Syfte – Syftet med denna studie är att öka förståelsen för kopplingen mellan Lean och kraftergonomi inom tillverkningsindustrin samt undersöka varför de, inom viss forskning, anses oförenliga. För att uppfylla syftet har det gemensamma snittet mellan Lean och kraftergonomi undersökts samt vilka konflikter som kan uppstå mellan Lean och kraftergonomi vid arbete inom tillverkningsindustrin. Metod – Litteraturstudier, med fokus på samverkan mellan Lean och kraftergonomi, har utgjort ett teoretiskt ramverk. Litteraturstudier har kompletterats med en fallstudie på ett företag inom tillverkningsindustrin. Empirisk data, utgjord av genomförda intervjuer, observationer och en riskbedömning på fallföretaget, har analyserats gentemot det teoretiska ramverket och därmed genererat studiens resultat. Resultat – Studiens resultat visar på en stark koppling mellan Lean och kraftergonomi, då de samverkar till att stödja och förbättra varandra. Den vanliga uppfattningen, att Lean skulle orsaka repetitivt arbete, motbevisas genom att Leans principer, såsom arbetsrotation, arbetsutvidgning och arbetsberikning, istället bidrar till variation. Att Lean orsakar repetitivt arbete motbevisas även genom att arbetets takt baseras på kundefterfrågan, istället för kortast möjliga cykeltid. Ett annat bevis för att Lean och kraftergonomi stödjer varandra är att kvalitetsbrister oftast beror på kraftergonomiskt krävande rörelser. Dessa rörelser ses som icke-värdeadderande aktiviteter enligt Lean och minskar effektiviteten i arbetet. En konflikt mellan Lean och kraftergonomi har dock identifierats i studien, vilket är rörelse i form av gång. Gång ses enligt Lean som en icke-värdeadderande aktivitet, medan det enligt kraftergonomi är en viktig faktor för ett varierat arbete. Implikationer – Studien bidrar till den forskning som visar på att Leans principer och metoder ligger i ett gemensamt snitt med kraftergonomi. Anledningen till att många verksamheter upplevt en försämrad kraftergonomi på grund av Lean, tros därför bero på en ofullständig implementering utan helhetssyn över verksamhetsstrategin. Studiens resultat är behjälpligt för verksamheter i alla stadier av arbete med Lean. Resultatet kan användas som underlag för beslut före implementering, som stöd under implementering och vid fortsatt uppföljning och förbättringsarbete enligt Leans principer och metoder. Förhoppningen är att resultatet ska kunna hjälpa verksamheter att minska sjukfrånvaron, genom ökad förståelse för Lean som verksamhetsstrategi. Varje verksamhet behöver dock ha i åtanke att den identifierade konflikten mellan Lean och kraftergonomi kräver en avvägning för varje specifik arbetssituation. Begränsningar – Studerad litteratur har innefattat teori, där både Lean och kraftergonomi behandlas. Genom enskilda studier av både Lean och kraftergonomi, hade mer information troligtvis erhållits och medfört ett mer omfattande resultat om kopplingen mellan de två. / Purpose – The purpose of this study is to increase the understanding of the connection between lean and physical ergonomics in manufacturing industry, and to investigate reasons why they, in certain research, are considered to be inconsistent. To fulfil this purpose the intersection between lean and physical ergonomics has been studied, as well as possible conflicts that may arise between lean and physical ergonomics in manufacturing industry. Method – The theoretical framework is based on literature studies, focusing on the interaction between lean and physical ergonomics, supplemented by a case study at a company in manufacturing industry. Empirical data from completed interviews, from observations, and from a risk assessment of the case study company, have been analysed against the theoretical framework and generated the study's results. Findings – The results of the study show a strong link between the principles and methods of lean and physical ergonomics, as they work together to support and improve each other. The common perception, that lean should cause repetitive work, is disproved through the principles of lean, such as work rotation, work enlargement and work enhancement, which all contribute to variation. Also, according to lean principles, work rate should be based on customer demand and not on shortest possible cycle time. Another evidence of lean and physical ergonomics supporting each other is the fact that quality defects mostly occur due to ergonomically demanding movements. Such movements reduce work efficiency, and should be considered as waste according to lean. In the study, one conflict has been identified between lean and physical ergonomics, regarding movements through walking. In lean, walking is considered a non-value adding activity, while it in physical ergonomics is seen as a vital factor for work variation. Implications – The study contributes to research showing that lean principles and methods have a common intersection with physical ergonomics. The reason why many companies have experienced impaired physical ergonomics from lean, is supposed to be through incomplete implementations, lacking operational strategy overview. The results from the study will be useful for companies in all phases of lean implementation. The result may assist decisions when considering implementation, during implementation, and in continued monitoring and improvement efforts according to lean principles and methods. It is hoped that the results can help reduce sick leave through increased understanding of lean as an operational strategy. Each company must, however, bear in mind that the identified conflict between lean and physical ergonomics will have to be weighed up carefully by that particular company. Limitations – Studied literature has included theory where both lean and physical ergonomics have been discussed. Through individual studies of lean and of physical ergonomics more information would most likely have been acquired, resulting in a more extensive result on the connection between the two.

