Occupational Health Team Research Articles

Persistência de Sintomas um ano após Infeção por SARS-COV-2 em trabalhadores e seu desempenho em atividades e participação em situações de vida

Introduction Although most individuals recover after acute infection by SARS-CoV-2, others may suffer from persistent symptoms with potential medium and long-term consequences on the performance of activities and participation, with possible implications for their fitness for work. Objective To analyze the persistence of symptoms twelve months after SARS-CoV-2 infection, and the perception of the performance level in activities and participation in life situations, of workers in a company of the industrial sector in the Aveiro Region. Methodology An observational study, developed in an Occupational Health Service of an industrial company in the region of Aveiro, including workers with positive SARS-COV-2 RT-PCR/TRAg test, between October/2020-January/2022. After signaling the infection, the Occupational Health Team applied a questionnaire collecting sociodemographic variables, a list of common symptoms during the acute phase of infection by SARS-COV-2, and the perceived functionality assessed by the Portuguese version of WHODAS 2.0-PT12 (where ’12 points’ means the most functionality). At twelve months, they filled out another list of persistent symptoms after SARS-CoV-2 infection and again WHODAS 2.0-PT12. Data analysis included descriptive statistics and univariate and multivariate linear regression. The analysis was conducted with the software JASP 0.16.3. Results Eighty-five workers were infected with SARS-CoV-2, with a mean age of 36.1±9.8years, 77.7% were male, 36.7% had higher education and 17.7% reported at least one chronic condition. At twelve months, thirty workers (35.3%) reported persistent symptoms, with fatigue (27.7%) and arthralgia (14.4%) being the most mentioned. The mean WHODAS 2.0 in the two evaluation moments was 19.2±8.0 vs 15.7±5.0. Significant associations between WHODAS 2.0 items and persistent symptoms of fatigue, headache, cough, myalgia, arthralgia, and previous chronic disease were found. Conclusions Persistent symptoms twelve months after acute SARS-CoV-2 infection have repercussions on workers’ self-perception of performance in some activities and participation in life situations. The occupational health team can implement continuous surveillance of the infected worker’s health, assess the presence of persistent symptoms of this infection, and implement an individualized rehabilitation program, which minimizes the impact of the persistence of symptoms on their work performance, and in activities and participation in life situations. KEYWORDS: Occupational Health, Occupational Medicine; Occupational Health Nursing, SARS-CoV-2, Symptoms, WHODAS 2.0.

Development of a clinical investigation protocol for occupational auditory health.

Considering that noise is present in different work environments, occupational health regulations have been created that advocate for the care of employees' auditory system in these environments. Occupational hearing assessment should be performed by audiologists through audiological examinations, otoscopy, as well as an interview to assess possible risk factors for the development of hearing loss. However, up to the present moment, a standardized set of updated questions for this interview has not been defined. To develop a clinical investigation instrument for occupational auditory health that provides support for clinical decision-making and differential diagnosis. The study was conducted using Design Thinking as a methodological approach in its stages of inspiration (problem identification), ideation (theoretical foundation and protocol design), and prototyping (protocol construction). This study was conducted with the objective of providing support for clinical decision-making and differential diagnosis of the auditory aspects of the assisted population. The Protocolo de Investigação Clínica da Saúde Auditiva Ocupacional was developed, consisting of six main sections that address medical history, lifestyle habits, exposure to non-occupational noise, work history, extra-auditory symptoms, and auditory and vestibular signs and symptoms, aimed at investigating workers' auditory health and related aspects. The developed instrument can be used for data collection and assist audiologists in the occupational health teams in diagnosis and decision-making processes.

