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«FICHA TÉCNICA Título Segurança e Higiene Ocupacionais - SHO 2012 - Livro de Resumos Autores/Editores Arezes, P., Baptista, J.S., Barroso, M.P., ...»

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Hanke, W. et al. 2004. The risk of adverse reproductive and developmental disorders due to occupational pesticide exposure: an overview of current epidemiological evidence. International Journal of Occupational Medicine and Environmental Health, 17(2), 223Hjollund,N.H. et al. 2000. Diurnal scrotal skin temperature and semen quality. International Journal of Andrology, 23, 309- 318.

Iavicoli, I. et al. 2009. The effects of metals as endocrine disruptors. Journal of Toxicology and Environmental Health, 12, 206- 233.

Jurewich, J. et al. 2009. Environmental factors and semen quality. International Journal of Occupational Medicine and Environmental Health, 22(4), 305- 329.

Li, P. et al. 2009. Maternal occupational exposure to extremely low frequency magnetic fields and the risk of brain cancer in the offspring. Cancer Causes Control, 20, 945-955.

Liang, C.C. et al. 2007. Biodynamic responses of seated pregnant subjects exposed to vertical vibrations in driving conditions. Vehicle System Dynamic, 45(11), 1017-1046.

McGrath, B.J. 2007. Identification health and safety risks for childcare workers. AAOHN Journal, 55(8), 321- 325.

Metules, J.J. 2000. Are you at risk for spontaneous abortion? RN, 63(8), 69-72.

Mogann, E.F. et al. 2005. The effects of standing, lifting and noise exposure on preterm birth, growth restriction and perinatal death in healthy low-risk working military women. The Journal of Maternal- Fetal and Neonatal Medicine, 18(3), 155-162.

Peters, C. et al. 2010. Fertility disorders and pregnancy complications in hairdressers- a systematic review. Journal of Occupational Medicine and Toxicology, 5(24), 1-13.

Stoy, J. et al. 2004. Semen quality and sedentary work position. International Journal of Andrology, 25, 5-11.

Toft, G. et al. 2005. Fertility in four regions spanning large contrasts in serum levels of widespread persistent organochlorines: a cross- sectional study. Environmental Health, 4(26), 1-13.

Vaktskjold, A. et al. 2007. Small- for-gestational-age newborn of female refinery workers exposed to nickel. International Journal of Occupational Medicine and Environmental Health, 20(4), 327-338.

Winker, R. et al. 2006. Reproductive toxicology in Occupational settings: an update. International Archives of Environmental Health, 79, 1-10.

Yan, X. et al. 2009. Pesticide concentrations in matrices collected in the perinatal period in a population of pregnant women and newborn in New Jersey, USA. Human and Ecological Risk Assessment, 15, 948-967.

Zhu, X. 2010. Maternal low-level lead exposure and fetal growth. Environmental Health Perspectives, 118 (10), 1471- 1475.

Riscos Ocupacionais dos Profissionais de Saúde Occupational Risks of Health Professionals Santos, Mónica Cliwork, Medicisforma, Atlanticare, email: s_monica_santos@hotmail.com

1. INTRODUÇÃO Os profissionais de saúde executam inúmeras tarefas sujeitas a fatores de risco muito variados; contudo, se alguns são facilmente percetíveis para a maioria, outros são facilmente ignorados. Pretende-se com esta revisão bibliográfica resumir o que de mais relevante e recente se publicou sobre o tema.

2. MATERIAIS E MÉTODOS Foi realizada uma pesquisa em maio de 2011, 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 Academic Search Complete”; utilizando as palavras-chave “nurse” e “physician” combinadas com “occupational health”, foram obtidos 1469 artigos, utilizando como critérios de seleção o acesso preferencial a texto completo, línguas inglesa, portuguesa ou espanhola e data de publicação igual ou superior ao ano 2000; em função da qualidade metodológica e da pertinência para o objetivo da revisão, foram escolhidos 66 trabalhos. Excecionalmente foram também considerados outros artigos da autora, já publicados ou aprovados e a aguardar publicação em revistas da área.

3. RESULTADOS E DISCUSSÃO A nível de riscos químicos, destacam-se os citostáticos, ou seja, medicamentos muito potentes, capazes de alterar células, usados nos tratamentos oncológicos, no sentido de serem destruídas as células cancerígenas; contudo, a afinidade pelo alvo e/ ou a forma de administração não garantem uma precisão absoluta, pelo que também são alteradas células normais.

A maioria dos fármacos usados em Oncologia está por isso, curiosamente, classificada como carcinogénica (Mader, 2008; Abbinante, 2008; Desroches, 2003; Davis, 2011; Nixon, 2009; Sugiura, 2010; Kopjar, 2009; Vaz, 2010). Outros agentes químicos importantes são os ácidos e aldeidos (sobretudo em laboratórios) (Vaz, 2010), bem como a prata, cobre, estanho e mercúrio (principalmente na medicina dentária) ou ainda os anestésicos (Moen, 2008).