Esse estudo teve como objetivo apreender a qualidade de vida (QV) de trabalhadores de enfermagem acometidos por Distúrbios Osteomusculares Relacionados ao Trabalho (DORT) e construir possíveis estratégias para a melhoria da mesma. Investigamos a QV em trabalhadores de Enfermagem com DORT em membros superiores de um Hospital Universitário. O estudo, de caráter exploratório-descritivo e abordagem qualitativa, foi desenvolvido tendo como população os trabalhadores de enfermagem de um hospital público universitário, constituindo 11 mulheres e dois homens, portadores de DORT em membros superiores, representantes de todas as categorias de enfermagem e de diversas unidades assistenciais. A coleta de dados foi realizada através de entrevista individual e grupo focal. Após aprovação do projeto em Comitê de Ética, a coleta de dados foi iniciada através das entrevistas com os sujeitos eleitos. Foram realizadas, também, cinco sessões de grupo focal, no período de novembro a dezembro de 2011. Os resultados de caracterização mostram que a média de tempo de trabalho nesta instituição é de 19 anos, denotando extensa exposição a cargas fisiológicas; sete trabalhadores realizam, concomitantemente ao trabalho remunerado, afazeres domésticos integralmente e cinco deles parcialmente; as atividades de lazer são apenas ocasionais; a maioria dos sintomas refere-se a quadros dolorosos em ombros, o que acaba prejudicando também a realização de atividades básicas e cotidianas. Após o tratamento dos dados de caracterização, as falas foram submetidas à análise de conteúdo e permitiram apreender quatro categorias: existindo com dor, QV é não ter limitações, meu trabalho influenciando na minha QV e cuidando e sendo cuidado. Na primeira categoria, os relatos revelam a influência da dor na constituição do sujeito, em suas expectativas e sua relação com o quadro emocional. Com relação à qualidade de vida, evidenciamos que esta encontra-se prejudicada pela co-existência de dois aspectos, mencionados na segunda e terceira categorias: dor e consequentes limitações e inadequações na organização e processo de trabalho, sendo mencionados alguns fatores desfavoráveis do cotidiano laboral: excesso de tempo no local de trabalho, inadequação de equipamentos e organização e processos de trabalho inapropriados. Dessa forma, as falas dialogam com as definições de Qualidade de Vida Relacionada à Saúde e Qualidade de Vida no Trabalho, sendo essas indissociáveis do conceito de QV para esses trabalhadores, já que as percepções do valor atribuído à vida estão sob influência da dor e que inadequações no processo de trabalho alteram significativamente a QV. Na última categoria, verificou-se satisfação com o processo grupal, com crescente conscientização e mudanças no cuidado a si. Em especial, foram despertadas ações cruciais para controle de quadros crônicos de DORT: a atenção a si e às combinações de fatores pessoais, físicos, sociais e emocionais. Também foram observados o meio, com seus riscos e benefícios e simples estratégias de saúde, apreendidas e construídas coletivamente. Construiu-se, junto aos trabalhadores, um programa educativo onde foram oferecidas novas perspectivas para amenização de sintomas, bem como modificações comportamentais relacionadas a componentes posturais e ambientais, indo ao encontro de um dos princípios de Promoção da Saúde e abordando um dos pilares da QV para esse grupo. Conclui-se que a QV desses trabalhadores está intimamente relacionada à dor e ao trabalho. Compreendeu-se que há a necessidade de combinação de estratégias mutissetoriais, com responsabilização dos próprios indivíduos e existência de ações coletivas do sistema de saúde e da comunidade / This study aimed to capture the quality of life (QoL) of nursing workers affected by Work Related Musculoskeletal Disorders (WMSDs) and build strategies for its improvement. We investigated the QoL of nursing workers with upper limb disorders in a University Hospital. The study is exploratory and descriptive with qualitative approach and was developed with the nursing staff of a public hospital, constituted of 11 women and two men suffering from disorders in the upper limbs, representatives of all categories of nursing and several units. Data collection was conducted through individual interviews and focus groups. After project approval by the