Carriage of Neisseria meningitidis (meningococci) in the sputum of people with cystic fibrosis (CF): occupational health risks and mitigating interventions for physiotherapists

ObjectivesTo estimate the carriage of Neisseira meningitidis (meningococci) in expectorated sputum from people with cystic fibrosis (CF) and to evaluate potential ramifications of such carriage for the health and (NM) wellbeing of physiotherapists performing airway clearance techniques. DesignDescriptive observational study. Main outcome measuresMeningococcal carriage rate, CFTR mutation type and time to first meningococcal culture were determined. ResultsMicrobiological data was examined from 100 patients from birth to present (31/12/2021), equating to 2455 patient years. NM was isolated from 6/100 (6%) adult CF patients who had F508del/F508del (homozygous), F508del/other (heterozygous) and other mutations. The median and mean time to first isolation of NM was 213 months and 230 months (standard deviation = 27.6 months), respectively, shortest time was 209 months, longest time 278 months. ConclusionsPhysiotherapists should be aware of the risks to themselves of acquiring Neisseria meningtidis from CF patients’ respiratory aerosols, whilst performing airway clearance techniques. Physiotherapists with underlying medical conditions or with specific concerns about meningococcal disease should discuss their circumstances with their occupational health team, to ensure optimal protection.

Occupational effects in patients with post-COVID-19 syndrome.

It is well recognized that some individuals experience persistent symptoms following an initial SARS-CoV-2 infection. Symptoms affect physical, cognitive and mental well-being and can adversely impact activities of daily living, including the ability to work. To examine the impact of post-COVID-19 syndrome with respect to effects on quality of life and impact on work in a cohort of people referred to a 'Long COVID' service. All triaged patients (over 18 years with symptoms more than 12 weeks since the initial infection) completed a symptom assessment questionnaire. Occupation and working status (at work, at work struggling with symptoms and off work) were also recorded. Impact on function and quality of life was assessed using the EQ5D5L questionnaire. A total of 214 patients (median age 51.0 years, 135 females) were seen from January to September 2021. Analysis of occupational status showed: 18% were working, 40% were working but struggling and 35% had stopped working due to symptoms. Those unable to work reported significantly more fatigue, a greater perception of the need for support and lower quality-of-life scores. This study shows the extensive impact of post-COVID-19 syndrome on the ability to return to work. Specific return-to-work guidance is needed to support a large proportion of those struggling with the condition. The involvement of the Occupational Health team should form part of the multidisciplinary, collaborative approach to support rehabilitation and improve long-term outcomes for this condition.

Cancro da Tiroide associado ao Trabalho

Introduction/framework/objectives The study of cancer and work-related etiology has been increasing, revealing some associations with previously undervalued occupational risk factors. In this sense, it is legitimate to find out whether Thyroid Cancer can be associated with certain occupational characteristics, so that occupational health and safety teams can effectively carry out its work. Thus, the aim of this review is to gather as much scientific evidence on the phenomenon as possible, to promote a healthier and safer work environment. Methodology This is a bibliographic review, initiated through a search carried out in January 2022, 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 In recent decades, this pathology has increased to about three times more, becoming one of the most frequent in some countries, which may be associated with the existence of greater medical surveillance and more regular auxiliary diagnostic exams, not least because most of the lesions detected are increasingly small and premature: although other researchers consider that the increase in incidence is real, due to ionizing radiation and worsening of the Body Mass Index. Discussion and Conclusions The work circumstances that seem to be more associated are ionizing radiation, as well as some dust and chemical agents present in demolition areas/collapsed buildings and/or mercury, although without full consensus among researchers. It will be necessary to carry out further studies to prove the etiology of work origin, which will only be possible if the Occupational Health and Safety teams are aware of the problem and carry out epidemiological studies to investigate this potential causality. Keywords: thyroid cancer, ionizing radiation, occupational health, occupational medicine and safety at work.