Para além disso, a generalidade dos profissionais de saúde está sujeita a patamares razoáveis de stress laboral, bullying, burnout e violência; condições estas com implicações na saúde física e emocional dos funcionários, bem como no absentismo, satisfação e produtividade (Oginska- Bulit, 2008; Selmanouic, 2008; Weyers, 2006; Lorenz, 2010; Rueden, 2010; Tooren, 2008; Golubie, 2009; Laschinger, 2009; Casteilon, 2011; Yildirim, 2009; Lewis, 2006; Simons, 2010;





Trossman, 2010; Menecz, 2009; Wu, 2007; Dickinson, 2008).

A nível organizacional destacam-se as alterações cronobiológicas secundárias aos horários prolongados, trabalho por turnos, envelhecimento dos funcionários e alterações nutricionais/ endocrinológicas inerentes (Santos, 2010 e 2011 a, b;

Whkoshi, 2010; West, 2010; Keller, 2009).

No contexto dos riscos biológicos destacam-se as hepatites B e C, bem como o HIV e, com particular importância nacional, a tuberculose (Vaz, 2010; Hambrige, 2011; Chen, 2009; Shah, 2006; Tabak, 2006; Twichell, 2003; Costa, 2010; Schabion, 2010; Seidlen, 2006; McGrath, 2007).

Na dimensão ergonómica realçam-se as lesões músculo-esqueléticas (Whkoshi, 2010; Smith, 2006; Tinubu, 2010;

Wardell, 2007; Stetler, 2003; Menzel, 2008; Freitas, 2009; Santos, 2011c; Drebit, 2010).

Por fim, a nível de riscos físicos, são mencionadas as radiações ionizantes e as mais banalizadas (segundo alguns autores, incorretamente) radiações não- ionizantes (Santos, 2011 d,e).

4. CONCLUSÕES As equipas de Saúde Ocupacional a exercer em instituições de saúde têm particularidades específicas (devido ao públicoalvo e gestão da instituição com que trabalham, por vezes muito pouco recetivos ao papel da Saúde Ocupacional) mas, mal consigam provar o seu valor, terão a potencialidade de conseguir resultados excecionais, minorando os riscos de saúde dos funcionários e aumentando a satisfação, produtividade e lucros da empresa.

5. REFERÊNCIAS Abbinante, A. et al. 2008. Riesgos y precauciones durante el manejo y dosificacion de citostáticos. Informe Médico, 10(3), 139-143.

Alzourik, K. et al. 2009. Awareness of bacterial resistance among physicians, pharmacists and nurses. International Journal of Occupational Medicine and Environmental Health, 22(4), 363- 372.

Amarasekera, M. et al. 2010. Prevalence of latex allergy among healthcare workers. International Journal of Occupational Medicine and Environmental Health, 23(4), 391- 396.

Bilski, B. et al. 2002. Viral hepatitis in health service in the province of Wielkopolska. International Journal of Occupational Medicine and Environmental Health, 15(4), 347- 352.

Occupational Safety and HygieneInternational Symposium on

Casteilón, A. 2011. Occupational violence in nursing: explanations and coping strategies. Revista Latino Americana de Enfermagem, 19(1), 156- 163.

Chen, L. et al. 2009. Sharp object injuries among health care workers in a Chinese province. AAOHN Journal, 57(1), 13-16.

Desroches, P. 2003. Cytotoxic Drug handlers- monitoring in the occupational health setting. AAOHN, 51(3), 106- 108.

Drebit, S. et al. 2010. Occupational and environmental risk factors for falls among workers in the healthcare sector. Ergonomics, 53(4), 525- 536.

Costa, J. et al. 2010. Results of five-year systematic screening for latent tuberculosis in healthcare workers in Portugal. Journal of Occupational Medicine and Toxicology, 5(22), 1-7.

Davis, J. et al. 2011. Exposure to hazardous drugs in healthcare: an issue that will not go away. Journal of Oncology Pharmacy Practice, 17(1), 9- 13.

Dickinson, T. et al. 2008. Stress and burnout in forensic mental health nursing: a literature review. British Journal of Nursing, 17(2), 82-87.

Filon, F. et al. 2001. Latex symptoms and sensitization in health workers. International Archives of Occupational and Environmental Health, 74, 219- 223.

Foster, T. et al. Prevalence of Needlestick injuries and other high risk exposures among healthcare workers in Jamaica. West Indian Medicine Journal, 59(2), 153- 159.

Freitas, J. et al. 2009. Distúrbios osteo-musculares relacionados ao trabalho em profissionais de enfermagem de um hospital universitário. Revista Eletrónica de Enfermagem, 11(4), 904- 911.

Golubie, R. et al. 2009. Work-related stress, education and work ability among hospital nurses. Journal of Advanced Nursing, 2057Green-Mokenze, J. et al. 2009. Thiuram allergy- a potencial dermal allergy among health careworkers. AAOHN Journal, 57(4), 139Hambridge, K. 2011. Needlestick and sharps injuries in the nursing student population. Art & Science, 25(27), 38- 45.