Ethics Committee, data collection began with interviews with the chosen subjects. Five focus group sessions were also carried out, from November to December in 2011. The sociodemographic results show that the average working time in this institution is 19 years, indicating extensive exposure to physiological loads; seven workers perform, concurrently with paid work, full housework and five of them partial; leisure activities are only occasional and the majority of symptoms refers to painful shoulders, which ultimately jeopardize the performance of basic activities of daily living. After treatment of the sociodemographic data, the reports were subjected to content analysis which raised four categories: existing with pain, QoL is having no limitations , my job influencing on my QoL and caring and being cared for. In the first category, the reports reveal the influence of pain in the constitution of the subject, their expectations and its relationship with the emotional picture. Regarding the quality of life, we found that it is hampered by the co-existence of two aspects mentioned in the second and third categories: pain and its resulting limitations and inadequacies in the work organization and process, and some unfavorable factors of daily work mentioned were: too much time at work, inappropriate equipment and improper work organization and processes. Thus, the speeches match with the definitions of Quality of Working Life and Health-Related Quality of Life, these being inseparable from the concept of QoL for these workers, since the perceptions of the value attributed to life are under the influence of pain and that inadequacies in the work process significantly alter QoL. In the latter category, there was satisfaction with the group process, with enhanced awareness and changes in their care. In particular, workers were sensitized to crucial ways to control chronic conditions of WMSDs: attention to themselves and to combinations of personal, physical, social and emotional aspects. Increased attention with the environment also happened, with recognition of its risks and benefits and the use of simple health strategies, learned and built collectively. It was built, along with the workers, an educational program where they were offered new prospects for alleviation of symptoms, as well as behavioral changes related to postural and environmental components, meeting one of the principles of Health Promotion and addressing one of the concepts of QoL for this group. In conclusion, QoL of these workers is closely related to pain and work. It was understood that there is a need for multiple combination of strategies, with accountability of the individuals themselves and the existence of collective actions of the health system and community

Background - Hand intense occupational activities have been associated with an increase in the incidence of carpal tunnel syndrome (CTS). CTS is characterized by an impairment of median nerve function. To date, a dose-response relationship between wrist activity and median nerve performance has not been documented. Since repetitive hand/wrist activity in the workplace has significant implications, it is important to establish a scientific basis for the aetiology of work-related carpal tunnel syndrome. Methods -- In a laboratory environment, twenty-seven clinically confirmed asymptomatic female subjects performed continuous repetitive wrist motion in the flexion-extension plane during which an angle of 120 degrees was subtended about the neutral wrist position. Four levels of wrist activity, corresponding with 0 (static), 22 (Iow), 38 (medium) and 49 (high) repetitions per minute, were prescribed. Wrist motion was recorded using a state-of-the-art 3D electromagnetic tracking system (HumanTRAC). Mathematical descriptors of wrist kinematics, including cycle time, amplitude, angular velocity and angular acceleration, were calculated. Sensory median nerve response to imposed physical stressors was monitored antidromically and recorded using a clinical electroneurometer every ten minutes throughout the simulated work activities. Near-nerve skin temperature was recorded at three sites along the distal sensory branch of the median nerve every twenty minutes. Results - After adjusting for changes in near-nerve skin temperature, a significant within-subject