Cancro Renal associado ao Trabalho

Introduction/framework/objectives There are several cancers that can be associated with some characteristics of the Work. Regarding the oncological pathology of the Kidney, there are not many publications. The aim of this review was to summarize what has been reported on the subject to date, in order to enhance the performance of Occupational Health and Safety Teams working in possibly targeted sectors. Methodology This is a Bibliographic Review, initiated through a search carried out in January 2022 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 Kidney Cancer, at the level of non-occupational etiology, may be associated with tobacco, obesity and high blood pressure (metabolic syndrome), as well as Cystic Kidney Disease, male gender, older age, black ethnicity and family history. It is believed that tobacco can explain 20 to 30% of it in men and 10 to 20% in women; being the dose-dependent relationship. The association with arterial hypertension also seems to be dose-dependent and more intense above 160 and 100 mmHg for systolic and diastolic, respectively. There are several working conditions capable of enhancing it; even so, studies sometimes do not consider the possible influence of biasing variables, such as smoking, including passive. Discussion and Conclusions Although without absolute consensus, this cancer seems to be enhanced by exposure to Radon/Uranium, Asbestos, Pesticides, derivatives of Fuels and various Chemical Agents (such as tri and tetrachlorethylene, dinitrotoluene and lead). Thus, the most targeted professional sectors could be mining; civil and naval construction, demolition sector; agriculture; production, packaging and distribution of relevant chemical agents; refineries and filling stations; as well as dry cleaning, printing, car and aircraft mechanics, maintenance, metallurgy, drivers and road pavers. It would be pertinent for some Occupational Health and Safety teams to initiate research projects in this context, for subsequent dissemination of conclusions, in order to advance knowledge and provide a healthier and safer work environment. KEYWORDS: kidney cancer, occupational health, occupational medicine and safety at work.

Cancro Testicular associado ao Trabalho

Introduction/framework/objectives Testicular Cancer usually appears at earlier ages than other oncological pathologies, therefore, it is more likely to be diagnosed in the active population. It is suspected that part of the cases may have an occupational etiology, so it will be relevant to develop efforts for its early diagnosis and prevention. In this sense, this review intends to highlight the most relevant publications on the subject, to facilitate the work of occupational health teams. Methodology The research and bibliographic review were carried out in January 2022, 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 It is most frequent in developed countries; corresponds to 1% of all cancers diagnosed in men, considering all age groups. Incidences have been increasing to nearly double over the last four decades in most countries, possibly due to some occupational and/or environmental exposures. Discussion and Conclusions Occupational issues that seem to be more related to this cancer are contact with some chemical agents (namely pesticides, asbestos, solvents and heavy metals); as well as ionizing radiation. Thus, some of the most relevant sectors will be agriculture, civil construction, demolitions, industry with the production of chemical agentes, paper and plastics, laundries and firefighters. It would be relevant for some Occupational Health and Safety teams to dedicate some time to investigating these issues, enhancing global scientific knowledge on this topic and, in particular, deepening the national level (global incidence, more relevant sectors/professions/tasks, as well as collective and individual protection measures most used and effective). KEYWORDS: testicular cancer, asbestos, pesticides, occupational health, occupational medicine, occupational safety.

Cancro Pancreático associado ao Trabalho

Introduction/framework/objectives Pancreatic cancer has a high mortality rate. Part of the etiology, for some researchers, may be related to work activities, so knowledge of risk factors may be important for the performance of Occupational Health and Security teams. Thus, taking into account that the evidence on the subject is scarce, the aim of this review was to summarize the available and most current information. Methodology This is a Bibliographic Review, initiated through a search carried out in January 2022 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 In 2008, around 280,000 new cases were estimated worldwide. Due to the low survival rate, the incidence number is similar to the mortality rate in the medium term. The five-year survival rate in some countries is 7 and 8% for males and females, respectively. This pathology generally does not show encouraging results in relation to chemotherapy or radiotherapy. Although without full consensus, it is believed that males are more likely to be affected. Discussion and Conclusions Part of pancreatic cancers may have an occupational origin through contact with ionizing radiation and, above all, some chemical agents: pesticides, fertilizers, cadmium, nickel (and other heavy metals), nitrosamines, chlorinated and polycyclic aromatics hydrocarbons, silica/asbestos, metallurgy fluids, paints and diesel fumes. Thus, the most relevant professional sectors will be agriculture and gardening, dry cleaning, construction/shipbuilding (and related areas), as well as photography. Taking into account the scarcity of data at a national level, it would be relevant to obtain studies that explore this phenomenon, namely, which levels of exposure to risk factors potentially carcinogenic, which professions are most exposed, which protection measures have been equated, as well as its effectiveness or even the rate of return to work and its eventual limitations. KEYWORDS: pancreatic cancer, pesticides, occupational health, occupational medicine, occupational safety.

