Introduction / framework / objectives The Call Center Workers presents as main risk factors/ occupational risks the sustained sitting posture, repetitive movements (and consequent musculoskeletal diseases), as well as visual effort (and possible diminishing of acuity and ocular discomfort), electromagnetic radiation (with nonconsensual consequences among researchers), noise (with possible hearing loss) and stress (with variable consequences among employees). Methodology This is an Integrative Bibliographic Review, initiated through a research conducted in December 2017 in the databases “CINALH plus with full text, Medline with full text, Database of Summary of Effects Reviews, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: Comprehensive, MedicLatina, Academic Search Complete and RCAAP. Content The Call Center operator can be defined as a worker that uses both the phone and the computer to sell or provide another service. There are basically two subtypes: those who receive calls from customers and try to clarify doubts and the services that take the initiative to contact in order to sell the product/ service. In this second group productivity control is more rigid and generate more conflicts with the supervisors. In our country, the main function of Call Centers seems to be to clarify the doubts (90%), in the context of customer service. In addition, one can work for the employer or be subcontracted. This modality of interaction with the client is more economical and attractive for the institution; in addition to allowing a much wider service schedule (in some contexts 24 hours a day and 365 days a year)- which, in turn, potentiates the stress and difficulty in reconciling work with personal life and family. In the case of woman, it can be added the household chores. Conclusions This is a professional sector with particularities in Occupational Health that exceed office work, whether due to the employment security (or lack of this), specific interaction with customers and managers, workload and autonomy. It would be pertinent to investigate better the national reality.

Introduction / framework / objectives The Call Center Workers presents as main risk factors/ occupational risks the sustained sitting posture, repetitive movements (and consequent musculoskeletal diseases), as well as visual effort (and possible diminishing of acuity and ocular discomfort), electromagnetic radiation (with nonconsensual consequences among researchers), noise (with possible hearing loss) and stress (with variable consequences among employees). Methodology This is an Integrative Bibliographic Review, initiated through a research conducted in December 2017 in the databases “CINALH plus with full text, Medline with full text, Database of Summary of Effects Reviews, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: Comprehensive, MedicLatina, Academic Search Complete and RCAAP. Content The Call Center operator can be defined as a worker that uses both the phone and the computer to sell or provide another service. There are basically two subtypes: those who receive calls from customers and try to clarify doubts and the services that take the initiative to contact in order to sell the product/ service. In this second group productivity control is more rigid and generate more conflicts with the supervisors. In our country, the main function of Call Centers seems to be to clarify the doubts (90%), in the context of customer service. In addition, one can work for the employer or be subcontracted. This modality of interaction with the client is more economical and attractive for the institution; in addition to allowing a much wider service schedule (in some contexts 24 hours a day and 365 days a year)- which, in turn, potentiates the stress and difficulty in reconciling work with personal life and family. In the case of woman, it can be added the household chores. Conclusions This is a professional sector with particularities in Occupational Health that exceed office work, whether due to the employment security (or lack of this), specific interaction with customers and managers, workload and autonomy. It would be pertinent to investigate better the national reality.

