surveys were conducted at different fire stations. The questionnaire contained demographic questions, nine questions on various attributes of risk and a question about risk perception of the subject in general. Results: Statistical analysis showed two distinct groups in terms of their perception of risk. The first group is represented by members with a high perception of risk and the second one with low risk perception. Finally, it is showed that educational level was only a significant variable for perceived risk explaining. Conclusions: Results are discussed in terms of existing literature concluding that training workers is necessary to raise their perception of risk. / Introducción: El personal de emergencia convive habitualmente con riesgos inherentes a su profesión. Objetivos: Profundizar acerca del concepto del riesgo percibido como herramienta para gestionar el riesgo ocupacional. Materiales y métodos: El modelo utilizado para la cuantificación del riesgo ha sido el paradigma psicométrico. De esta forma, se realizaron encuestas anónimas en las diferentes estaciones de bomberos. El cuestionario contenía preguntas sociodemográficas, nueve preguntas acerca de distintos atributos del riesgo y una pregunta acerca de la percepción del riesgo en general del sujeto. Resultados: El análisis estadístico muestra dos grupos claramente diferenciados en cuanto a su percepción del riesgo, siendo uno de ellos caracterizado por tener sus integrantes una alta percepción del riesgo y el otro por tener una baja percepción del riesgo. Por último, se muestra que solamente el nivel educacional era una variable significativa en la explicación del riesgo percibido. Conclusiones: Los resultados son discutidos en función de la literatura existente concluyendo que se debe formar a los trabajadores para elevar su percepción del riesgo.

No município de São Paulo, em 1970 foram relatados 169 casos novos de câncer de laringe, com uma taxa de incidência ajustada por idade pela população mundial de 25,5/100.000 (30-74 anos) e 299 casos em 1985, elevando a taxa para 37,6 (ambos nosexo masculino). O Tabagismo e o consumo de álcool são os fatores de risco mais bem estabelecidos para o câncer de laringe. Com relação aos fatores ocupacionais, o único carcinógeno estabelecido é a exposição à névoa de ácidos inorgânicosfortes. É proposto um estudo caso-controle de base hospitalar, para investigar e quantificar o papel da exposição ocupacional no desenvolvimento do câncer de laringe e é discutida uma nova proposta de avaliação de exposição que visa melhorar avalidade interna desse tipo de estudo / Laryngeal cancer comprises 3,1% of the new cases of cancer in men in the world, representing the tenth most common malign neoplasm for males. In São Paulo City, 169 new cases of laryngeal cancer were reported in 1970, representing 25,5/100.000 and 299 cases in 1985, increasing the rate to 37,6/100.000 (both for males, age standardized truncated rate, 30-74 years). The best established risk factors for laryngeal cancer are tobacco and alcohol. In respect to occupational factors, the only established carcinogen is exposure to strong inorganic acid mists. However, asbestos, pesticides, paints, gasoline and diesel engine emissions, dusts, among other factors are reported in the literature as occupational agents that increase the risk of laryngeal cancer. A hospital-based case-control study was conducted, in seven hospitals in São Paulo, to investigate occupational risk factors for laryngeal cancer. The study included 122 laryngeal cancers and 187 controls, selected by frequency matching on sex and age. Detailed information on smoking, alcohol consumption, and occupational history was collected. Occupational hygienists assessed the exposure to 49 agents. Odds Ratios (OR) and 95% confidence intervals (95% CI) were estimated by unconditional logistic regression, and were adjusted for sex, age, smoking and alcohol. Laryngeal cancer was associated with exposure to respirable free crystalline silica (OR 1,83, 95% CI 1,00 - 3,36), soot (from coal, coke, fuel oil, wood) (OR 1,78, 95% CI 1,03 - 3,03), fumes (OR 2,55, CI 95% 1,14 - 5,67) and to live animals (OR 1,80, 95% CI 1,02 - 3,19). This study showed that occupational exposures to: respirable free crystalline silica, soot (from coal, coke, fuel oil, wood), fumes and live animals are risk factors for laryngeal cancer.