Cancro do Pulmão associado ao Trabalho

Introduction/framework/objectives Lung Cancer is fairly common and usually very lethal. Part of the cases seems to have an occupational etiology, so it will be relevant for professionals in the area to have some notions on the subject. The aim of this review was to summarize what was most recent and pertinent published on this subject. Methodology This is a Bibliographic Review, initiated through a search carried out in January 2022, 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 It is the deadliest cancer worldwide; it is the most frequent in males and the third most prevalent in females. Some researchers consider that it is possible that some hormonal issues can boost the number of cases in females. In this last ones, the most frequent is adenocarcinoma, less associated with tobacco. It is believed that the occupational origin can explain almost a third of the cases. In this context, asbestos are the most relevant factor (responsible for 55 to 85% of cases with occupational etiology), according to some authors. Discussion and Conclusions In the literature, there is reasonable evidence that Lung Cancer is more likely to occur in situations where there is exposure to Radon, Asbestos/Silica, Polycyclic Aromatic Hydrocarbons, Fiberglass, Diesel, Aluminum, Sulfur Dioxide and/or Particulate Matter. Thus, some of the professional sectors highlighted in this context will be Construction (General and Naval), Foundries and Mines. Despite this, there is little available literature that demonstrates the study of this phenomenon in national companies, so it would be relevant for some Occupational Health and Safety teams to dedicate some time to investigating these issues, enhancing global scientific knowledge on this topic and, in particular, epidemiologically characterizing the national panorama (incidence, most affected sectors/professions/tasks, as well as most used and/or effective collective and individual protection measures). Keywords: lung cancer, asbestos, silica, radon, occupational health, occupational medicine and occupational security.

Satisfação Laboral

Introduction/framework/objectives Job Satisfaction has the capacity to influence the quality of working life and even overall quality of life, so the study of this subjet will certainly enhance the performance of Occupational Health and Safety teams. Methodology This is a Bibliographic Review, initiated through a search carried out in January 2022, 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”. Contents Although there are many definitions for this concept, the different proposals do not conflict with each other and represent a similar general idea. In the bibliography there is abundant information on what are the factors that enhance and mitigate Job Satisfaction, as well as the main advantages with the existence of Labor Satisfaction. Discussion and Conclusions There are several parameters that, if well worked out, will be able to enhance the Job Satisfaction of employees, as well as provide advantages, certainly sufficiently encouraging for institutions to be motivated to invest in it. Most authors argue that the management of expectations, remuneration/rewards, type of leadership, employment relationship/security, justice, respect, autonomy, self-esteem, commitment, sense of belonging, working hours, technical support and access to workshops are the most relevant in this context; as training, participation in decision-making, the possibility of career progression and the existence of good social relations between colleagues and managers. Keywords: job satisfaction, occupational health and occupational medicine.