effect of duration of exposure (time) was detected. Sensory median nerve conduction velocity differed statistically by 2.1 ms-1 between the static and high wrist activity conditions after 120 minutes of exposure, signifying adverse effects on nerve conduction that are uniquely attributable to repetitive hand motion. Wrist activity measures of mean angular acceleration presented a highly significant association with nerve performance, where nerve conduction decreased as wrist activity increased. Using regression analysis, a maximum safe wrist-workload exposure limit of 0.91 repetitions per minute is proposed. Limitations of this result are discussed. A biomechanical model is presented to calculate the effect of physical risk factors on tendon forces at the wrist. This model offers a method by which findings of the study can be employed for workplace exposure surveillance and development of ergonomic workstation design recommendations. Conclusions -- Across the study population of clinically asymptomatic female participants, a change in median nerve performance was observed. This significant effect was evoked due to imposed physical stressors. A dose response relationship between work intensity, exposure time and median nerve conduction velocity was demonstrated. The research explored in this thesis presents a foundation for the future development of a "Dynamic Median Nerve Stress Test". This test would involve the performance of a repetitive motion activity of the wrist during which changes in the function of the median nerve are closely monitored. The Dynamic Median Nerve Stress Test might prove to be valuable both as a provocative clinical test as well as an important research tool.

Os Distúrbios Osteomusculares Relacionados ao Trabalho (DORT) acometem a saúde do trabalhador, desde a década de 90, gerando ocorrências num grande número de pessoas, em diferentes países e diversas atividades, sendo um dos casos mais evidenciados no contexto ocupacional. Trabalhadores sujeitos a cargas de trabalho semelhantes, que desempenham a mesma atividade, podem apresentar variações significativas no seu estado de saúde relacionado ao trabalho. Uma forma eficaz de reduzir o número de casos de DORT é a prevenção, que só se torna efetiva se for participativa e abrangente e se minimizar os fatores de risco presentes nas situações de trabalho. O objetivo deste estudo foi realizar a gestão preventiva dos problemas relacionados aos DORT, através de uma abordagem ergonômica estruturada, interpretações, prevalências, tipos de tratamentos ou reabilitações para retorno ao trabalho, bem como avaliar e gerar dispositivos de controle dos problemas relacionados aos DORT em uma indústria cimenteira, baseando-se na estratégia SOBANE, por ser uma estratégia de prevenção que avalia os fatores de risco e permite a interação com os trabalhadores. (excluída a frase sobre limitação do método) Como resultado prático para a empresa foram propostas recomendações através de plano de ação detalhado, de forma a melhorar continuamente as atividades e postos de trabalho, reduzindo os fatores de risco. / Work Related Musculoskeletal Disorders (WRMD) affect the health of workers, since the Nineties, generating occurrences in a great number of people, in different countries and several activities, which are being one of expressed cases in the occupational context. Employees subjected to similar loads, performing the same activity, can present significant variations of their state of health work related. An effective way to reduce the number of WRMD cases is the prevention, only becomes effective if it is participative and comprehensive and if it minimizes the risk factors present at the workplace. The purpose of this study was to conduct the preventive management of the problems related to WRMD, through a structural ergonomic approach, interpretation, prevalences, types of treatments or rehabilitation to return to work, as well as generating controls devices of problems related to WRMD in a cement industry, based on SOBANE strategy, to be a prevention strategy which evaluates the risk factors and allows the interaction with employees. On the basis of the findings, recommendations are proposed through a detailed action plan, in order to apply continuous improvement in the work environment, reducing the risk factors.