RESUMO Objetivo Relatar a experiência de reinserção laboral de funcionários públicos após longo período de ausência por doença (acima de 3 meses), em Regime Próprio de Previdência Social municipal do interior do Estado de São Paulo, Brasil, no período entre março de 2014 e janeiro de 2016. Método Tratou-se de um estudo realizado a partir de uma análise documental de 121 processos de auxílio-doença de funcionários públicos em períodos longos de ausência laboral por doença, ou seja, licenças acima de três meses em um Regime Próprio de Previdência Social. Foram analisados formulários de atualização cadastral, relatórios e atestados médicos, laudos de exames médicos, relatórios e pareceres da equipa transdisciplinar, laudos de perícia médica, ofícios encaminhados ao SEESMT e outros órgãos, tentando identificar a estrutura do trabalho realizado pela equipa transdisciplinar, as ações desenvolvidas, o perfil dos funcionários com longos períodos de afastamento atendidos, os desfechos dos casos após intervenção, o número de trabalhadores reinseridos e as reincidências de afastamento dos mesmos. Para análise dos dados utilizou-se a análise descritiva simples, com a tabulação no programa Microsoft Excel®, 2013 sendo os dados quantitativos submetidos a testes estatísticos de análise descritiva para o cálculo da porcentagem, do mínimo, máximo, média e desvio padrão das variáveis. Resultados A equipa transdisciplinar realizou cerca de 656 atendimentos e 38 reuniões intersetoriais no período considerado. Os funcionários tinham idade média de 52,4 anos e tempo médio de afastamento de 11 meses, com preeminência do género feminino (74%), professores do ensino básico (n=50) e com diagnóstico de doenças psiquiátricas (n=53). Cerca de 60% (n=73) dos funcionários foram reinseridos no trabalho, dos quais 41% (n=31) necessitaram de condições específicas, como restrição funcional (n=20), readaptação (n=6), mudança e/ou adequação do posto de trabalho (n=4) e mudança de turno (n=1), as quais foram proporcionadas por ações da equipa e parcerias com outros setores. Entre os funcionários reinseridos no trabalho, cerca de 73% (n=55) não apresentaram novos afastamentos no período considerado. Conclusão Constatou-se que ocorreu uma atenuação das ausências laborais prolongadas após o início das ações da equipa, tendo como ponto de partida uma avaliação holística de profissionais não médicos para além de uma perspectiva estritamente focada na doença/deficiência. Também foi possível a reinserção laboral de funcionários com comprometimentos de ordens diversas a partir de um referencial ampliado de funcionalidade, que a considera como resultante da interação entre as estruturas e funções do corpo, atividades, participação e condições ambientais.

Introduction Mineral production generates a significant volume of tailings resulting from mining and processing. Such tailings are accumulated in dams of large volumes that are subject to rupture that can cause environmental consequences and loss of lives of the nearby populations and the workers involved. This article describes the case of iron ore waste dam break, located in Mariana, State of Minas Gerais, Brazil. Objectives This article aims to describe the events that resulted in the dam beak of Fundão Tailings Dam in Mariana, State of Minas Gerais, Brazil, and to present the limits of the actions taken to correct the failures observed during the operation of the dam. Methodology Documentary analysis and the data of the “Report of Accident Analysis – Breaking of the Fundão Tailings Dam, in Mariana, MG”, prepared by a team of Labor Inspectors, of the Ministry of Labor of Brazil, of which take part the authors. Documentary and bibliographical research on theories of organizational factors of accidents was also carried out. Results The study showed the events that have occurred since the implementation of the Dam and that have led to a progressive deterioration in the capacity of support of the stored volume. Also pointed to the company’s failures to correct the fragilities that have been verified throughout its history and which culminated in the dam break. This caused an unprecedented environmental catastrophe in the history of Brazilian mining and the deaths of residents and workers who were in the area. Discussion Increased accidents like this do not have a single cause, but result from a combination of factors accumulated over time, whose origin can be explained by technical-organizational decisions or even company policies taken throughout history. In this case, management decisions were made regarding the operation and maintenance of the tailings disposal system to correct the detected failures, but these were not sufficient to prevent the dam break. Conclusion This increased work-related accident and its consequent environmental catastrophe reveal failures in the company’s management, licensing, monitoring, monitoring and emergency system processes, which were unable to guarantee the dam’s safety, the company itself and the affected populations. This allows us to conclude on the unsustainability of the occupational and environmental management adopted.

Introduction / framework / objectives This theme have drawn the attention of the authors in the past, due to another article published in this magazine (which highlighted the sector of day centers / nursing homes and their employees); more recently one of authors started work in a Call Center company, in which a reasonable percentage of workers referred symptoms associated with Indoor Air Quality (IAQ). The need to search for more information has arisen, since the general population is spending more leisure time and work time in closed areas. Methodology This is an Integrative Bibliographic Review, initiated through a survey conducted in March 2018 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 Academic Search Complete ". Content Sometimes the valorization of the lower energy expenditure, thermal comfort and isolation of the external contaminants, justifies reduced ventilation. Some researchers believe that the risks of indoor pollution may be greater than outside. In addition to architectural parameters, IAQ also depends on occupants behavior (ventilatory habits, smoking inside the building and choice of cleaning agents, furniture and other materials), as well as of external issues such as weather. Most researchers highlight carbon monoxide, ozone, radon, particulate matter, fibers, biological agents (bacteria, fungi) and pollen; as well as volatile organic compounds and polycyclic aromatic hydrocarbons. There are individuals who have medical particularities that make them more susceptible to changes in IAQ, such as asthma and various allergies. Conclusions Some parameters of the Interior Air Quality have the capacity to cause annoying symptomatology to workers and, consequently, decrease their quality of life, satisfaction and productivity, boosting absenteeism. Therefore, professionals working in Occupational Health should have some notions related to this topic, in order to better contribute to attenuate this issue in their clients.