Cancro Hematopoiético associado ao Trabalho

Introduction/framework/objectives Hematopoietic oncological pathologies may be associated with some work conditions. The bibliography on the subject is not very exhaustive and, therefore, the associated knowledge is not very developed among professionals in the area and/or workers/managers/employers. The aim of this review is to summarize the most recent and relevant publications on the subject. Methodology This is a Bibliographic Review, initiated through a search carried out in January 2022 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 In the work environment, the most relevant chemical agents in relation to leukemia are benzene, tetrachlorethylene, styrene, chlorophenols, aromatic amines, creosote, chromium, arsenic, ethylene oxide, asbestos, antineoplastic agents and pesticides. The International Agency for Research on Cancer (IARC) has identified more than one hundred chemical carcinogens and, of these, about a quarter increase the risk of leukemia and lymphoma. This entity classifies butadiene and formaldehyde (used in the plastic, rubber and textile production industry, for example) as included in group 1, that is, carcinogenic to humans; she further published that benzene, ethylene oxide, some pesticides and formaldehyde as probably linked to leukemia (group 2a); as well as some types of radiation. This institution highlighted the existence of a greater hematopoietic risk related to professional activities associated with shipbuilding, footwear and rubber production, although the conclusions are not consensual among researchers. In turn, chimney sweeping work has been shown to be associated with all types of hematopoietic cancer. Discussion and Conclusions There are some risk factors with suspected or proven association with the etiology of some hematopoietic oncological pathologies. It is essential that professionals in the sector acquire a minimum of knowledge regarding what the scarce bibliography describes, so that it is possible to plan collective and individual protection measures that manage to mitigate the risk. It would also be interesting if some occupational health and safety teams, working in institutions with workers exposed to these working conditions, were able to investigate the topic, releasing innovative and/or more complete data to the bibliography than what is currently published. KEYWORDS: hematopoietic cancer, leukemia, lymphoma, multiple myeloma, occupational health and occupational medicine.

Cancro do Pulmão associado ao Trabalho

Introduction/framework/objectives Lung Cancer is fairly common and usually very lethal. Part of the cases seems to have an occupational etiology, so it will be relevant for professionals in the area to have some notions on the subject. The aim of this review was to summarize what was most recent and pertinent published on this subject. Methodology This is a Bibliographic Review, initiated through a search carried out in January 2022, 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 It is the deadliest cancer worldwide; it is the most frequent in males and the third most prevalent in females. Some researchers consider that it is possible that some hormonal issues can boost the number of cases in females. In this last ones, the most frequent is adenocarcinoma, less associated with tobacco. It is believed that the occupational origin can explain almost a third of the cases. In this context, asbestos are the most relevant factor (responsible for 55 to 85% of cases with occupational etiology), according to some authors. Discussion and Conclusions In the literature, there is reasonable evidence that Lung Cancer is more likely to occur in situations where there is exposure to Radon, Asbestos/Silica, Polycyclic Aromatic Hydrocarbons, Fiberglass, Diesel, Aluminum, Sulfur Dioxide and/or Particulate Matter. Thus, some of the professional sectors highlighted in this context will be Construction (General and Naval), Foundries and Mines. Despite this, there is little available literature that demonstrates the study of this phenomenon in national companies, so it would be relevant for some Occupational Health and Safety teams to dedicate some time to investigating these issues, enhancing global scientific knowledge on this topic and, in particular, epidemiologically characterizing the national panorama (incidence, most affected sectors/professions/tasks, as well as most used and/or effective collective and individual protection measures). Keywords: lung cancer, asbestos, silica, radon, occupational health, occupational medicine and occupational security.

