SINAN NET: AN INFORMATION SYSTEM FOR THE MONITORING OF WORKERS’ HEALTH

The present study objectified to analyze resulting information in workers’ injury records from the Information System of Injury Records (SINAN NET), at Workers’ Sentinel Health Unit in Curitiba City/ Brazil in order to underlie reflections concerning the type of information that this injury database represent to workers. 78 notified cases of Serious Labor accidents were analyzed, with Exposition to Biological Material as well as repetitive strain injury (RSI). Regarding the notification process, some difficulties arose in the filling-in of occupational status and occupations, however its implementation and development is easy and fast-paced, which will eventually contribute to workers’ health surveillance. Therefore, the correct use of SINAN NET, the analysis and interpretation of its data are fundamental in order to define workers’ health status objectifying to delineate measures for intervention and improvement of working conditions and, consequently, Brazilian workers’ health.El actual estudio tuvo como objetivo analizar la información resultante de la notificación de las enfermedades de los trabajador del Sistema de Información de Agravios de Notificación (SINAN NET), en un unidad de salud del trabajador de Curitiba, para subvencionar la reflexión referente al tipo de información de este registro. Fueron analizados 78 casos de accidentes de trabajo graves, con exposición a material biológico y de lesión del esfuerzo repetido. Con relación al proceso de la notificación, se hallaron algunas dificultades, como las respuestas acerca de ocupaciones/ocupacionales, pero estas son de facil y de rápidos implantación y notificación, lo que viene a contribuir con el monitoreo de la salud del trabajador. El uso correcto de la SINAN NET, el análisis y la interpretación de sus datos son esenciales para definir la situación de salud de los trabajadores, con la intención de planear las acciones y mejorar las condiciones del trabajo y, por consecuencia, la salud de eses trabajadores en el Brasil.O presente estudo teve por objetivo analisar as informações resultantes da notificação dos agravos relacionados à Saúde do Trabalhador, incluídos no Sistema de Informação de Agravos de Notificação (SINAN NET), em uma Unidade Sentinela em Saúde do Trabalhador de Curitiba, para subsidiar a reflexão acerca do tipo de informações que este registro dos agravos representa ao trabalhador. Foram analisados 78 casos notificados de Acidentes de Trabalho Grave, com Exposição a Material Biológico e de Lesões de Esforços Repetidos. Com relação ao processo de notificação algumas dificuldades foram encontradas como o preenchimento da situação ocupacional e ocupações, porém é fácil e rápida a implantação e desenvolvimento, o que vem contribuir no monitoramento da saúde do trabalhador. A correta utilização do SINAN NET, a análise e interpretação de seus dados são fundamentais para se definir qual é a situação de saúde dos trabalhadores, com o intuito de planejar as ações para intervir e melhorar as condições de trabalho e conseqüentemente, a saúde destes trabalhadores no Brasil

Descriptive epidemiology of somatising tendency: findings from the CUPID study.

Somatising tendency, defined as a predisposition to worry about common somatic symptoms, is importantly associated with various aspects of health and health-related behaviour, including musculoskeletal pain and associated disability. To explore its epidemiological characteristics, and how it can be specified most efficiently, we analysed data from an international longitudinal study. A baseline questionnaire, which included questions from the Brief Symptom Inventory about seven common symptoms, was completed by 12,072 participants aged 20-59 from 46 occupational groups in 18 countries (response rate 70%). The seven symptoms were all mutually associated (odds ratios for pairwise associations 3.4 to 9.3), and each contributed to a measure of somatising tendency that exhibited an exposure-response relationship both with multi-site pain (prevalence rate ratios up to six), and also with sickness absence for non-musculoskeletal reasons. In most participants, the level of somatising tendency was little changed when reassessed after a mean interval of 14 months (75% having a change of 0 or 1 in their symptom count), although the specific symptoms reported at follow-up often differed from those at baseline. Somatising tendency was more common in women than men, especially at older ages, and varied markedly across the 46 occupational groups studied, with higher rates in South and Central America. It was weakly associated with smoking, but not with level of education. Our study supports the use of questions from the Brief Symptom Inventory as a method for measuring somatising tendency, and suggests that in adults of working age, it is a fairly stable trait

Classification of neck/shoulder pain in epidemiological research: a comparison of personal and occupational characteristics, disability, and prognosis among 12,195 workers from 18 countries

To inform case definition for neck/shoulder pain in epidemiological research, we compared levels of disability, patterns of association, and prognosis for pain that was limited to the neck or shoulders (LNSP) and more generalised musculoskeletal pain that involved the neck or shoulder(s) (GPNS). Baseline data on musculoskeletal pain, disability, and potential correlates were collected by questionnaire from 12,195 workers in 47 occupational groups (mostly office workers, nurses, and manual workers) in 18 countries (response rate = 70%). Continuing pain after a mean interval of 14 months was ascertained through a follow-up questionnaire in 9150 workers from 45 occupational groups. Associations with personal and occupational factors were assessed by Poisson regression and summarised by prevalence rate ratios (PRRs). The 1-month prevalence of GPNS at baseline was much greater than that of LNSP (35.1% vs 5.6%), and it tended to be more troublesome and disabling. Unlike LNSP, the prevalence of GPNS increased with age. Moreover, it showed significantly stronger associations with somatising tendency (PRR 1.6 vs 1.3) and poor mental health (PRR 1.3 vs 1.1); greater variation between the occupational groups studied (prevalence ranging from 0% to 67.6%) that correlated poorly with the variation in LNSP; and was more persistent at follow-up (72.1% vs 61.7%). Our findings highlight important epidemiological distinctions between subcategories of neck/shoulder pain. In future epidemiological research that bases case definitions on symptoms, it would be useful to distinguish pain that is localised to the neck or shoulder from more generalised pain that happens to involve the neck/shoulder region.Monash University which funded data collection in Australia through its grant schemes; NHMRC which supported Helen Kelsall and Donna Urquhart in Australia through fellowships; Coordenação de Aperfeiçoamento de Pessoal de nível Superior (CAPES), Brasilia, DF, Brazil supported Leila Mansano Sarquis through a post-doctoral fellowship (BEX no 6841/14–7), enabling her to work on this paper during an attachment at University of Southampton, UK. Sergio Vargas-Prada was supported by the program Rio-Hortega, Institute of Health Carlos III (ISCIII), Spai