Introduction Being verified a exposure of some industrial workers to heat thermal stress, a special interest appeared in researching its effects on their health. Objectives Identify the impact of heat thermal stress on industrial worker’s health, as well as the potentials domains of intervention of Nursing Work in this context. Methodology Proceeded to the development of an Integrative Literature Review through research on B-on, MEDLINE and COCHRANE databases with the keywords “occupational heat stress” AND “workers” AND “industry” and “health impact”. Results Continuous exposure to thermal heat stress triggers, on industrial workers, certain physiological responses that deserve special attention of Occupational Health. Are described, in this article, its influence on renal, cardiac, cognitive changes and in the quality and quantity of semen. Conclusions The Work Nurse plays a fundamental role in preventing disease and promoting health on workers, given its proximity to the different organizational structures of the company: workers, managers and human resources, and can act either individually through targeted health education, or collectively, through the intervention with the administration to improve working conditions.

Background: Animal production has evolved into large-scale operations with a higher concentration of animals, as well as their food and waste, resulting in an environment rich in dust, gases, biological agents, chemicals and other indoor air pollutants. The aim of this study is to identify the main occupational toxic risks related to the animal production industry. Methods: We perform an integrative review by search of studies published in Medline between 2007 and 2017 regarding toxicological risks related to the production of cattle, goats, horses, pigs and sheep, as well as production of rabbits, hares, birds and fish in aquaculture. Results: The vast majority of the literature focuses on the production of poultry, cattle and pigs, the latter with the greatest number of identified toxicological risks. Dusts, gases (among which carbon dioxide, ammonia and hydrogen sulphide are prominent) and aflatoxins appear to be the main exposures of this activity. Most of the associated problems are respiratory and the prevention remains the best way to avoid them. Conclusion: Proliferation of highly concentrated livestock breeding and feeding units in enclosed spaces is a non-modifiable factor that has brought problems in terms of occupational health, posing a threat to their workers. To keep the sustainability of this industry, economic viability is important but also a greater care with its workforce is necessary.

Introduction: Knowing the grip strength of a worker’s hand can estimate their functional capacity for manual tasks, which in turn can contribute to a better targeting of the gripper functions. Objective:To establish a reference index for the profile of manual grip muscle strength, in addition to the retention rate of this force, based on the evaluation of workers performing distinct functions in a metallurgical industry. Method: The sample consisted of three groups of five individuals with no history of musculoskeletal diseases and with similar physical habits, containing in the Brazilian Ratings of Occupation (CBO): Group A – uses no grip strength; Group B – uses intense force, but not constant; Group C – uses intense strength constantly. Results: It was observed in the evaluation of body mass index (BMI) and Media Force in Newtons (N) within 60 seconds the following values: Group A – BMI of 25.23 and Force Average 142.97 N; Group B – BMI of 25.97 and Force Average 195.25 N; Group C – BMI of 29.49 and Force Average 270.94 N. For the body position on the handgrip strength, we followed the rules by ASHT. Conclusion: In this study, it was possible to identify that the activities involving constant intense force (Group C) present superior grip strength.

Introduction / framework / objectives: The footwear industry is well developed in some areas of our country, so there is a reasonable number of workers involved in this sector. The main risk/ risk factors are the contact with chemical agents (and eventual oncological, respiratory, dermatological, ophthalmological and otorhinolaryngological pathology); as maintained/ forced postures (standing or sitting) and repetitive movements (and consequent musculoskeletal injuries); visual acuity (and eventual diminution of acuity, eye fatigue); noise (emphasizing in hypoacusis); use of machines capable of cause accidents (such as cutting, bruising, docking, amputation) and vibrations (with possible vascular and neurological changes). It is intended with this review better understand the existing risks/ risk factors in the professional sector. Methodology: This is an Integrative Bibliographic Review, initiated through a survey conducted in November 2017 in the databases “CINALH plus with full text, Medline with full text, Database of summaries of effects reviews, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: Comprehensive, MedicLatina, Academic Search Complete and RCAAP. Content: The bibliography on this sector is scarce and emphasizes mainly the chemical agents and, secondarily, the musculoskeletal issues. In the footwear industry the tasks with the greatest contact with the solvents are the gluing and preparation of the soles, as well as assembly and finishing. In a study where about 100 companies from the north of the country were evaluated, the most frequent solvents were toluene and n-hexane; in 58% of the cases, values above the maximum levels recommended by NP 1796, EN 689 and ACGIH threshold limit values were found. Conclusions: The literature consulted highlighted hematological alterations (as lymphomas and leukemias); neuropathies and paresis; hepatotoxicity; dermatitis; renal insufficiency; asthma and sleep apnea; hearing loss; discromotopsy / maculopathy; as well as Carpal Tunnel Syndrome or Guyon’s Channel, tendinitis and tenosynovitis, Raynaud’s syndrome, and Kienbock, Quervain and Dupuytren diseases. It would be pertinent to develop investigations that evaluate the national reality.