Cancro da Mama associado ao Trabalho

Introduction/framework/objectives There are work circumstances that can increase the oncological risk and Breast Cancer is no exception to this situation. However, knowledge on this subject is not particularly abundant among workers and/or Occupational Health and Safety teams professionals. This review was intended to mitigate this issue. Methodology This is a Bibliographic Review, initiated through a search carried out in January 2022 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 Night shifts are chronodisruptive, probably due to decreased melatonin production. Other researchers add that night work and/or nocturnal exposure to light disturbs the circadian rhythm and hormone secretion (with emphasis also on prolactin, glucocorticoids, adrenocorticotropic hormone, corticoliberin and serotonin). However, there is no consensus that night shifts imply lower levels of prolactin secretion and that this is associated with Breast Cancer. Some studies may be biased due to having studied night shifts versus exposure to light during these shifts (the latter being the situation that presents evidence of moderately increasing the risk of this Cancer). In addition, more recent investigations consider more possibly biasing variables. It is believed that nocturnal exposure to light implies changes in the production of melatonin and vitamin D. However, others consider that these data are not supported by robust scientific evidence or free of controversy, even due to the difference between the different types of night shifts. In 2007, the IARC published some data on this possible relationship- namely that night shifts were probably carcinogenic to humans (group 2A), and/or that there was evidence of an association between oncological processes and night shifts, probably for Breast Cancer in particular, based on sufficient evidence in animals and limited evidence in humans. Discussion and Conclusions Most of the bibliography on the subject emphasizes night shifts and/or exposure to light during them as a work etiology, although without full consensus between causality and/or pathophysiology. Pesticides, solvents and products included in kitchen fumes (polycyclic aromatic hydrocarbons), aldehydes and polycyclic aromatic amines) are also mentioned. It would be an asset for some Occupational Health and Safety professionals, with adequate logistical capacity, to investigate the area, subsequently disclosing the conclusions covered. Keywords: breast cancer, occupational health, occupational medicine and occupational safety.

Cancro da Bexiga associado ao Trabalho

Introduction/framework/objectives Bladder cancer is reasonably prevalent, and in some cases it may be related to work characteristics. It would be relevant for most professionals to have some knowledge of what is published on this topic. Methodology This is a bibliographic review, initiated through a search carried out in January 2022 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 Bladder Cancer is the most frequent or the second most prevalent among genito-urinary neoplasms and the second most deadly in that context. Considering all oncological pathologies, it is estimated that it is the 7th or 9th most prevalent. By sex, it is two to four times more frequent in males. It arises from the interaction between genetic and environmental factors, namely occupational. Some researchers argue that, in developed countries, occupational exposure is the main cause, followed by smoking; however, most studies claim the opposite. The most relevant chemical agents are aromatic amines, polycyclic aromatic hydrocarbons and pesticides; as well as combustion products/diesel emissions and heavy metals. Discussion and Conclusions There are some risk factors with suspected or proven association with the etiology of Bladder Cancer. It is important to disclose these, so that occupational health and safety teams can take collective and individual protection measures to mitigate this. It would also be interesting for these companies to carry out more research on the subject, adding evidence to what has already been published or providing an overview of the state of the art in Portugal. Keywords: bladder cancer, occupational health, occupational medicine and safety at work.

Cancro da Laringe associado ao Trabalho

Introduction/framework/objectives Evidence that Laryngeal Cancer may originate at work or be influenced by behaviors carried out in the workplace has been increasing, although this relationship is still undervalued by health professionals. In this sense, the aim of this study is to identify occupational risk factors for laryngeal cancer, so that occupational health professionals can have information available to facilitate workers’ health promotion and disease prevention tasks or, at the limit, suspect the problem earlier. Methodology This is a Bibliographic Review, initiated through a search carried out in January 2022, 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 Laryngeal Cancer is the most prevalent at the aerodigestive level; that is, about 130.000 new cases per year worldwide in males and 21.000 in females, although with some differences between countries. Although the main risk factors are alcohol and tobacco consumption, which contribute synergistically to the problem, there are activities, mainly in the primary and secondary sectors, which, due to their exposure to physical and chemical agents (such as silica, asbestos, asbestos, polycyclic aromatic hydrocarbons, heavy metals and other components of paints and cement, for example). Discussion and Conclusions There are some risk factors with suspected or proven association with the etiology of Laryngeal Cancer. It is essential that professionals in the sector acquire a minimum of knowledge regarding what the bibliography describes, to be able to take collective and individual protection measures that can mitigate the risk. It is essential that professionals in the sector acquire a minimum of knowledge regarding what the bibliography describes, to be able to implement collective and individual protection measures that manage to mitigate the risk. It would also be desirable for occupational health teams, with workers exposed to these working conditions, to be able to investigate the topic, releasing innovative and/or more complete data to the bibliography than what is currently published, including giving a perspective of the state of the art in our country.

Development of an interprofessional task-based learning program in the field of occupational health: a content validity study

ObjectiveOne of the duties of the educational system is to provide situations in which students learn the tasks corresponding to their future careers in an interprofessional team. This study was designed to develop an interprofessional task-based training program.MethodsThis was a curriculum development study conducted by content validity methodology in two stages: 1) ‘framework development’ which resulted in the creation of the framework items; and 2) ‘evaluation of the framework’ (judgment and quantification). The first stage consisted of task identification, generation of sub-tasks, and assimilation of items into a usable format. The second stage consisted of the judgment –quantification of the content validity of items and the framework. After that, the framework of the tasks of the occupational health team was finalized in the expert panel. After explaining the tasks, a matrix for task-expected roles in the occupational health team and a matrix for task-required skills to perform each task were developed. The next step determined the appropriate teaching and assessment methods for each task. Finally, an expert panel reviewed and approved the components of the interprofessional task-based training program.ResultsIntegrating the interprofessional education strategy with task-based learning was considered innovative in occupational health team training. In the development stage, 48 items were extracted, and then 35 tasks were generated in the step of identification of tasks. In the second step, 174 sub-tasks were developed. The tasks and sub-tasks were categorized into seven areas. After the stage of evaluation of the framework, 33 tasks were categorized into seven main areas, including "assessment and identification of workplace hazards" (n = 10), "control of occupational hazards" (n = 4), "determining the appropriate job position for each person" (n = 3), "occupational health examinations" (n = 6), "management of occupational/work-related diseases" (n = 5), "inter-organizational and inter-disciplinary relations, and legal judgment" (n = 3) and "education and scholarship in occupational health services" (n = 2).ConclusionThe results of the present study can be used in developing the use of the interprofessional strategy and task-based training as two appropriate strategies for the purposeful development of learners' abilities in the fields involved in providing occupational health services in their future careers.

Critical evaluation of applications of artificial intelligence based linguistic models in Occupational Health.

This article explores the impact and potential applications of large language models in Occupational Medicine. Large language models have the ability to provide support for medical decision-making, patient screening, summarization and creation of technical, scientific, and legal documents, training and education for doctors and occupational health teams, as well as patient education, potentially leading to lower costs, reduced time expenditure, and a lower incidence of human errors. Despite promising results and a wide range of applications, large language models also have significant limitations in terms of their accuracy, the risk of generating false information, and incorrect recommendations. Various ethical aspects that have not been well elucidated by the medical and academic communities should also be considered, and the lack of regulation by government entities can create areas of legal uncertainty regarding their use in Occupational Medicine and in the legal environment. Significant future improvements can be expected in these models in the coming years, and further studies on the applications of large language models in Occupational Medicine should be encouraged.

Brucelose- a propósito de um Caso Clínico

Introduction Brucellosis is a zoonosis caused by a gram-negative coccobacillus bacterium of the genus Brucella, which can be transmitted by direct contact with animals or their secretions. Is an acute or subacute systemic disease that generally starts two to four weeks after inoculation. Its symptoms are nonspecific, but typically are presented with fever, night sweats, arthralgias or asthenia. Although being endemic in underdeveloped countries, is still an underdiagnosed and underreported disease. Case Report This is a 28 year old veterinarian assistant male, with close and frequent contact with cattle, sheep and goats. He is unaware of having ever been submitted to an aptitude test for work and, as personal protective equipment, uses gloves and a rubber apron only. He was observed in the hospital emergency department, due to recurrent testicular pain and constitutional symptoms. Serology test showed a borderline IgG for brucellosis. Therefore, the case was notified in the National System of Epidemiological Vigilance. The patient was treated with doxycycline and rifampicin, and the testicle was surgically removed. The surgical piece accused Brucella spp, which confirmed the diagnosis of brucellosis with orchiepididymitis. Discussion Considering that the symptoms of brucellosis are unspecific, a detailed clinical history, including occupational exposure/background, is fundamental for the diagnosis. The incidence of cases associated with occupational exposure is relevant, being veterinarians and large animal veterinary assistants among the professional groups with higher risk. Low adherence to personal protective equipment and lack of knowledge may be factors that perpetuate the infection. It is essential to facilitate access to Occupational Health services to ensure the health surveillance of these workers. Conclusion Brucellosis is one of the most neglected zoonosis worldwide, however, it’s one of the three most common in Portugal. This case report urges the healthcare professionals to acknowledge these less known work-related diseases, in particular zoonosis, that are often underdiagnosed. The professional risk assessment and the implementation of protective measures are fundamental in reducing occupational risk, being the assessment of working conditions by a qualified safety technician required. Thus, Occupational Health teams play a leading role in preventing professional illnesses, promoting health, implementing preventive measures and reducing morbidity and mortality. KEYWORDS: Occupational Health, Work Medicine, Work Security, Brucellosis, Veterinary.