Izdes, S. et al. 2010. DNA damage, glutathione and total antioxidant capacity in anesthesia nurses. Archives of Environmental & Occupational Medicine, 65(4), 211- 217.

Keller, S. 2009. Effects of extended workshifts and shiftwork on patient safety, productivity and employee health. AAOHN Journal, 57(12), 497- 502.

Kopjar, N. et al. 2009. The genotoxic risk in healthcare workers occupationally exposed to cytotoxic drugs- a comprehensive evaluation by the SCE assay. Journal of Environmental Science and Health, part A, 44, 462- 479.

Laschinger, H. et al. 2009. Workplace empowerment, incivility and burnout: impact on staff nurse recruitment and retention outcomes.

Journal of Nursing Management, 17, 302- 311.

Latza, V. et al. 2005. Effectiveness of a nationwide interdisciplinary preventive program for latex allergy. International Archives of Occupational Health, 78, 394- 402.

Lewis, M. 2006. Nurse bullying: organizational considerations in the maintenance and perpetration of health care bullying cultures.

Journal of Nursing Management, 14, 52- 58.

Lorenz, V. et al. 2010. Burnout and stress among nurses in a Universitary Terciary Hospital. Revista Latino/ Americana de Enfermagem, 18(6), 1084-1091.

Moen, B. et al. 2008. Neurological Symptoms among dental assistants: a cross-sectional study. Journal of Occupational Medicine and Toxicology, 3(10), 1-7.

Mader, R. et al. 2008. Longitudinal biomonitoring of nurses handling antineoplasic drugs. Journal of Clinical Nursing, 18, 263- 269.

McGrath, B. 2007. Identifying health and safety risk for childcare workers. AAOHN Journal, 55(8), 321- 325.

Menecz, D. et al. 2009. Aggression at the workplace- psychological consequences of abusive encounter with coworkers and clients.

International Journal of Occupational Medicine and Environmental Health, 22(3), 243- 260.

Menzel, N. 2008. Underreporting of musculoskeletal disorders among health care workers. AAOMN Journal, 56(12), 487- 493.

Nixon, S. et al. 2009. Safe handling of hazardous drugs: are you protected? Clinical Journal of Oncology Nursing, 13(4), 433-440.

Selmanouic, S. et al. 2008. Most often stress at the workplace among physicians in University Clinical center in Tuzla. Materia Sociomédica, 20(3), 152- 155.

Palczynski, C. et al. 2000. Nasal provocation test in the diagnosis of natural rubber latex allergy. Allergy, 55, 34- 41.

Paula, C. et al. 2010. O sofrimento psíquico do profissional de enfermagem da unidade hospitalar. Chia Colombia, 10(3), 267- 279.

Johnson, S. 2009. International perspectives on workplace bullying among nurses: a review. International Council of Nurses, 34- 40.

Santos, M. 2011 ou 2012 (aprovado para publicação mas ainda sem data definida). Cronobiologia ao serviço da Saúde Ocupacional.

Segurança.

Santos, M. 2011 ou 2012 (aprovado para publicação mas ainda sem data definida). Cronobiologia da alimentação/ nutrição, contextualizada à Medicina do Trabalho. Segurança.

Santos, M. 2011. Ginástica Laboral: o que o Médico do Trabalho e o Técnico de Higiene e Segurança precisam de conhecer: parte II.

Segurança, 201, 34-38.

Santos, M. 2011 ou 2012 (aprovado para publicação mas ainda sem data definida). Radiações ionizantes e Saúde Ocupacional.

Segurança.

Santos, M. 2011 ou 2012 (aprovado para publicação mas ainda sem data definida). Radiação não ionizante: é importante?. Segurança.

Santos, M. 2010. Correlação entre alguns parâmetros da Síndrome Metabólica e Atividade Física entre pais e filhos em idade escolar.

REDAF, 2(1), 1-29.

Schabion, A. et al. 2010. Risk of latent TB infection in individuals employed in the healthcare sector in Germany: a multicentre prevalence study. BMC Infectious Diseases, 10(107), 1-10.

Seidler, A. et al. 2006. Review of Epidemiological Studies on the Occupational risk of tuberculosis in low-incidence areas.

Respiration, 72, 431- 446.

Shah, S. et al. 2006. Percutaneous injuries among dental professionals in Washington State. BMC Public Health, 6(269), 1-5.

Simons, S. et al. 2010. Bullying in the workplace- a qualitative study of newly licensed nurses. AAOHN Journal, 58(7), 305- 311.

Smith, D. et al. 2006. Musculoskeletal disorders and their after-effects among health professionals in Beijing. Occupational Ergonomics, 6, 25-34.

Sugiura, S. et al. 2010. Risks to health professionals from hazardous drugs in Japan: a pilot study of environmental and biological monitoring of occupational exposure to cyclophosphamide. Journal of Oncology Pharmacy Practice, 17(1), 14- 19.

Stetler, C. et al. 2003. Use of evidence for prevention of work- related musculoskeletal injuries. Orthopaedic Nursing, 22(1), 32- 41.



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