Métodos para detetar o Risco de surgirem Lesões Músculo-Esqueléticas relacionadas com o Trabalho- sabemos o suficiente?

2020 ◽  
Vol 10 ◽  
pp. 1-66
Author(s):  
Mónica Santos
Keyword(s):  
Occupational Health ◽  
Full Text ◽  
Direct Methods ◽  
Practical Experience ◽  
Cochrane Central Register ◽  
Self Assessment ◽  
Work Related ◽  
Cochrane Database ◽  
Central Register ◽  
Almost All

Introduction / background / objectives Work-related Musculoskeletal Injuries are prevalent and relevant. There are several methods for detecting risk, depending on the tasks performed. However, not all professionals working in the Occupational Health teams have well-structured knowledge or practical experience in most of these methods. Methodology It is a Review, initiated through a survey conducted in April 2020, in the databases “CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive, MedicLatina and RCAAP ”. Content There are several categories of methods for assessing the risk of Musculoskeletal Lesions Related to Work. For that we have, in a very synthetic way, the self-assessment questionnaires (completed by the workers), the observational methods (more or less complex) and the direct methods. This work describes in detail OWAS, RULA, REBA, NIOSH Equation and Strain Index. Conclusions Articles are easily found in indexed databases that mention that they used them, but due to the limitations imposed by most journals in view of the size of the document, almost all authors only mention the name of the method they used and, at most, make a description very synthetic of it. In turn, in some Master’s or Doctoral Theses (where this problem does not exist), a more detailed methodological description can be found, but even so, it is not always possible to understand in practice how to use all methods or we find discreetly different versions, result of adaptations or a mixture of methods, carried out over the decades. Any professional on an Occupational Health Team will have a reasonable sense of what are the most damaging tasks; however, presenting this evidence, attenuating subjectivity and making use of the hierarchy that mathematical scales can offer, makes evaluations more scientific, rigorous and easier to be accepted as valid by the Employer/ Representatives/ Workers and, consequently, increase the receptivity to proposed measures to mitigate/ correct the problem and reassess it after this phase. It would be desirable for all professionals in the field to have at least a generic idea of ​​the existing methods and to know where they can go to obtain more information, in order to execute these techniques, if necessary.

Tatuadores: principais Fatores de Risco e Riscos Laborais, Doenças Profissionais associadas e Medidas de Proteção recomendadas

2020 ◽  
Vol 10 ◽  
pp. 1-58
Author(s):  
Mónica Santos
Keyword(s):  
Risk Factors ◽  
Full Text ◽  
Cochrane Central Register ◽  
Protection Measures ◽  
Implementation Phase ◽  
Occupational Risks ◽  
Cochrane Database ◽  
Central Register ◽  
Safe Work ◽  
Individual Protection

Introduction/ objectives Over the last few decades getting tattoos has been progressively better accepted by society in most countries; thus, the number of establishments and professionals in the area has also increased. However, since it is a recent activity and with heterogeneous norms/ licensing, these individuals often escape the evaluation by Occupational Health. The literature on this subject is scarce. This review was intended to characterize the profession of tattoo artist with regard to: vocational training; main risk factors/ occupational risks; more prevalent semiology and associated major diseases; work accidents; collective/ individual protection measures adopted and associated legislation. Methodology This is a Scoping Review, initiated through a survey conducted in April 2019 in the databases “CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: Comprehensive, MedicLatina, Academic Search Ultimate, Science Direct, Web of Science, SCOPUS and RCAAP. Content In most countries, a person can work in the area without having specific qualifications; the products can be purchased via internet and the rules for opening the establishment vary locally. Given the absence of norms that parameterize the necessary qualifications to exercise, the same happens in the process of teaching in this sector. The main occupational risks/ risk factors are the quimical and biological agents, vibrations, noise, forced/ maintained postures, repetitive movements, visual effort, handling needles and sharps and prolonged shifts. Musculoskeletal semiology is very prevalent. Discussion / Conclusions / Limitations / Projects for the Future The risk factors are very similar to other professional sectors, such as dental medicine, which has already been studied in detail. Most of the few published documents on Tattoo Artists have a simplistic methodology and the samples are small. In addition, the absence of uniform labor standards and licensing undermines safe work. It would be very important that these arise and be progressively perfected. In a post-implementation phase, it would be desirable to have an institution with the capacity and authority to monitor compliance and to require the correction of identified problems. Similarly, it would also be interesting if the education process were also formalized and compulsory, perhaps starting at a technical level and evolving (if the progression of the sector allows or requires), to other degree.