Interação entre as caraterísticas do Calçado e o Risco de Queda ao mesmo nível

Introduction/framework/objectives Falls to the same level are reasonably frequent and, if in some professional sectors there is a reasonable number of employees who have access to adequate footwear, in other contexts this does not happen. In addition, not all professionals working in the Occupational Health teams will be able to make recommendations to choose the model to be acquired. The aim of this review was to summarize the most recent and relevant publications on this topic, in order to try to alleviate this issue. Methodology This is a Bibliographic Review, initiated through a search carried out in August 2021 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”. Contents Accidents are associated with a decrease in productivity, more indemnities for disability, an increase in the number of days lost from work, more pain/suffering for the employee at the time and, eventually, permanent disability in the future. Falling to the same level will depend on extrinsic or environmental factors (such as weather, light, obstacles, distractions, footwear, tasks per se and floor characteristics) and intrinsic or human factors (joint/muscular and reflex issues-postural stability and fatigue muscle/intense exercise). Discussion and Conclusions Although the selected articles did not produce a synthesis of information that would allow the topic to be approached with much confidence and robust evidence, were found data that could minimally guide the activity of professionals working with employers with this risk factor, namely: providing a adequate illuminance and temperature, eliminate or reduce obstacles, prepare a floor with grooves perpendicular to the main direction of displacement, attenuate or eliminate water or other contaminants, avoid or attenuate the maintained standing posture, as well as vigorous exercise immediately before/fatigue, control the displacement speed and develop joint and muscular strength of the employee. As for the characteristics of the shoe itself, these can be summarized in the existence of deep grooves in the sole, a non-elevated heel, a model that is above the ankle and the use of flexible, light materials with soles that cause adequate friction. It would be pertinent taht some professionals working in Occupational Health to better investigate the topic (differences between models/materials and areas of work/specific tasks; as well as comfort and adherence) and publish the conclusions obtained in journals in the area. Keywords: fall to the same level, non-slip footwear, occupational health and occupational medicine.

Bissinose

Introduction / framework / objectives The interest in applying task rotation to mitigate some occupational risk factors has been mentioned for a long time but, in reality, most professionals working in Occupational Health teams do not have experience in the development of these schemes and, perhaps, may even not knowing that there are computer algorithms that could aim the whole process more scientifically. Methodology This is a Bibliographic Review, initiated through a search carried out in August 2021 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”. Contents Rotation is an administrative technique used with the objective of preventing Musculoskeletal Injuries; however, designing a rotation protocol can be complex in some circumstances. It can be defined as the change of tasks in a cyclic and regular way, in a previously stipulated order, in a certain interval. Advantages cover the Employee and/or Employer. Rotation can be decided by the hierarchical superior or by the employees themselves (with autonomy); in the latter case the acceptability is higher. Discussion and Conclusions Job rotation seems to be a good option in general work situations, as long as it is well considered; for more complex situations, computer programs/algorithms may be used to assist in the process. KEYWORDS: rotation, occupational health, occupational safety and occupational medicine.