Introduction: Manufacturing workers may be exposed to high levels of benzene, an organic solvent widely used in tanning and shoe industry, for which there is evidence of health risk, with emphasis on carcinogenicity in humans. This review pretends to identify characteristics, risks and forms of prevention regarding benzene, aiming to contribute to discussion about the control, reduction or possible elimination of its use. Methodology: A review of literature was carried out through researches in the Pubmed and Medline databases with the descriptors “benzene” AND “industry” AND “occupational exposure” AND “shoe” AND “workers”, as well as updated portuguese legislation related to the topic. Results: Human exposure to benzene is associated with acute and/or chronic adverse health effects, and may occur on occupational level. This happens during the use of fuels and solvents. Tanning and shoemaking workers are one of the most exposed groups. Benzene is often absorbed via inhalation and dermal, presenting a fast distribution with short half-life to lipid tissues, where it reaches higher concentrations. The most relevant acute toxic effects are observed in the central nervous system, lung, eyes and skin while the chronic ones are related to myelotoxicity and neurological and psychological changes. According to International Agency for Research on Cancer, benzene is a human carcinogen (group 1), being etiological agent for leukemia.It has been found that benzene levels in the exhaled air correlate with exposure, and it is also possible to monitor the toxic effects at urinary or hematological level. As a preventive measure, the use of appropriate protective equipment, the use of alternative solvents, optimization of ventilation systems, the implementation of adapted legislation, and public awareness of benzene exposure and risk mitigation measures are currently recommended. Conclusions: Regarding to occupational exposure, the success of future prevention measures will depends on increase knowledge by the employed population and employees. Current scientific evidence reports the need for health professionals training to identify and follow cases of occupational exposure and acute/chronic intoxication. This review opens up space to more research in occupational medicine which, in consequence, will help taking preventative actions more effective.

Introduction / objectives: In dental care institutions there are usually dentists (general practitioners and/ or specialists), dental assistants, receptionists and sometimes managers. The main risk factors/ occupational risks of the former are the possible contact with biological agents; maintained/ forced postures, repetitive movements and vibrations; noise; electromagnetic radiation and visual effort to use screens with frequency; ionizing radiation by Rx and chemical agents. The other professional classes mentioned above are subject to electromagnetic radiation, visual effort, maintained seated posture and repetitive movements. There are a fair amount of published work on occupational health in this sector, but the generality of these addresses specific aspects, and it is not easy to find a global perspective of the subject, minimally complete and succinct. This review intends to better understand the risk/ risk factors in this professional sector. Methodology: This is an Integrative Bibliographic Review, initiated through a survey conducted in December 2017 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 Complete and RCAAP “. Content: The most relevant biological agents in this context are hepatitis B and C viruses, as well as HIV. In several tasks these professionals remain for prolonged periods in maintained and/ or forced postures (sitting, standing and almost static, although with some repetitive movements associated and sometimes without adequate pauses). In this professional sector there is relevant exposure to noise. The instruments with higher decibel levels were the high-speed turbine and the compressor; dental pens, the air compressor, the vacuum cleaner, the amalgamator and the air conditioning units themselves. Of all the chemical agents used so far, mercury is the most relevant. In some contexts there is exposure to Rx. Conclusions: None of the selected articles mentioned collective protection measures directly. However, in this context, the use of the least toxic chemical agents, a good ergonomic design of the work station, the use of equipment that emits the least possible noise and vibration, the rotation of tasks and the appropriate training of professionals. At the level of personal protective equipment are mentioned the use of long-sleeved gown, visor or glasses, hat and gloves of latex. Work accidents in this sector are mainly justified by the small work field, the use of sharp instruments and/ or high speed work, with the creation of aerosols and splashes being fairly frequent, as well as physical proximity to the client and/ or the sudden movements that it may have. The part of the body generally most affected by short-piercing accidents is the finger; the needles should never be recapsulated with the other hand holding the cap, nor should the needles be reused, bent or broken. None of the articles consulted focused on occupational diseases; however, a variety of musculoskeletal pathologies, infectious diseases (HIV, hepatitis B and C, above all), various oncological issues, and emotional level, anxiety, depression and burnout are highlighted at this level. It would be pertinent to develop investigations that evaluate the national reality.