scholarly journals Vibrações, Ruído e Hipoacusia: associação fisiopatológica ou não?

2020 ◽  
Vol 9 ◽  
pp. S137-S148
Author(s):  
Mónica Santos ◽  
Armando Almeida ◽  
Catarina Lopes ◽  
Tiago Oliveira
Keyword(s):  
Risk Factors ◽  
Occupational Health ◽  
Bone Conduction ◽  
Health And Safety ◽  
Occupational Risk ◽  
Cochrane Central Register ◽  
Occupational Risk Factors ◽  
Cochrane Database ◽  
Central Register ◽  
Sympathetic Vasoconstriction

Introduction / framework / objectives Vibrations and noise are two reasonably prevalent occupational risk factors and, in many situations, present together. If a pathophysiological association between them is real, it will be very relevant to verify this, in order to readjust, if necessary, the vibration and noise limits considered safe. Methodology This is an Scoping Review, initiated by a September 2019 survey of the “Cochrane Central Register of Controlled Trials databases, CINALH plus with full text, Database of Abstracts of Reviews of Effects, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: Comprehensive, MedicLatina, Academic Search Ultimate, Science Direct, SCOPUS and RCAAP.” Content Some researchers have quantified higher hearing losses in workers simultaneously exposed to noise and vibrations; however, workers exposed to vibration from work instruments are generally also exposed to higher levels of noise. If there is a pathophysiological link between these two occupational risk factors, it is believed that this may be related to the theory of sympathetic vasoconstriction (observed in white-finger syndrome) and may also damage the cochlea, producing ischemic damage to the hair cells. Another hypothesis points out that some work tools may give rise to vibrations that can reach the inner ear directly, through bone conduction (especially at the temporal level). Conclusions Most of the studies consulted did not have a very robust methodology that allows a rigorous evaluation of whether the most intense hypoacusis in individuals simultaneously exposed to vibration results from a true pathophysiological association, or if it is only a statistical bias. It would be interesting for occupational health teams to investigate on clients with workers simultaneously exposed to these two risk factors (and, if possible, with combinations of different intensities), in order to produce knowledge capable of enhancing occupational health and safety.

scholarly journals Saúde Ocupacional aplicada à Dança

2020 ◽  
Vol 10 ◽  
pp. S172-S182
Author(s):  
Mónica Santos ◽  
Armando Almeida ◽  
Catarina Lopes
Keyword(s):  
Systematic Reviews ◽  
Full Text ◽  
Allied Health ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Cochrane Database ◽  
Central Register ◽  
Text Database

