Orientador: Heleno Rodrigues Correa Filho / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-11T19:31:13Z (GMT). No. of bitstreams: 1 Silva_JandiraMacielda_D.pdf: 4032092 bytes, checksum: baaf8a956aeb177cbfbb94ada6b0a565 (MD5) Previous issue date: 2008 / Resumo: Contemporaneamente, o câncer vem sendo considerado um grave problema de saúde pública em todo o mundo, observando-se aumento na mortalidade e nas taxas de incidência. No Brasil, representa a segunda causa de mortalidade. A maioria dos estudos epidemiológicos sobre exposição ocupacional e câncer tem sido realizada nos países desenvolvidos, com características sócio-econômicas diversas daquelas observadas em países não desenvolvidos. Nos países industrializados estima-se que as exposições ocupacionais sejam responsáveis por cerca de 4% de todos os cânceres humanos. Este estudo avaliou possíveis associações entre cânceres hematológicos e exposição a cancerígenos ocupacionais em pacientes residentes na Região Sul de Minas Gerais, representada por 130 municípios e 2.167.585 habitantes. A abordagem metodológica foi a de um estudo epidemiológico observacional, do tipo caso - controle, na razão de 1:1, com base em registros públicos realizados para casos de câncer atendidos e tratados no Sistema Único de Saúde da região. Controles foram pacientes usuários dos serviços de saúde da região, não portadores de diagnósticos compatíveis com câncer. O estudo incluiu 139 casos e 160 controles não emparelhados. Coletaram-se informações sobre exposição ocupacional às substâncias químicas, com destaque, para os agrotóxicos e os solventes orgânicos. Associações positivas, com significância estatística, entre cânceres hematológicos e exposições ocupacionais foram observadas, tanto para agrotóxicos (OR=3,471; IC95%=2,009-5,998), como também, para o grupo de solventes orgânicos, lubrificantes, combustíveis e tintas (OR=2,730; IC95%=1,503-4,960). Regressão logística evidenciou associação mais forte para os agrotóxicos (OR=3,976; IC95%=2,266-6,976), diante dos solventes, combustíveis e lubrificantes (OR=2,539; IC95%=1,398-4,614) após o ajustamento para idade / Abstract: Contemporarily, the Cancer has been considered a serious problem of public health in whole world. Its standard of world-wide distribution presents important geographic variations, being observed an increase in the mortality and in the rates of incidence. In Brazil, the neoplasms represent the second more common cause of mortality. Almost the totality of the epidemiological studies searching to relate occupational exposition and cancer has been carried through in the developed countries, with diverse social and economic characteristics of those observed in countries like Brazil. In the industrialized countries it is esteemed that the occupational expositions are responsible for about 4% of all the human cancers. This study has as objective to study possible associations between hematological cancers and exposition to occupational carcinogens in resident patients in the south region of Minas Gerais, region which is composed by 130 cities and 2.167.585 inhabitants. The methodological approach is an epidemiological study of case - control type, in the rate of 1:1, based on carried through public registration for cases of cancer that entered and were treated in the Unique System of Health - SUS of the region. The study included 139 cases and 160 controls. Information had been collected on occupational and ambient exposition to chemical substances, with prominence, for the pesticides and the organic solvent. Associations between hematological cancers and exposition to occupational and ambient risks factors had been investigated, including pesticides and organic solvent. After calculating the Odds Ratio - OR of hematological cancers, with the respective intervals (IC 95%), it was concluded that the pesticides and the organic solvent can contribute to the cause of the hematological cancers / Doutorado / Saude Coletiva / Doutor em Saude Coletiva

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It has long been known that chronic exposures to high concentrations of respirable coal mine dust can lead to the development of lung diseases such as Coal Worker's Pneumoconiosis, commonly referred to as "black lung", and silicosis. Since the mid-1990s, an alarming resurgence of diseases has been documented in central Appalachia, where underground mining often necessitates significant extraction of rock strata along with the thin seams of coal. These circumstances have prompted concern over if or how changing dust composition might be a factor in contemporary disease prevalence. Until now, the total mass concentration and quartz mass fraction of respirable dust have been regulated and monitored in US coal mines. Unfortunately, however, these two metrics alone do not paint a full picture of dust composition. Earlier work in the author's research group established a preliminary thermogravimetric analysis (TGA) method for coal mine dust. The method is intended to allow estimation of three key mass fractions of the dust from separate sources: coal from the coal strata being mined; non-carbonate minerals from the rock strata being mined or drilled; and carbonates that are primarly sourced from application of rock dust products to the mine floor or ribs. However, accuracy of the preliminary method was substantially limited by poor dust recovery from the fibrous filter media used for sample collection. This thesis includes two studies: The first study aims to establish an improved TGA method. It uses smooth polycarbonate (PC) filters for dust sampling and a modified thermal ramping routine. The method is verified using laboratory-generated respirable dust samples. In the second study, the improved TGA method is used to analyze 75 respirable mine dust samples, collected in 15 US mines. Replicate samples are also analyzed by scanning electron microscopy using energy dispersive X-ray (SEM-EDX). TGA and SEM-EDX results are compared to gain insights regarding the analytical methods and general trends in dust composition within and between mines. / Master of Science / It has long been known that chronic exposures to excessive respirable coal mine dust can lead to the development of lung diseases such as Coal Worker’s Pneumoconiosis (“Black Lung”) and silicosis. Disease rates in central Appalachia have shown an alarming and unexpected increase since the mid-1990s, despite declining dust concentrations evident from regulatory compliance monitoring data. Clearly, there is a need to better understand coal mine dust composition, which will require additional analytical methods. Thermogravimetric analysis (TGA) has been proposed as one possible method, because it should allow estimation of three key dust components from separate sources: coal from the coal strata being mined; non-carbonate minerals from the rock strata being mined or drilled; and carbonates from application of rock dust products to the mine floor and ribs. However, preliminary work with TGA showed limited accuracy, mostly due to sampling materials. In this thesis, two studies were performed. The first study aims to establish an improved TGA method using smooth, polycarbonate (PC) filters. The second study demonstrates the method on a large number of mine dust samples, and compares the results to those gained by an alternative method that uses electron microscopy.

This diploma thesis is focused on self-evaluation of knowledge of nurses in intensive care and rescue workers' working at ICU and AIC in area of monitoring and interpretation of ECG. The aim of this diploma thesis was to map how nurse in intensive care and rescue workers evaluate themselves in issue of ECG, at what level are their knowledge and abilities to be able to discribe what strategies were contributive for gaining knowledge and what motivation did they have and what barriers they had to face. Quantitative research took place by means of anonymous questionnaire survey. In total, there were 120 respondents from population of nurses in intensive care and rescue workers working at ICU and AIC. As emerged from the questionnaire survey, nurses in intensive care and rescue workers who were included in this survey, evaluate their ECG knowledge on average. Those who passed certificated course of ECG evaluate themselves above average. Respondets said that they must be able to evaluate ECG curvve in their job and it belongs to their competence. It is evident from survey, that they do not have or they do not know they have nursing standart for ECG, and if they have then they get and evaluate acoording to this standart. The most common source of knowledge and abilities in ECG area they gained when...

Orientador: Jorge Muniz Junior / Resumo: A produção e os fatores de risco que interferem na produtividade do trabalhador, vêm sendo discutido como um fator estratégico na administração das empresas. O presenteísmo visa analisar quais são os fatores de saúde que interferem na produtividade do trabalhador. O ruído ocupacional é uma realidade na qual os trabalhadores estão expostos diariamente e na qual há evidências científicas do efeito do ruído na saúde do funcionário. Este estudo tem como objetivo investigar a associação entre variáveis sociodemográficas e do trabalho com a ocorrência do presenteísmo e a relação com a exposição ao ruído ocupacional. Para tal estudo, a pesquisa caracterizara-se como exploratória, com abordagem quantitativa. No delineamento foi realizado um estudo de caso em uma indústria localizada no Vale do Paraíba, com uma amostra de 306 sujeitos. Os dados foram obtidos por meio da aplicação do protocolo WLQ de presenteísmo, do questionário de dados sociodemográficos e documentos a respeito do ruído fornecidos pela empresa. A análise de associação dos desfechos foi realizada por meio de regressão logística multivariada e com nível de significância de 5%. Pode-se verificar que, a demanda física foi a que teve maior escore, bem como que o ruído pode ser considerado como variável que influencia o presenteísmo. Dentre as variáveis significativas estão dor de cabeça, dor nas costas, percepção de saúde, sono, bem-estar, tensão no trabalho, turno de trabalho e sexo. Pretendeu-se com esta pesquisa contri... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Production and risk factors that interfere with worker productivity have been discussed as a strategic factor in the management of companies. The presenteeism aims to analyze which are the health factors that interfere in the productivity of the worker. Occupational noise is a reality in which workers are exposed daily and in which there is scientific evidence of the effect of noise on employee health. This study aims to investigate the association between sociodemographic variables and work with the occurrence of presenteeism and the association with exposure to occupational noise. For this study, the research was characterized as exploratory, with a quantitative approach. A case study was conducted in an industry located in Vale do Paraíba, with a sample of 320 subjects. The data were obtained through the application of the WLQ protocol of presenteeism, the sociodemographic data questionnaire and documents about the noise provided by the company. The association analysis of the outcomes was performed using multivariate logistic regression and with significance level of 5%. It can be verified that the physical demand was the one that had the highest score, as well as that the noise can be considered as a variable that influences the presenteeism. Among the significant variables are headache, back pain, health perception, sleep, well-being, tension at work, work shift and sex. This research aimed to contribute to the search for improvements in what relates to worker's product... (Complete abstract click electronic access below) / Doutor

Os catadores de materiais recicláveis, cuja profissão é reconhecida pelo Ministério do Trabalho desde 2002, têm a necessidade de assegurar a sua própria sobrevivência bem como a dos seus familiares. Os Determinantes Sociais da Saúde (DSS) buscam analisar as condições econômicas e sociais que afetam a saúde. Os DSS envolvem cinco níveis superpostos: comportamento e estilo de vida; redes sociais e comunitárias; condições de vida e trabalho, macrodeterminantes e condições de saúde. Todos influenciam na ocorrência de problemas de saúde e nos fatores de risco da população. O objetivo deste trabalho é caracterizar os Determinantes Sociais da Saúde dos catadores de materiais recicláveis, através da análise de dados secundários obtidos no Sistema Único de Assistência Social-SUAS e delimitados geograficamente ao município de Serrana. A população de catadores de material reciclado revelou uma prevalência acentuada de homens com idade média de 40 anos, a maioria solteiros e autodeclarados como pardos. Dentro da avaliação dos DSS, 93,75% dos indivíduos declaram não praticar esportes, 75% são fumantes, não possuem acesso à TV e internet e 69% são analfabetos. Por outro lado, os indivíduos possuem moradias dignas com infraestrutura de água e esgoto. As condições de saúde desses indivíduos também foram analisadas e uma parcela apresentou alterações em exames de sangue, como: colesterol (37,5%), glicemia (12,5%) e nível de plaquetas (6,25%). Outra variável analisada foi o ambiente de trabalho, com 37,5% de notificações de algum tipo de acidente, como corte de mão, braço ou pé durante a coleta de lixo. Concluímos que avaliar esses fatores é importante para identificar os riscos que o grupo de catadores de materiais recicláveis é exposto e compreender a intervenção sobre os mecanismos de estratificação social. Os DSS são ferramentas importantes para que a gestão pública conheça a realidade dos catadores de recicláveis e consiga apresentar políticas públicas eficazes, melhorando, assim, a qualidade de vida dessas pessoas extremamente vulneráveis e de função social importante, pois são essenciais à conservação do território e na redução da quantidade de resíduos / Waste recyclers, whose profession has been recognized by the Brazilian Ministry of Labor since 2002, have a need to ensure their own survival, as well as their family members\' maintenance. Social Determinants of Health (SDHs) are used to analyze economic and social conditions affecting a population\'s health. SDHs consist of five superimposed levels: behavior and lifestyle, social and community networks, life and work conditions, macrodeterminants, and health conditions. All of them have a relationship with health problems and risk factors in a population. This study aimed to characterize the SDHs of recyclable waste collectors living in the city of Serrana - SP (Brazil), through secondary data taken from the Unified Social Assistance System (SUAS). This group consisted mainly of men with a mean age of 40 years, most of whom were single and self-reported as brown or \'pardo\' (a mixture of white, black, and Amerindian races). Results of the SDH assessment showed that 93.75% of the individuals reported not playing sports; 75% declared being smokers, not having TV and internet access; and 69% were illiterate. However, these individuals live in decent housing with water and sewage infrastructure. The health conditions of these workers were also analyzed, and blood examination revealed alterations in the levels of cholesterol (37.5%), blood glucose (12.5%), and platelets (6.25%). We also assessed the work environment and noted that work accidents such as hand, arm, or foot cutting during waste collection represented 37.5% of the cases. Thus, we conclude that these factors are important to identify risks to which recyclable waste pickers are exposed, as well as to understand social stratification mechanisms. In short, SDHs are of paramount importance for public administrators to know the reality of recyclable waste collectors and elaborate effective public policies to improve their quality of life, since they are extremely vulnerable people and play a major social role contributing to the environmental conservation and waste reduction

With the rise of the new social movements and increasing number of protests over service delivery in South Africa’s poorest townships, many activists have started to question whether unions are able to relate to the demands of the unorganised and poor. It is argued that under the new democracy COSATU has become bureaucratic and is too closely aligned to the ANC to challenge government policies and play a transformative role in society. Such concerns are not entirely new. Labour historians and industrial sociologists have long debated the political potential and democratic character of trade unions and there is a vast literature documenting the organisational styles of unions in South Africa today and in the past. Based on examination of union archival records and interviews with key informants, this study traces the emergence of the ‘workers control’ tradition in South African trade unions. ‘Workers control’ is a unique approach based on non-racial, industrial trade unions, which are democratically organised on the factory floor. Such unions, which are ideally controlled by elected worker representatives at all levels and united nationally on the basis of sharing common policies and resources, create the basis for an autonomous movement that promotes the interest of workers. Although most closely associated with FOSATU (1979-1985), this study found that workers control had deeper historical roots. Workers control was a product of the ideological and organisational renewal that characterised the 1970s and was initially created by the Trade Union Advisory Coordinating Committee (TUACC) in Natal and, later, the Witwatersrand. TUACC, which included significant numbers of women employed as semi-skilled production workers and unskilled migrant men, reflected complex shifts in the labour market and the economy. It was in this context that ordinary union members together with a diverse layer of activists developed TUACC’s unique approach to organisation. The power of white university trained activists in determining union policies has been overestimated and worker leaders, particularly more educated women workers, played an important role in building TUACC unions. Based on a Gramscian analysis, TUACC maintained that democratic unions based on strong shop floor organisation could exploit loop holes in the law and participate in industrial structures without undermining union autonomy and democracy. TUACC, however, was less clear of how to relate to political movements and parties. TUACC distanced itself officially from the banned ANC to avoid repression, but some workers and unionists looked to homeland and traditional leaders for alliances. This tension between the creation of a democratic trade union culture and the workers’ support of more autocratic political and traditional leaders and populist movements was never resolved. All of TUACC’s affiliates were founder members of COSATU and this study gives us some insight into the traditions that inform COSATU’s responses to social movements, political parties and the state today. Drawing on the insights of the Anracho-syndicalism, this study also highlights some of the dangers of separating the economic and political activities of workers into unions and political parties respectively.

Introdução: O Atendimento Pré Hospitalar (APH) tem por finalidade prestar atendimento em situações de urgência e emergência clinica ou traumática, no local do evento e durante o transporte até uma instituição de destino, com o suporte especifico para o tipo de urgência ou emergência. Os trabalhadores da equipe do APH móvel vivenciam situações emergenciais que envolvem constante exposição a materiais biológicos. Considerando a ocorrência de acidentes de trabalho com exposição a material biológico potencialmente contaminado como um dos principais riscos para os trabalhadores da saúde. A escassez de estudos que contemplem o APH, propõe-se o desenvolvimento deste estudo. Objetivo: Elaborar protocolos de prevenção de acidentes de trabalho e de condutas pós-exposição ocupacional a material biológico para trabalhadores de saúde de um serviço de atendimento préhospitalar (APH). Método: Trata-se de uma pesquisa documental, na qual o levantamento de dados foi realizado de duas maneiras: pesquisa bibliográfica e pesquisa documental. A pesquisa bibliográfica foi feita por meio de buscas em bases de dados. A pesquisa foi conduzida em sete fases: determinação dos objetivos; elaboração do plano de trabalho; identificação das fontes; localização das fontes e obtenção do material; tratamento dos dados; confecção das fichas e redação do trabalho; construção lógica e redação do trabalho. O estudo foi desenvolvido no Serviço de Atendimento Móvel de Urgência (SAMU) gerenciado pelo Consórcio Intermunicipal de Saúde da Região Ampliada Oeste do Estado de Minas Gerais (CIS-URG OESTE). O corpus da análise foi representado por periódicos, artigos e dispositivos legais nacionais, estaduais e institucional que regulamentam a Rede de Urgência e Emergência no âmbito nacional. Foram selecionados 104 documentos. A coleta de dados foi realizada no mês de outubro de 2018 e o tratamento dos dados foi de forma sistematizada, organizada, descritiva e analítica. Não houve necessidade de apreciação da Comissão Nacional de Ética e Pesquisa - CONEP para o desenvolvimento deste estudo por não envolver seres humanos. Resultado: Os documentos foram agrupados em duas categorias, permitindo conhecer, delinear e estabelecer os protocolos e fluxos de atendimento aos trabalhadores do SAMU. A primeira categoria de organização do material foi referente a pesquisa bibliográfica. A segunda categoria representou a pesquisa documental; a qual foi subdividida em quatro etapas para análise de toda a legislação nacional, estadual e regional acerca da regulamentação da Rede de Urgência e Emergência no âmbito nacional e o conjunto de documentos sobre a atuação do CIS-URG OESTE. Os dispositivos legais e manuais ministeriais acerca das condutas da promoção da saúde do trabalhador exposto a material biológico no Brasil serviram de embasamento teórico para elaboração de protocolos de prevenção de acidentes e de condutas pósexposição ocupacional a material biológico aos trabalhadores de saúde que atuam no APH do CIS-URG OESTE. Após analises dos referidos documentos, foram elaborados fluxogramas de atendimento aos trabalhadores e os protocolos de ações de prevenção e tratamento imediato em casos de acidentes de trabalho com material biológico neste estudo. Assim este material representa uma produção técnica que será utilizada no CIS-URG OESTE para a promoção da saúde no trabalho. Considerações finais: O trabalho em saúde no APH não é apenas um processo técnico e mecânico, desprovido do caráter humanizante. Representa um conjunto de relações dos diversos atores, um processo complexo cujas condições de trabalho potencialmente, são geradoras de adoecimento. Deste modo, a produção técnica elaborada neste estudo, representa ações técnicas, educativas e de padronização de ações que visam promover a saúde e a qualidade de vida do trabalhador de saúde do APH na Região Ampliada Oeste de Minas Gerais / Introduction: Pre-hospital Care (PHC) is intended to provide emergency and clinical or trauma emergency services, at the event site and during transportation to a destination institution, with specific support for the type of emergency or emergency. The workers of the mobile PHC team experience emergency situations that involve constant exposure to biological materials. Considering the occurrence of occupational accidents with exposure to potentially contaminated biological material as one of the main risks for health workers. The shortage of studies that contemplate the PHC, the development of this study is proposed. Objective: To elaborate protocols for the prevention of occupational accidents and post-occupational exposure to biological material for health workers of a pre-hospital care service (PHC). Method: it is a documentary research, in which the data collection was carried out in two ways: bibliographic research and documentary research. The bibliographic research was done through searches in databases. The research was conducted in seven phases: determination of objectives; preparation of the work plan; identification of sources; location of sources and procurement of material; processing of data; preparation of the fiches and writing of the work; logical construction and writing of the work. The study was developed in the Mobile Emergency Care Service (MECS) managed by the Intermunicipal Health Consortium of the Western Region of the State of Minas Gerais (CIS-URG WEST). The corpus of the analysis was represented by national, state and institutional periodicals, articles and legal provisions that regulate the Emergency and Emergency Network at the national level. We selected 104 documents. Data collection was performed in October 2018 and the data treatment was systematized, organized, descriptive and analytical. There was no need for appreciation of the National Commission for Ethics and Research (CONEP) for the development of this study because it did not involve human beings. Results: The documents were grouped in two categories, allowing to know, to delineate and to establish the protocols and flows of service to the workers of MECS, to wit: first category of organization of the material was referring to bibliographical research; which constituted the synoptic record of the selected primary sources, the second category: documentary research; and this subdivided into four stages or moments referring to the thematic axes; which includes all national legislation that implements and establishes the urgency and emergency network at the national level, the state legislation that implements the emergency and emergency network at the state and regional level, and the set of documents and legislation that constitute the CIS- URG WEST for the management of the emergency and emergency services of the said region and the legal provisions and ministerial manuals that dictates the conduct of prevention, promotion and recovery of workers exposed to biological material, which served as a basis for the elaboration of prevention protocols of accidents and of conducts after occupational exposition to biological material to the health workers that work in the PHC of the CIS-URG WEST. Finals considerations: The work in health in the PHC is not only a technical and mechanical process, devoid of the humanizing character. It represents a set of relations of the various actors, a complex process whose working conditions potentially generate illness. Thus, the technical production elaborated in this study represents technical, educational and standardization actions that aim to promote the health and quality of life of the PHC health worker in the Extended Western Region of Minas Gerais