Os Distúrbios Osteomusculares Relacionados ao Trabalho (DORT) acometem a saúde do trabalhador, desde a década de 90, gerando ocorrências num grande número de pessoas, em diferentes países e diversas atividades, sendo um dos casos mais evidenciados no contexto ocupacional. Trabalhadores sujeitos a cargas de trabalho semelhantes, que desempenham a mesma atividade, podem apresentar variações significativas no seu estado de saúde relacionado ao trabalho. Uma forma eficaz de reduzir o número de casos de DORT é a prevenção, que só se torna efetiva se for participativa e abrangente e se minimizar os fatores de risco presentes nas situações de trabalho. O objetivo deste estudo foi realizar a gestão preventiva dos problemas relacionados aos DORT, através de uma abordagem ergonômica estruturada, interpretações, prevalências, tipos de tratamentos ou reabilitações para retorno ao trabalho, bem como avaliar e gerar dispositivos de controle dos problemas relacionados aos DORT em uma indústria cimenteira, baseando-se na estratégia SOBANE, por ser uma estratégia de prevenção que avalia os fatores de risco e permite a interação com os trabalhadores. (excluída a frase sobre limitação do método) Como resultado prático para a empresa foram propostas recomendações através de plano de ação detalhado, de forma a melhorar continuamente as atividades e postos de trabalho, reduzindo os fatores de risco. / Work Related Musculoskeletal Disorders (WRMD) affect the health of workers, since the Nineties, generating occurrences in a great number of people, in different countries and several activities, which are being one of expressed cases in the occupational context. Employees subjected to similar loads, performing the same activity, can present significant variations of their state of health work related. An effective way to reduce the number of WRMD cases is the prevention, only becomes effective if it is participative and comprehensive and if it minimizes the risk factors present at the workplace. The purpose of this study was to conduct the preventive management of the problems related to WRMD, through a structural ergonomic approach, interpretation, prevalences, types of treatments or rehabilitation to return to work, as well as generating controls devices of problems related to WRMD in a cement industry, based on SOBANE strategy, to be a prevention strategy which evaluates the risk factors and allows the interaction with employees. On the basis of the findings, recommendations are proposed through a detailed action plan, in order to apply continuous improvement in the work environment, reducing the risk factors.

Orientador: Jose Inacio de Oliveira / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-06T19:26:31Z (GMT). No. of bitstreams: 1 Shiraishi_WilmaHideko_M.pdf: 1998354 bytes, checksum: 503ec8f6636f894c6c459636f7045b26 (MD5) Previous issue date: 2006 / Resumo: Neste estudo analisa-se o perfil epidemiológico dos pacientes com diagnóstico clinico de tendinite do supra-espinhal relacionada ao trabalho, atendidos no Ambulatório de Medicina do Trabalho do Hospital das Clínicas da UNICAMP, no período de janeiro de 2002 a dezembro de 2004 e verifica-se, dentre as lesões do manguito rotador, quais as tendinites mais freqüentes. Trata-se de um estudo descritivo, com dados coletados dos prontuários do Serviço de Arquivo Medico (SAME), utilizando-se o Software Epi-info 6 para o registro de dados. Foram analisados 246 prontuários de pacientes atendidos no Ambulatório com diagnóstico clínico de Distúrbios Osteomusculares Relacionados ao Trabalho (DORT). Desses, identificaram-se 112 pacientes com lesão do manguito rotador e, dentre estes, 106 eram especificamente tendinites do tendão do músculo supra-espinhal. Foram investigadas as variáveis relacionadas a sexo, idade, procedência, ocupação, lado do ombro comprometido, tipo de lesão, ramo de atividade econômica, situação de trabalho no primeiro atendimento, benefícios previdenciários, nexo com o trabalho e distribuição do diagnóstico clinico geral dos DORT neste período. Os resultados mostraram que, dentre as lesões do manguito rotador, a tendinite do tendão do músculo supra-espinhal obteve a maior freqüência, com 106 casos (94,6%); seguida do músculo subescapular com 4 (3,6%); músculo ínfra-espinhal com 2 (1,7%) e nenhuma referência do redondo menor. O grupo concentra-se na faixa etária de 22 a 71 anos de idade, com média de idade de 40 anos (dp= 8,75) sendo que, destes, 74 (69,8%) eram do sexo feminino. O lado do ombro mais comprometido foi o direito em 52 casos (49,1%), o esquerdo em 28 (26,4%) e bilateral em 26 (24,5%). Dentre as principais ocupações, os operadores de máquina e os auxiliares de produção tiveram a maior prevalência (25,4%). Em seguida, auxiliar de cozinha (11,3%) e auxiliar de serviços gerais (6,6%). Do total, 44 (41,5%) pacientes pertenciam à indústria alimentícia e 25 (23,6%) à indústria metalúrgica. Dos pacientes com diagnóstico clínico de tendinite de supra-espinhal o nexo causal com o trabalho foi estabelecido em 100 pacientes (94,3%) / Abstract: Epidemiological profile of pacients with supraspinatus tendinitis related to work in an outpatient Clinic of A Medical School Hospital. This study analyzes the epidemiological profile of patients that consulted at the Occupational Health Outpatient Clinic of the UNICAMP General Hospital, in the period between January 2002 and December 2004, and had clinical diagnosis of work-related Supraspinatus Tendinitis. It also verifies the most frequent tendinitis among rotator cuff injuries. It is a descriptive study using data collected from patients' records in the Medical Record File Service (SAME) and Epi-info6 software was used for recording the data. A total of 246 records of outpatients seen at the Hospital Clinic with clinical diagnoses of Work Related Musculoskeletal Disorder (WRMD) were analyzed. In this group, 112 patients with Rotator Cuff Tendinitis were selected and among these there were 106, specifically, with Supraspinatus Tendinitis. Variables such as gender, age, origin, occupation, side of injured shoulder, type of injury, area of economic activity, work status at first appointment, workers compensation benefits, relation of injury to work, and the distribution of clinical diagnoses of WRMD during the period mentioned, were examined. The results showed that among rotator cuff injuries, supraspinatus tendinitis was the most frequent with 106 cases (94.6%); next came subscapular]s injuries with 4 cases (3.6%), infraspinatus with 2 (1.7%), and there was no reference to teres minor. The age of this group varies from 22 to 71 years old, mean age being 40 (sd=8,75). Among them, 74 (69.8%) patients were female. The side most frequently injured was the right shoulder in 52 cases (49.1%), the left in 28 (26.4%) and both in 26 (24.5%). Among the main occupations, machine operators and production helpers were the most prevalent, both with 25.4%. Next came cooks (11.3%) and all-task helpers (6.6%). A total of 44 (41.5%) patients pertained to the food industry and 25 (23.6%) to metallurgical industry. In the group of patients with clinical diagnosis of supraspinatus tendinitis the relation of injury to work was established in 100 patients (94.3%) / Mestrado / Saude Coletiva / Mestre em Saude Coletiva

Esse estudo teve como objetivo apreender a qualidade de vida (QV) de trabalhadores de enfermagem acometidos por Distúrbios Osteomusculares Relacionados ao Trabalho (DORT) e construir possíveis estratégias para a melhoria da mesma. Investigamos a QV em trabalhadores de Enfermagem com DORT em membros superiores de um Hospital Universitário. O estudo, de caráter exploratório-descritivo e abordagem qualitativa, foi desenvolvido tendo como população os trabalhadores de enfermagem de um hospital público universitário, constituindo 11 mulheres e dois homens, portadores de DORT em membros superiores, representantes de todas as categorias de enfermagem e de diversas unidades assistenciais. A coleta de dados foi realizada através de entrevista individual e grupo focal. Após aprovação do projeto em Comitê de Ética, a coleta de dados foi iniciada através das entrevistas com os sujeitos eleitos. Foram realizadas, também, cinco sessões de grupo focal, no período de novembro a dezembro de 2011. Os resultados de caracterização mostram que a média de tempo de trabalho nesta instituição é de 19 anos, denotando extensa exposição a cargas fisiológicas; sete trabalhadores realizam, concomitantemente ao trabalho remunerado, afazeres domésticos integralmente e cinco deles parcialmente; as atividades de lazer são apenas ocasionais; a maioria dos sintomas refere-se a quadros dolorosos em ombros, o que acaba prejudicando também a realização de atividades básicas e cotidianas. Após o tratamento dos dados de caracterização, as falas foram submetidas à análise de conteúdo e permitiram apreender quatro categorias: existindo com dor, QV é não ter limitações, meu trabalho influenciando na minha QV e cuidando e sendo cuidado. Na primeira categoria, os relatos revelam a influência da dor na constituição do sujeito, em suas expectativas e sua relação com o quadro emocional. Com relação à qualidade de vida, evidenciamos que esta encontra-se prejudicada pela co-existência de dois aspectos, mencionados na segunda e terceira categorias: dor e consequentes limitações e inadequações na organização e processo de trabalho, sendo mencionados alguns fatores desfavoráveis do cotidiano laboral: excesso de tempo no local de trabalho, inadequação de equipamentos e organização e processos de trabalho inapropriados. Dessa forma, as falas dialogam com as definições de Qualidade de Vida Relacionada à Saúde e Qualidade de Vida no Trabalho, sendo essas indissociáveis do conceito de QV para esses trabalhadores, já que as percepções do valor atribuído à vida estão sob influência da dor e que inadequações no processo de trabalho alteram significativamente a QV. Na última categoria, verificou-se satisfação com o processo grupal, com crescente conscientização e mudanças no cuidado a si. Em especial, foram despertadas ações cruciais para controle de quadros crônicos de DORT: a atenção a si e às combinações de fatores pessoais, físicos, sociais e emocionais. Também foram observados o meio, com seus riscos e benefícios e simples estratégias de saúde, apreendidas e construídas coletivamente. Construiu-se, junto aos trabalhadores, um programa educativo onde foram oferecidas novas perspectivas para amenização de sintomas, bem como modificações comportamentais relacionadas a componentes posturais e ambientais, indo ao encontro de um dos princípios de Promoção da Saúde e abordando um dos pilares da QV para esse grupo. Conclui-se que a QV desses trabalhadores está intimamente relacionada à dor e ao trabalho. Compreendeu-se que há a necessidade de combinação de estratégias mutissetoriais, com responsabilização dos próprios indivíduos e existência de ações coletivas do sistema de saúde e da comunidade / This study aimed to capture the quality of life (QoL) of nursing workers affected by Work Related Musculoskeletal Disorders (WMSDs) and build strategies for its improvement. We investigated the QoL of nursing workers with upper limb disorders in a University Hospital. The study is exploratory and descriptive with qualitative approach and was developed with the nursing staff of a public hospital, constituted of 11 women and two men suffering from disorders in the upper limbs, representatives of all categories of nursing and several units. Data collection was conducted through individual interviews and focus groups. After project approval by the Ethics Committee, data collection began with interviews with the chosen subjects. Five focus group sessions were also carried out, from November to December in 2011. The sociodemographic results show that the average working time in this institution is 19 years, indicating extensive exposure to physiological loads; seven workers perform, concurrently with paid work, full housework and five of them partial; leisure activities are only occasional and the majority of symptoms refers to painful shoulders, which ultimately jeopardize the performance of basic activities of daily living. After treatment of the sociodemographic data, the reports were subjected to content analysis which raised four categories: existing with pain, QoL is having no limitations , my job influencing on my QoL and caring and being cared for. In the first category, the reports reveal the influence of pain in the constitution of the subject, their expectations and its relationship with the emotional picture. Regarding the quality of life, we found that it is hampered by the co-existence of two aspects mentioned in the second and third categories: pain and its resulting limitations and inadequacies in the work organization and process, and some unfavorable factors of daily work mentioned were: too much time at work, inappropriate equipment and improper work organization and processes. Thus, the speeches match with the definitions of Quality of Working Life and Health-Related Quality of Life, these being inseparable from the concept of QoL for these workers, since the perceptions of the value attributed to life are under the influence of pain and that inadequacies in the work process significantly alter QoL. In the latter category, there was satisfaction with the group process, with enhanced awareness and changes in their care. In particular, workers were sensitized to crucial ways to control chronic conditions of WMSDs: attention to themselves and to combinations of personal, physical, social and emotional aspects. Increased attention with the environment also happened, with recognition of its risks and benefits and the use of simple health strategies, learned and built collectively. It was built, along with the workers, an educational program where they were offered new prospects for alleviation of symptoms, as well as behavioral changes related to postural and environmental components, meeting one of the principles of Health Promotion and addressing one of the concepts of QoL for this group. In conclusion, QoL of these workers is closely related to pain and work. It was understood that there is a need for multiple combination of strategies, with accountability of the individuals themselves and the existence of collective actions of the health system and community

Os Distúrbios Osteomusculares Relacionados ao Trabalho (DORT) acometem a saúde do trabalhador, desde a década de 90, gerando ocorrências num grande número de pessoas, em diferentes países e diversas atividades, sendo um dos casos mais evidenciados no contexto ocupacional. Trabalhadores sujeitos a cargas de trabalho semelhantes, que desempenham a mesma atividade, podem apresentar variações significativas no seu estado de saúde relacionado ao trabalho. Uma forma eficaz de reduzir o número de casos de DORT é a prevenção, que só se torna efetiva se for participativa e abrangente e se minimizar os fatores de risco presentes nas situações de trabalho. O objetivo deste estudo foi realizar a gestão preventiva dos problemas relacionados aos DORT, através de uma abordagem ergonômica estruturada, interpretações, prevalências, tipos de tratamentos ou reabilitações para retorno ao trabalho, bem como avaliar e gerar dispositivos de controle dos problemas relacionados aos DORT em uma indústria cimenteira, baseando-se na estratégia SOBANE, por ser uma estratégia de prevenção que avalia os fatores de risco e permite a interação com os trabalhadores. (excluída a frase sobre limitação do método) Como resultado prático para a empresa foram propostas recomendações através de plano de ação detalhado, de forma a melhorar continuamente as atividades e postos de trabalho, reduzindo os fatores de risco. / Work Related Musculoskeletal Disorders (WRMD) affect the health of workers, since the Nineties, generating occurrences in a great number of people, in different countries and several activities, which are being one of expressed cases in the occupational context. Employees subjected to similar loads, performing the same activity, can present significant variations of their state of health work related. An effective way to reduce the number of WRMD cases is the prevention, only becomes effective if it is participative and comprehensive and if it minimizes the risk factors present at the workplace. The purpose of this study was to conduct the preventive management of the problems related to WRMD, through a structural ergonomic approach, interpretation, prevalences, types of treatments or rehabilitation to return to work, as well as generating controls devices of problems related to WRMD in a cement industry, based on SOBANE strategy, to be a prevention strategy which evaluates the risk factors and allows the interaction with employees. On the basis of the findings, recommendations are proposed through a detailed action plan, in order to apply continuous improvement in the work environment, reducing the risk factors.

Work-related musculoskeletal disorders constitutes a substantial burden for society, generating individual suffering and financial costs. Quantifying the musculoskeletal stress and establishing exposure-response relationships is an important step in facing this problem. Observational methods for assessing exposure in the field of ergonomics have shown poor results, and the technical measurement methods that exists are often complicated to use which limits their scope to scientific purposes. This work describes the development of a prototype measurement system aimed to simplify ambulatory measurements of musculoskeletal load, specifically aimed at the wrist and hand. Wearable sensors including Inertial Measurement Units (IMU:s) and Electromyography (EMG) were connected to a smartphone and used for measuring wrist movement and forearm muscle activity. Data sampled in the smartphone was stored online in a cloud database, and a webapplication was developed to visualize work-load exposure. Testing under controlled conditions indicated that muscular rest can be measured and classified according to suggested risk thresholds. Accurate angular measurements were difficult to implement because of lacking inter-sensor alignment in the horizontal plane, as well as uncertainties in the Bluetooth protocol. Future work should focus on the IMU:s and look to further develop a method of correcting the relative angle error, as well as investigating accurate time synchronization of the two sensors.Alternatively, deriving angular velocities directly from the IMU gyroscopes could be investigated.

No description available.