O setor da dança está pouco retratado em contexto de Saúde Ocupacional e a bibliografia é razoavelmente escassa. Neste setor o profissional pode apenas efetuar ensaios e atuações (a solo ou em equipa), pode dar aulas para eventuais futuros colegas e/ ou para leigos ou acumular ambas as vertentes. Trata-se de uma Revisão Bibliográfica, iniciada através de uma pesquisa realizada em agosto de 2020 nas bases de dados “CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive, MedicLatina e RCAAP”. A dança é uma arte complexa, cujo instrumento é o corpo. Conjuga movimento com a emoção, servindo também como forma de comunicação. Em alguns estilos de dança a rotina de treinos é muito exigente e competitiva, de forma a aperfeiçoar departamentos como força, resistência, velocidade, flexibilidade, equilíbrio e controlo. Aos treinos intensos, por vezes, associam-se algias e lesões concretas. Por exemplo, no Ballet clássico, a exigência técnica é muito elevada e desafiante e, na bibliografia selecionada, é certamente a dança mais estudada neste contexto. A escassa bibliografia encontrada incide sobretudo nas principais lesões associadas (quer acidentes de trabalho, quer doenças profissionais); sendo que alguns artigos também destacam o eventual consumo de substâncias psicoativas em algumas modalidades específicas. Os autores elaboraram uma descrição dos principais Fatores de Risco/ Riscos Laborais deste setor, no geral; bem como listaram as Medidas de Proteção (coletivas e individuais) que consideram ser mais adequadas. O setor da dança está muito pouco estudado pela Saúde Ocupacional, sendo pertinente a análise da realidade portuguesa, sobretudo em alguns estilos muito desenvolvidos no nosso país e sobre os quais não se encontrou qualquer bibliografia específica (mesmo em contexto internacional). PALAVRAS-CHAVE: dança, bailarino, saúde ocupacional e medicina do trabalho.

scholarly journals Risco Biológico e/ou Químico eventualmente associado ao uso de adereços pelo Trabalhador (como anéis, alianças, relógios, pulseiras)

2020 ◽  
Vol 9 ◽  
pp. S40-S47
Author(s):  
Mónica Santos ◽  
Armando Almeida ◽  
Catarina Lopes ◽  
Tiago Oliveira
Keyword(s):  
Full Text ◽  
Scientific Evidence ◽  
Statistical Evidence ◽  
Hand Washing ◽  
Microbial Load ◽  
Cochrane Central Register ◽  
Cochrane Database ◽  
Central Register ◽  
Relevant Topic ◽  
Nail Varnish

Introduction/ background/ objectives There are some manuals of Good Practices, in some professional sectors, that highlight the need to stop use jewelry at work (such as finger rings, watches, bracelets and/ or equivalent), relating to the potentialization of contact with biological agents and/ or chemical. The studies dedicated to this theme are very scarce and all related to health professionals; although, in many other sectors, it is a relevant topic, like in food production, tattooing, preparation of equipment that needs to be sterile and any sector that deals with chemical agents, for example. Methodology It is an Scoping Review, initiated through a research conducted in December 2019 in the databases “CINALH plus with full text, Medline with full text, Database of Effects Review Abstracts, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Record, Nursing and Allied Health Collection: comprehensive, MedicLatina, Scopus and RCAAP ”. Content The use of finger rings decreases efficacy of hand washing, since some bacteria can remain in microscopic irregularities under the ring. In addition, they can tear the protective gloves; even so, the use of this individual protective equipment attenuates the microbial load of the rings. However, some investigators argue that there is no statistical evidence that the use of rings will alter postoperative infraction rates. Those with smooth surfaces, like classic wedding rings, do not appear to be so problematic. As for watches and bracelets, it appears that they do not contribute to a significant increase in the rate of infringement; yet some researchers recommend that they be removed, before hand washing. The use of nail varnish decreases efficacy of hand washing, since some bacteria can remain in the microscopic irregularities of the varnish; however, there is no robust statistical evidence that the use of varnishes alters the rate of postoperative infection. Long nails have a higher microbial load, especially if recovered by irregular varnish (with a few days). In addition, big nails can also increase the likelihood of tearing the glove, whether natural or artificial. So it makes sense that some professionals use them short. Since scientific evidence that correlates hospital infection to the use of artificial jewelry or nails among healthcare professionals is not very robust, the norms at some institutions are in the format of recommendations only. Conclusions Studies are scarce and do not appear to be concordant or robust on several occasions, so it would be useful that Occupational Health teams, from companies with biological and/ or chemical risk, design and carry out studies and, subsequently, publish it to specialty magazines. In doubt, until clear evidence appears, objects such as finger rings, rings, watches and bracelets should be removed before work and hand washing and the size of long/ artificial nails or varnish must be carefully pondered.

scholarly journals Radiação Ótica Artificial em contexto de Saúde Ocupacional- a Scoping Review

2020 ◽  
Vol 9 ◽  
pp. S112-s122
Author(s):  
Mónica Santos ◽  
Armando Almeida ◽  
Catarina Lopes ◽  
Tiago Oliveira
Keyword(s):  
Occupational Health ◽  
Scoping Review ◽  
Full Text ◽  
Optical Measurement ◽  
Occupational Risk ◽  
Information Storage ◽  
Motor Vehicles ◽  
Cochrane Central Register ◽  
Occupational Risk Factors ◽  
Cochrane Database

Introduction / framework / objectives Most workers and professionals working in Occupational Health teams will not particularly value this occupational risk factor, especially when compared with others that may also exist in the workplace; therefore, knowledge about this area is not particularly developed, nor is the bibliography abundant. The aim of this review is to summarize the most recent and pertinent publications on the subject. Methodology This is a Scoping Review, initiated by a September 2019 search of the databases “CINALH plus with full text, Medline with full text, Cochrane Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: Comprehensive, MedicLatina, Academic Search Ultimate, Science Direct, Web of Science, SCOPUS and RCAAP”. Content Many workers are exposed to this radiation, particularly through lighting and computer displays; therefore, the rule of suppressing exposure (as sometimes attempted to do with other risks) does not have the same applicability in this context. In areas such as Health and in some Shows/ Art manifestations the limits of the directives can be overcome. Any artificial light, internal or external, also fits in this concept (even from motor vehicles). It is particularly frequent in the following professional sectors/ tasks: high temperature work (glass or metal), graphic work, aesthetic treatments, indoor work with powerful lighting, sterilization, welding, laser welding in plastic manufacturing, activities material processing (cutting, marking, drilling/ photolithography), optical measurement, communications, optical information storage and spectroscopy. Conclusions The theme does not adresses the same attention as other occupational risk factors, so it is poorly developed and some of the population will not even know it exists. It would be interesting for national Occupational Health teams, with clients with large numbers of employees exposed, to better investigate the issue, quantifying the knowledge of workers/ managers and employers, recording the semiology and associated pathologies, clarifying which radiation subtypes are involved in the various tasks, also suggesting valid collective and individual protection measures (specifying model and/ or materials).

scholarly journals Ruído: Medidas de Proteção Coletivas e Individuais

2020 ◽  
Vol 9 ◽  
pp. S82-S90
Author(s):  
Mónica Santos ◽  
Armando Almeida ◽  
Catarina Lopes ◽  
Tiago Oliveira
Keyword(s):  
Occupational Health ◽  
Full Text ◽  
Noise Exposure ◽  
Structure Design ◽  
Protective Equipment ◽  
Cochrane Central Register ◽  
Protective Measures ◽  
Protection Measures ◽  
Occupational Risk Factor ◽  
Cochrane Database

Introduction / framework / objectives Noise is an occupational risk factor extensively addressed in the Occupational Health literature. However, its pathophysiological consequences have traditionally been emphasized, sometimes neglecting more detailed explanations concerning personal protective equipment and collective protective measures. Methodology This is a Scoping Review, initiated by a September 2019 search of the databases “CINALH plus with full text, Medline with full text, Cochrane Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: Comprehensive, Academic Search Ultimate, Science Direct, SCOPUS and RCAAP.” Content There are several collective protection measures (at the workspace structure/ design and use of various materials/ devices) that are able to attenuate noise exposure. When exceeding the lower exposure value (80 decibels) the employer must provide hearing protection; if the upper exposure value (85 decibels) is reached or exceeded its use is required (after prior enhancement of collective protective measures). However, workers and their representatives have to be consulted to choose the model. In selecting the latter, account should be taken of European Community certification, appropriate attenuation, compatibility with tasks and other protective equipment used simultaneously; as well as the physical condition of the worker, acceptability and comfort that it will generate. The effectiveness of these will depend on time of use, correct utilization, shape/ size, fit to the ear, pressure (head and/ or ear), resistance to extreme temperatures and material. Conclusions Occupational health team professionals generally need up-to-date information on individual and collective protection measures to mitigate the effects of noise in the workplace. The bibliography (in indexed databases) on these two themes is not very abundant and / or easily accessible. However, these measures, well used, can attenuate noise, promoting safer and healthier work. It would be pertinent for Occupational Health teams who deal with clients with different noise levels, to investigate which of these techniques are most appropriate to each situation and how employees adhere better to the process and perform their part more effectively.

scholarly journals Análise da Revisão Cochrane: Alta Hospitalar Precoce para Hospitalização Domiciliária. Cochrane Database Syst Rev. 2017;6:CD000356.

2017 ◽  
Vol 30 (12) ◽  
pp. 835
Author(s):  
Mariana Alves ◽  
Miguel Bigotte Vieira ◽  
João Costa ◽  
António Vaz Carneiro
Keyword(s):  
Systematic Review ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Care Group ◽  
Cochrane Central Register ◽  
Cochrane Database ◽  
Central Register ◽  
Objective Evidence ◽  
Hospital At Home ◽  
At Home

Hospital at home is a service that provides active treatment by healthcare professionals in the patient’s home for a condition that otherwise would require acute hospital in-patient care. However, the clinical benefit of this intervention and its effect on health costs are not established. This Cochrane systematic review aimed to assess the effectiveness and costs of managing patients with hospital at home compared with inpatient hospital care. A systematic review of the literature was carried out by searching the following databases to 9 January 2017: Cochrane Effective Practice and Organization of Care Group (EPOC) register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, EconLit and clinical trials registries. Thirty-two randomized trials (2 of which unpublished), including 4746 patients, were included. The present review provides insufficient objective evidence of economic benefit (through a reduction in hospital length of stay) or improved health outcomes.

scholarly journals Serum bilirubin and ischaemic stroke: a review of literature

2020 ◽  
Vol 5 (2) ◽  
pp. 198-204
Author(s):  
Xiao Wang ◽  
Danhong Wu ◽  
Ping Zhong
Keyword(s):  
Ischaemic Stroke ◽  
Serum Bilirubin ◽  
Neuroprotective Effect ◽  
Cochrane Library ◽  
Cochrane Central Register ◽  
Cochrane Database ◽  
Central Register ◽  
Comprehensive Search ◽  
Endogenous Antioxidant ◽  
The Cochrane Library

Bilirubin, a product of heme metabolism, is the most potent endogenous antioxidant which increases in many oxidative stress conditions such as stroke. It has been widely known to exert neuroprotective effect on stroke through mechanisms involved in development, therefore, it can influence the occurrence and prognosis of ischaemic stroke (IS). In this review, studies were identified by a comprehensive search of Pubmed, Embase, the Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Methodology Register) and Web of Science to examine the correlation between serum bilirubin levels and risks of developing IS as well as IS outcomes. Additional studies were identified by reviewing references and contacting authors.

scholarly journals A Systematic Review and Jurisdictional Scan of the Evidence Characterizing and Evaluating Assisted Peritoneal Dialysis Models

2020 ◽  
Vol 15 (4) ◽  
pp. 511-520 ◽  
Author(s):  
Mark Hofmeister ◽  
Scott Klarenbach ◽  
Lesley Soril ◽  
Nairne Scott-Douglas ◽  
Fiona Clement
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Peritoneal Dialysis ◽  
Cochrane Central Register ◽  
Home Based ◽  
Cochrane Database ◽  
Central Register ◽  
Professional Assistance ◽  
Dialysis Outcomes ◽  
Assisted Peritoneal Dialysis

Background and objectivesCompared with hemodialysis, home peritoneal dialysis alleviates the burden of travel, facilitates independence, and is less costly. Physical, cognitive, or psychosocial factors may preclude peritoneal dialysis in otherwise eligible patients. Assisted peritoneal dialysis, where trained personnel assist with home peritoneal dialysis, may be an option, but the optimal model is unknown. The objective of this work is to characterize existing assisted peritoneal dialysis models and synthesize clinical outcomes.Design, setting, participants, & measurementsA systematic review of MEDLINE, Cochrane Central Register of Controlled Trails, Cochrane Database of Systematic Reviews, Embase, PsycINFO, and CINAHL was conducted (search dates: January 1995–September 2018). A focused gray literature search was also completed, limited to developed nations. Included studies focused on home-based assisted peritoneal dialysis; studies with the assist provided exclusively by unpaid family caregivers were excluded. All outcomes were narratively synthesized; quantitative outcomes were graphically depicted.ResultsWe included 34 studies, totaling 46,597 patients, with assisted peritoneal dialysis programs identified in 20 jurisdictions. Two categories emerged for models of assisted peritoneal dialysis on the basis of type of assistance: health care and non–health care professional assistance. Reported outcomes were heterogeneous, ranging from patient-level outcomes of survival, to resource use and transfer to hemodialysis; however, the comparative effect of assisted peritoneal dialysis was unclear. In two qualitative studies examining the patient experience, the maintenance of independence was identified as an important theme.ConclusionsReported outcomes and quality were heterogeneous, and relative efficacy of assisted peritoneal dialysis could not be determined from included studies. Although the patient voice was under-represented, suggestions to improve assisted peritoneal dialysis included using a person-centered model of care, ensuring continuity of nurses providing the peritoneal dialysis assist, and measures to support patient independence. Although attractive elements of assisted peritoneal dialysis are identified, further evidence is needed to connect assisted peritoneal dialysis outcomes with programmatic features and their associated funding models.

Velcro Ties in Early Postoperative Pediatric Tracheostomy Care: A Systematic Review and Meta-analysis

2020 ◽  
pp. 019459982096472
Author(s):  
Brent A. Chang ◽  
Joshua Gurberg ◽  
Erin Ware ◽  
Kimberly Luu
Keyword(s):  
Meta Analysis ◽  
Prospective Trial ◽  
Final Analysis ◽  
Cochrane Central Register ◽  
Limited Data ◽  
Cochrane Database ◽  
Central Register ◽  
Significant Difference ◽  
Randomized Prospective Trial ◽  
The Difference

Objective To systematically review the literature to determine the difference in complications between standard twill and Velcro ties following pediatric tracheostomy. Data Sources MEDLINE, Embase, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, Web of Science, and CINAHL Plus were searched up to August 2020. Review Methods Two authors independently screened articles for eligibility. Retrospective and prospective studies were included as long as there was a direct comparison between twill and Velcro ties. Quantitative and qualitative analysis was performed. The main outcomes were skin-related complications and accidental decannulation. Results Three studies were included in the final analysis: 1 randomized prospective trial and 2 retrospective studies. There were 238 patients total (137 twill, 101 Velcro). Combined analysis showed skin-related complications in 23% of the Velcro group and 44% of the twill group. Meta-analysis for skin-related complications showed no significant difference when comparing Velcro with standard twill ties (risk ratio, 0.53 [95% CI, 0.24-1.17]; P = .12, n = 238 participants from 3 studies, I2 = 66%). Accidental decannulation rates were overall low and comparable between groups (1.0% of twill, 1.4% of Velcro). Conclusion Based on limited data, skin-related complications were not statistically different between Velcro and twill ties. Accidental decannulation is rare with Velcro and standard twill ties, and both are viable options following pediatric tracheostomy.

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