Patterns of multi-site pain and associations with risk factors

To explore definitions for multisite pain, and compare associations with risk factors for different patterns of musculoskeletal pain, we analysed cross-sectional data from the Cultural and Psychosocial Influences on Disability study. The study sample comprised 12,410 adults aged 20-59years from 47 occupational groups in 18 countries. A standardised questionnaire was used to collect information about pain in the past month at each of 10 anatomical sites, and about potential risk factors. Associations with pain outcomes were assessed by Poisson regression, and characterised by prevalence rate ratios (PRRs). Extensive pain, affecting 6-10 anatomical sites, was reported much more frequently than would be expected if the occurrence of pain at each site were independent (674 participants vs 41.9 expected). In comparison with pain involving only 1-3 sites, it showed much stronger associations (relative to no pain) with risk factors such as female sex (PRR 1.6 vs 1.1), older age (PRR 2.6 vs 1.1), somatising tendency (PRR 4.6 vs 1.3), and exposure to multiple physically stressing occupational activities (PRR 5.0 vs 1.4). After adjustment for number of sites with pain, these risk factors showed no additional association with a distribution of pain that was widespread according to the frequently used American College of Rheumatology criteria. Our analysis supports the classification of pain at multiple anatomical sites simply by the number of sites affected, and suggests that extensive pain differs importantly in its associations with risk factors from pain that is limited to only a small number of anatomical sites.<br/

The CUPID (Cultural and Psychosocial Influences on Disability) study: methods of data collection and characteristics of study sample

Background: The CUPID (Cultural and Psychosocial Influences on Disability) study was established to explore the hypothesis that common musculoskeletal disorders (MSDs) and associated disability are importantly influenced by culturally determined health beliefs and expectations. This paper describes the methods of data collection and various characteristics of the study sample.Methods/Principal Findings: standardised questionnaire covering musculoskeletal symptoms, disability and potential risk factors, was used to collect information from 47 samples of nurses, office workers, and other (mostly manual) workers in 18 countries from six continents. In addition, local investigators provided data on economic aspects of employment for each occupational group. Participation exceeded 80% in 33 of the 47 occupational groups, and after pre-specified exclusions, analysis was based on 12,426 subjects (92 to 1018 per occupational group). As expected, there was high usage of computer keyboards by office workers, while nurses had the highest prevalence of heavy manual lifting in all but one country. There was substantial heterogeneity between occupational groups in economic and psychosocial aspects of work; three- to five-fold variation in awareness of someone outside work with musculoskeletal pain; and more than ten-fold variation in the prevalence of adverse health beliefs about back and arm pain, and in awareness of terms such as “repetitive strain injury” (RSI).Conclusions/Significance: the large differences in psychosocial risk factors (including knowledge and beliefs about MSDs) between occupational groups should allow the study hypothesis to be addressed effectivel

Epidemiological differences between localized and non-localized low back pain

Study Design. A cross-sectional survey with a longitudinal follow-up.Objectives. The aim of this study was to test the hypothesis that pain, which is localized to the low back, differs epidemiologically from that which occurs simultaneously or close in time to pain at other anatomical sitesSummary of Background Data. Low back pain (LBP) often occurs in combination with other regional pain, with which it shares similar psychological and psychosocial risk factors. However, few previous epidemiological studies of LBP have distinguished pain that is confined to the low back from that which occurs as part of a wider distribution of pain.Methods. We analyzed data from CUPID, a cohort study that used baseline and follow-up questionnaires to collect information about musculoskeletal pain, associated disability, and potential risk factors, in 47 occupational groups (office workers, nurses, and others) from 18 countries.Results. Among 12,197 subjects at baseline, 609 (4.9%) reported localized LBP in the past month, and 3820 (31.3%) nonlocalized LBP. Nonlocalized LBP was more frequently associated with sciatica in the past month (48.1% vs. 30.0% of cases), occurred on more days in the past month and past year, was more often disabling for everyday activities (64.1% vs. 47.3% of cases), and had more frequently led to medical consultation and sickness absence from work. It was also more often persistent when participants were followed up after a mean of 14 months (65.6% vs. 54.1% of cases). In adjusted Poisson regression analyses, nonlocalized LBP was differentially associated with risk factors, particularly female sex, older age, and somatizing tendency. There were also marked differences in the relative prevalence of localized and nonlocalized LBP by occupational group.Conclusion. Future epidemiological studies should distinguish where possible between pain that is limited to the low back and LBP that occurs in association with pain at other anatomical locations.Level of Evidence: