The Workers' Health field: reclaiming knowledge and practices in the interface between work and health

This article discusses the underlying theoretical and operational premises in the fields of workers' health and occupational health, highlighting their respective frameworks and epistemological differences, based on Foucaultian archeology. the theme is particularly relevant, due to: the apparently limited attention to interdisciplinary research approaches in workers' health; various setbacks in public health measures at the social policy level; related weaknesses in the Brazilian trade union movement; and the conceptual misinterpretations drafted into the final report of the 3(rd) National Workers' Health Conference in November, 2005, convened by the Ministries of Social Security, Health, and Labor. the event resulted from the Workers' Health Conferences held in various States and Municipalities, mobilizing some 100,000 activists throughout Brazil and electing the delegates to the 3(rd) National Conference.Universidade Federal de São Paulo, Escola Paulista Med, BR-04119060 São Paulo, SP, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, BR-04119060 São Paulo, SP, BrazilWeb of Scienc

An Analysis of the Historical Trajectory and Actions of the Environment Health Working Group of the Brazilian Collective Health Association (ABRASCO)

The purpose of this research was to retrace the historical path of a Health and Environment Working Group (GTSA) constituted by a professional association (Brazilian Collective Health Association - ABRASCO) to address the relationships that are established between health and the environment, understood in their socio-ecological dimension. The method used was document analysis and interviews with informed informants. The experiences lived by the group were systematized according to the science/politics/ actions (collective) dimensions, which were analyzed as to their reciprocal relations. Changes in approaches and expansions of knowledge objects and of the group’s actions, contingent upon the different political, social, economic, health and environmental junctures observed in Brazilian reality, were identified . In part, such changes were conceived and could be made thanks to the group’s maturity in scientific, technical and political terms. These changes occurred in view of the worsening of environmental problems and their dire consequences for the health and the living and working conditions of the populations that are subjected to them. This is compounded, by the State’s gradual withdrawal from and denial of these problems, which has resulted in a reversal of public policies. Against this backdrop, its critical thinking lead the GTSA to prioritize its practice in partnership with social movements. Finally, the GTSA came up with its own way of dealing with health and environmental issues in Brazil, developing a potential repertoire of ways to generate and use knowledge and knowhow on a collective scale for the maintenance of life and health in a healthy environment

Environmental health : reflexions of the Brazilian Association of Post-Graduation in Collective Health - ABRASCO

O Brasil, apesar de sua extraordinária biodiversidade e do enorme potencial instalado para desenvolver ações integradas na temática do ambiente, não tem dado, do ponto de vista programático, a prioridade que o tema ambiente merece. A Associação Brasileira de Pós-Graduação em Saúde Coletiva-ABRASCO reconheceu a importância de organizar um Grupo Temático “Saúde e Ambiente” para, de maneira mais organizada, participar da luta pelo desenvolvimento sustentável, através da ação política no campo da saúde coletiva, em busca de ambientes saudáveis e da promoção da saúde. O objetivo principal deste Grupo Temático-GT foi contribuir para que o tema da saúde ambiental seja internalizado no campo da Saúde Coletiva. Método: O Grupo escolheu três eixos para discussão em uma oficina do V Congresso Brasileiro de Epidemiologia, em Curitiba, no ano de 2002. O resultado resultado do debate ocorrido foi apresentado segundo três eixos: identificação do campo teórico-conceitual em Saúde Ambiente; a política de saúde e ambiente; o caminho metodológico. A conclusão foi apresentada no formato de uma agenda do GT para o biênio 2002-2004. _______________________________________________________________________________________ ABSTRACTNot with standing its extraordinary biodiversity and enormous installed potential to develop actions integrated in to the topic of environmental health, Brazil has not given the environmental the priority the subject deserves from the programmatic, point of view. The Brazilian Association of Post-Graduation in Collective Health - ABRASCO recognized the importance of organizing a Thematic Group “Health and Environment” in order to, in a more organized fashion, participate in the struggle for sustainable development, through political action in collective health, oriented to wards health environments and health promotion. The main objective of this Thematic Group was to facilitate the subject of the environmental health to be internalized in to the field of the Collective Health. Method: The theme was debated in a workshop during the V Brazilian Congress of Epidemiology in Curitiba, in 2002. Results were presented according to three axes: 1- Identification of the theoretical-conceptual field in Environmental Health; 2- the politics of health and environment; 3- methodological route. The general conclusion was presented as an agenda for ABRASCO’s Thematic Group in Environmental Health for the biennial 2002-2004

Evaluation of central auditory processing in adolescents exposed to metallic mercury

BACKGROUND: central auditory processing and exposure to metallic mercury. AIM: to evaluate the performance on tests of central auditory processing in adolescents exposed to metallic mercury. METHOD: participants were 52 adolescents, of both genders, who presented hearing thresholds within normal limits. The study group (SG) was composed by 21 adolescents who worked on the burning of gold-mercury amalgams, on the re-burning of gold in stores that sell this metal or who lived next to gold mines or gold shops. The control group (CG) was composed by 31 adolescents who had no history of exposure to mercury. Investigation procedures included the application of a clinical, occupational and mercury exposure history questionnaire, basic audiometric assessment as well as central auditory processing tests. RESULTS: Statistical significant differences in the auditory processing tests of non-verbal sound sequence memory test (p = 0,001), frequency pattern test (p = 0,000), duration pattern test (p = 0,000) and SSW test in Portuguese (p = 0,006) were observed between SG and CG. CONCLUSION:adolescents exposed to metallic mercury presented a lower performance on most of the auditory processing tests when compared to those who had no history of exposure to mercury. The main deficit found in the study was related to difficulty in distinguishing successive brief sounds.TEMA: processamento auditivo central e exposição ao mercúrio metálico. OBJETIVO: comparar o desempenho nos testes comportamentais de processamento auditivo central entre adolescentes expostos e não expostos ao mercúrio metálico. MÉTODO: foram avaliados 52 adolescentes de ambos os sexos que apresentavam limiares auditivos dentro dos padrões de normalidade. O grupo de estudo (GE) incluiu 21 adolescentes que referiram trabalhar na queima dos amálgamas de ouro-mercúrio, re-queimar ouro em lojas que comercializam este metal ou residir próximos às áreas de garimpos e às lojas que comercializam ouro. O grupo de comparação (GC) foi composto por 31 adolescentes que não apresentaram história de exposição ao mercúrio. Os procedimentos incluíram um questionário sobre a história clínica, laboral e da exposição ao mercúrio, audiometria tonal liminar e bateria de testes para avaliação do processamento auditivo central. RESULTADOS: As diferenças de desempenho na avaliação do processamento auditivo central entre o GE e o GC foram estatisticamente significantes para o teste de memória seqüencial para sons não verbais (p = 0,001), para os testes de padrão de freqüência (p = 0,000) e de duração (p = 0,000) e para o SSW em Português (p = 0,006). CONCLUSÃO: os adolescentes expostos ao mercúrio metálico apresentaram desempenho significativamente inferior aos não expostos para a maioria dos testes comportamentais do processamento auditivo central e a principal alteração encontrada nessa população foi no processamento de sons breves e sucessivos.Universidade Federal do Rio de Janeiro Instituto de Estudos de Saúde ColetivaUniversidade Federal de São Paulo (UNIFESP)Universidade Federal do Rio de Janeiro Instituto de Estudos em Saúde Coletiva Faculdade de MedicinaUNIFESPSciEL

Challenges for the construction of 'Health and Environment "in view of its Thematic Group in the Brazilian Association of Collective Health

'Saúde e Ambiente' é o núcleo de saberes e práticas em torno das relações entre a sociedade e a natureza, mediadas pelo modo de produção e o trabalho humano, que ajudam a compreender a determinação do processo saúde-doença das diferentes classes e grupos sociais. Este artigo discute os desafios para a construção desse campo na perspectiva do seu Grupo Temático da Associação Brasileira de Saúde Coletiva. Como marco teórico de análise adotam-se os três eixos do 2º Simpósio Brasileiro de Saúde Ambiental. Para ajudar a identificar os desafios contemporâneos é traçada uma linha do tempo da trajetória do grupo no seu contexto histórico. Dentre os principais desafios identificados, destaca-se o de construir uma práxis científica interdisciplinar, intersetorial e participativa, que dialogue e construa conhecimentos com movimentos sociais.'Health and Environment' is the nucleus of knowledge and practices surrounding the relations between society and nature, mediated by the mode of production and human labor, which help to understand the determination of the health-disease process of different social classes and groups. This paper discusses the challenges to build this field from the perspective of its Thematic Group of the Association of Collective Health. The three core themes of the 2nd Brazilian Symposium on Environmental Health are taken as the theoretical framework for analysis. A timeline of the group's trajectory, in its historical context, helps to identify the contemporary challenges. Among the main challenges identified, the challenge of building an interdisciplinary, intersectoral and participatory scientific practice, which could build knowledge and dialogue with social movements, is highlighted

Hepatitis B and C in household and health services solid waste workers.

Human contact with solid waste poses biological, chemical, and physical health risks for workers involved in waste collection, transportation, and storage. The potential risk to human health resulting from contact with health services waste or household waste still sparks considerable controversy. The aim of this study was to identify the context of scientific discussions on risk/infection from the hepatitis B and C viruses in workers that collect solid waste from health services or households. The search covered publications up to 2013 in Brazilian and international databases, and 11 articles were selected through a literature review. Of these, six conclude that there is an increased risk of infection in workers that collect household waste when compared to those unexposed to waste, three point to greater risk for workers that collect health services waste as compared to those that collect ordinary waste, and the other two found no difference between exposed and unexposed individuals

Are Current or Future Mesothelioma Epidemics in Hong Kong the Tragic Legacy of Uncontrolled Use of Asbestos in the Past?

BACKGROUND: Because of the long latent period of asbestos-related mesothelioma, investigators suggest that the high incidence of this disease will continue in the coming decades. OBJECTIVES: We describe the time trends of mesothelioma incidence and its relationship to historical consumption of asbestos in Hong Kong and project future trends of mesothelioma incidence. METHODS: We obtained local annual consumption of total asbestos for 1960-2006 (converted to kilograms per person per year). Age-standardized incidence rates (ASIRs) of mesothelioma were computed and depicted on graphs using the centered moving average method. Indirectly standardized rates were regressed on a transformation of consumption data that assumed that the latency between asbestos exposure and mesothelioma diagnosis followed a normal distribution with a mean ± SD of 42 ± 10.5 years. RESULTS: ASIRs for males started to increase substantially in 1994 and were highest in 2004; for females, ASIRs climbed in the 1980s and in the early 1990s but have fluctuated without obvious trends in recent years. The highest asbestos consumption level in Hong Kong was in 1960-1963 and then decreased sharply afterward. Using past asbestos consumption patterns, we predict that the mesothelioma incidence rate for males will peak in 2009, with the number of cases peaking in 2014, and then slowly decline in the coming decades. CONCLUSIONS: Hong Kong experienced an epidemic of mesothelioma from 2000 to 2006 that corresponded with the peak of local asbestos consumption in the early 1960s assuming an average latent period of 42 years. The incidence is anticipated to decline in the coming decades but may not decrease back to the background risk level (the risk unrelated to asbestos exposure)

La vigilancia en la Atención Basica a la Salud: perspectivas para el alcance de la Vigilancia en Salud

A Vigilância à Saúde é Modelo Assistencial com potencial para a reorganização dos processos de trabalho. O estudo objetivou identificar e analisar a estruturação das práticas de vigilância na Atenção Básica, em um território do Município de São Paulo. Foram entrevistados 14 sujeitos, de fevereiro a abril de 2006: gerentes e trabalhadores da saúde que atuavam junto à vigilância epidemiológica. Sob o marco da determinação social da saúde-doença, e da concepção materialista de processo de trabalho, verificou-se que o trabalho cotidiano se apresentou fragmentado. Foram identificados como limitantes para a implementação da vigilância à saúde, a precariedade da infra-estrutura, a falta de qualificação profissional apropriada, de incentivo político-gerencial e de participação da população. Conclui-se, mesmo diante de tal situação que, no nível local, há potencial para transformar a organização do trabalho em saúde e atender as necessidades de saúde da população, através da operacionalização Vigilância à Saúde.The Surveillance in Health is constituted as an Assistance Model with potential to reorganize the working processes. This study was developed to identify and analyze surveillance practices in the Primary Health Care field, in a region of São Paulo City-Brazil. Interviews were performed with 14 individual, from February to April 2006: health workers and administrators who had been operating in the Epidemiologic Surveillance area of health basic units. The speeches were analyzed based on the social theory of the health-disease process and by the materialistic interpretation of the labor process. It was verified that their work was fragmented. The precariousness of the working structure, the lack of professional qualification and of management-political support, besides the lack of participation from the population were all identified as barriers that limit health surveillance practices. It was concluded that, in a local level, there is a potential to change the organization of the working process in health and meet the health needs of the population through a Health Surveillance Model.La Vigilancia en Salud se constituye como un Modelo Asistencial con potencialidad para la reorganización de los procesos de trabajo. Este estudio tuvo como objetivo identificar y analizar la estructura de las acciones de vigilancia en la Atención Básica de Salud en una determinada región de salud de la Municipalidad de São Paulo-Brasil. Fueran entrevistados 14 profesionales de salud, incluyendo gerentes y trabajadores de la vigilancia epidemiologica. Las entrevistas fueran analizadas con base en el marco de la interpretación social de la salud-enfermedad y de la concepción materialista del proceso de trabajo. Se ha verificado que el trabajo se presentó fragmentado. Se ha verificado limitaciones para la implementación de la vigilancia en salud: la precariedad del trabajo en términos de logistica, la falta de formación profesional apropiada, y la falta de incentivo político-gerencial y de la participación de la población para operar en las acciones de vigilancia en el sentido ampliado. Se concluye que, en nivel local, hay fortalezas para transformar la organización del trabajo en el contexto de la salud, a través del Modelo de la Vigilancia en Salud

“Suape: desenvolvimento para quem?” – Documentário como estratégia para vigilância e promoção da saúde

Pernambuco has expanded the Port Industrial Complex of Suape (PICS) with the installation of a petrochemical pole financed by the Growth Acceleration Program. This model of economic development is causing profound political, socioeconomic and cultural transformations, generating injustice and conflict reflected on the health and the environment of the population. This article examines these processes of vulnerabilization from the social representation of subjects who live and work in Suape. Action research was conducted, following the principles of the ecosystem approaches to health through field visits, and structured interviews systematized in six analytical categories using key phrases and central ideas of speech that resulted in the documentary Suape, development for whom? Eight cinema discussions were performed for validating the documentary and discussions about the problems experienced in Suape and about intervention strategies in defense of health were conducted. It is concluded that the documentary was an appropriate communication strategy for the vulnerable population because it made possible the development of thematic discussions on health, health surveillance and environmental issues experienced in the territory, in an enlarged and participative way, highlighting today and tomorrow’s dangers and inconveniences. The documentary also made it possible to sketch out a series of diaries of struggle in defense of health promotion and protection of the environment, expressed in the cinema debate.Pernambuco tem ampliado o Complexo Industrial Portuário de Suape (CIPS) mediante a instalação de um polo petroquímico financiado pelo Programa de Aceleração do Crescimento. Esse modelo de desenvolvimento econômico tem ocasionando profundas transformações políticas, socioeconômicas e culturais, gerando injustiças, conflitos refletidos na saúde e no ambiente da população. Este artigo analisa esses processos de vulneração a partir da representação social dos sujeitos que vivem e atuam em Suape. Realizou-se pesquisa-ação, seguindo princípios da abordagem ecossistêmica em saúde através de visita de campo, entrevistas semiestruturadas sistematizadas em seis categorias analíticas utilizando Expressões Chave e Ideias Centrais do discurso que resultaram no documentário “Suape, desenvolvimento para quem?”. Foram realizados oito cine debates para validação do documentário e discussão sobre as problemáticas vivenciadas em Suape e estratégias de atuação em defesa da saúde. Conclui-se que o documentário se configurou como uma estratégia de comunicação adequada para a população vulnerada, pois possibilitou discussões temáticas de saúde, vigilância e questões ambientais vivenciadas no território, de forma ampliada e participativa evidenciando perigos e nocividades atuais e futuros. Também possibilitou esboçar uma série de agendas de luta em defesa da promoção da saúde e da proteção do meio ambiente, expressas no cine debate

Aproximaciones teóricas acerca de la Vigilancia en Salud: un horizonte para la integralidad

Investigou-se a proposição e o desenvolvimento da vigilância à saúde seja como instrumento ou modelo de atenção à saúde, nas bases de dados LILACS e MEDLINE, sob os descritores vigilância da população e cuidados primários de saúde. Identificaram-se diferentes propostas e terminologias para a vigilância à saúde que se assemelham pelo uso da epidemiologia e da noção de território. Destaca-se o uso de instrumentos como indicadores de necessidades de saúde, geoprocessamento e análise de redes de vigilância em saúde. Conclui-se que a vigilância à saúde se constitui num potencial campo para promover a saúde, o controle social da informação e avaliação das políticas e ações de saúde.This study was an investigation of the proposition and development of health surveillance as an instrument or model of health. A literature search was conducted in LILACS and MEDLINE databases using the key words population's surveillance and primary health care. The literature indicated the existence of different propositions and terminologies for health surveillance which are used in epidemiology and territorial surveillance. There was emphasis on the use of health indicators, geoprocessing, and analysis of network of health surveillance agencies. Health surveillance can be used to promote health, social control of information, and to evaluate health policies and its implementation.Se investigó la proposición y el desarrollo de la vigilancia a la salud sea como instrumento o como modelo de atención a la salud, en las bases de datos LILACS y MEDLINE, bajo los descriptores vigilancia de la población y cuidados primarios de salud. Se identificaron diferentes propuestas y terminologías para la vigilancia a la salud que se asemejan por el uso de la epidemiología y de la noción de territorio. Se destaca el uso de instrumentos como indicadores de necesidades de salud, geo-procesamiento y análisis de redes de vigilancia en salud. Se concluye que la vigilancia a la salud se constituye en un campo potencial para promover la salud, el control social de la información y evaluación de las políticas y acciones de salud