Objective: To analyze the eventual relationship between infectious diseases and individuals who have habitual professional contact with money notes. Methods: This is a cohort study, retrospective, observational, analytical, non-randomized. Individuals working with habitual manipulation of money notes were included in the group “exposed” group and compared to “non-exposed” group. The infectious diseases analyzed were those of respiratory, gastrointestinal and ophthalmological origin. Results: There were 603 cases in “exposed” group and 752 in “non-exposed” group. There was no statistically significant difference in the number of medical certificate and total days lost due to infectious disease in both groups (p = 0.3197 and p = 0.0954, respectively). In the “exposed” group, the relative risk for medical leave due to infectious diseases of gastrointestinal origin was 1.131 (95% CI 0.865 to 1.479, with p = 0.366), ophthalmologic 0.769 (95% CI 0.517 to 1.1421, with p = 0.191) and respiratory 0.735 (95% CI 0.572 to 0.9456, p = 0.015). Conclusion: The usual contact with money notes did not increase the risk of medical licenses for infectious diseases.

Introduction / framework / objectives: Veterinarians and their collaborators (Veterinarian Nurses and Auxiliaries) are subject to numerous occupational hazards. The objective of this study is to characterize their perception regarding the existence of occupational risk and risk factors, their use of personal protective equipment, susceptibility to occupational accidents and diseases, exposure to work stress and the use of occupational health team. Methodology: This is a descriptive, cross-sectional study, carried out after the application of an online survey, using a sampling technique for convenience, with the collaboration of associations, veterinary clinics, as well as some companies of occupational health. Data collection took place between June 2017 and March 2018 and the final value of the sample represents the number of veterinarians, veterinary nurses and auxiliaries working in veterinary clinics / hospitals who have volunteered to respond anonymously and voluntarily to the survey. Results: Ninety-one individuals responded and 90 surveys were validated (one was eliminated because of incoherence of responses). The sample consisted mainly of female workers (87.8%), under the age of 30 (53.3%), with little professional experience (53.3% worked for less than 5 years) and predominant profession in veterinary medicine (80.0%). Risk factors include contact with immunoallergenic products, stress, handling of chemicals and biological risk in contact with animals. The use of uniforms and a mask is particularly important for personal protective equipment. The existence of a personal history of occupational accidents is very frequent (93.3%), and animal injuries such as nibbling, scratching or abrasions are very prevalent, followed by bites or cuts with potentially contaminated sharp objects. However, there were few cases where there were functional limitations. At the level of occupational diseases, the musculoskeletal lesions (26.7%) stand out, although only one case has been declared as a suspected occupational disease. Stress emerged as a very frequent phenomenon, affecting almost all workers (96.7%), especially the difficulty in reconciling professional and personal lives (81.1%), wage dissatisfaction (76.7%) and the high workload (73.3%). Finally, it is observed that the majority (63.2%) have a work medicine consultation at least every two years, but only 28.9% perceive the work performed by the Technician of Hygiene and Safety and only 26.7% report having workshops related to their occupational hazards. Conclusion: A small sample of 90 individuals divided into three professional classes with distinctive characteristics and questions that failed to cover all the possible answers may have biased the results of the statistical treatment; because if in some situations relationships were found between variables consistent with the occupational bibliography for most of the professions and in line with the authors’ clinical experience, in other cases the opposite occurred. Among the several statistical relationships highlighted, the associations between female sex, stress and the general existence of symptoms associated with work, as well as the associations between exercising as a veterinarian, feeling occupational stress due to conflict with clients and being exposed to cut / chop accidents with potentially contaminated objects. This study served as a starting point for a first summary characterization of this sector, and a larger study with broader and better structured questions is obviously desirable.