Occupational stressors and work accidents among health workers

Authors

DOI:

https://doi.org/10.11606/s1518-8787.2021055002938

Keywords:

Health Personnel, psychology, Accidents, Occupational, prevention & control, Occupational Exposure, Containment of Biohazards, Inservice Training

Abstract

OBJECTIVE To test the association between occupational stressors and work accidents due to exposure to biological material (ATbio) in health workers, considering the isolated and combined analysis of the dimensions of two models, the demand-control model (DCM) and the effort-reward imbalance model (ERI). METHODS Cross-sectional study in a representative sample of workers with higher, technical and secondary education, including health agents from primary and medium-complexity care units in five cities in Bahia. Random sampling was selected, stratified by geographic area, level of service complexity and occupation. The outcome variable was ATbio; The main exposure was occupational stressors, assessed by the DCM and ERI. Incidences and relative risks were estimated as a function of the acute, short-term nature of the outcome of interest. Associations between ATbio and isolated and combined DCM and ERI dimensions were tested. RESULTS A total of 3,084 workers participated in the study. The global incidence of ATbio was 3.4% and was associated with high psychological demand, high effort and high commitment to work, adjusted for sex, age, education and work shift. High-strain work and a situation of imbalance between efforts and rewards were associated with ATbio. With the combination of the models, an increase in the measure of association with the outcome was observed. Significant associations of greater magnitude were observed in the complete combined models. ATbio’s risk was 5.23 times higher among those exposed in both complete models compared to the absence of exposure in both models. CONCLUSIONS Occupational stressors were associated with ATbio. Advantages in using the combined models were observed. The approach of different psychosocial dimensions has expanded the ability to identify exposed groups, offering a solid basis for interventions for ATbio’s prevention in health.

References

Brasil. Lei Nº 8.213, de 24 de julho de 1991. Dispõe sobre os Planos de Benefícios da Previdência Social e dá outras providências. Diário Oficial da União. 25 jul 191.

Souza HP, Otero UB, Silva VSP. Perfil dos trabalhadores de saúde com registros de acidentes com material biológico no Brasil entre 2011 e 2015: aspectos para vigilância. Rev Bras Med Trab. 2019;17(1):106-18. https://doi.org/10.5327/Z1679443520190305

Gonçalves KOS, Rocha RG, Assad LG, Tavares JMAB, Marta CB. Riscos e circunstâncias de acidentes com material biológico com o trabalhador de enfermagem. Rev Enferm Atual Derme. 2019 [citado 20 fev 2020];87(25). Disponível em: https://revistaenfermagematual.com.br/index.php/revista/article/view/195

Yasin J, Fisseha R, Mekonnen F, Yirdaw K. Occupational exposure to blood and body fluids and associated factors among health care workers at the University of Gondar Hospital, Northwest Ethiopia. Environ Health Prev Med. 2019;24(1):18. https://doi.org/10.1186/s12199-019-0769-9

Wang PC, Delp L. Health status, job stress and work-related injury among Los Angeles taxi drivers. Work. 2014;49(4):705-12. https://doi.org/10.3233/WOR-131696

Johannessen HA, Gravseth HM, Sterud T. Psychosocial factors at work and occupational injuries: a prospective study of the general working population in Norway. Am J Ind Med. 2015;58(5):561-7. https://doi.org/10.1002/ajim.22431

Lee SJ, You D, Gillen M, Blanc PD. Psychosocial work factors in new or recurrent injuries among hospital workers: a prospective study. Int Arch Occup Environ Health. 2015;88(8):1141-8. https://doi.org/10.1007/s00420-015-1038-x

Liu X, Zong Y, Huang G, Wang S, Zhou Y, Guo Z, et al. [Association between occupational stress, social support, and occupational unintentional injuries: a case-control study]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2015;33(2):110-2. Chinese.

Kim YK, Ahn YS, Kim K, Yoon JH, Roh J. Association between job stress and occupational injuries among Korean firefighters: a nationwide cross-sectional study. BMJ Open. 2016;6(11):e012002. https://doi.org/10.1136/bmjopen-2016-012002

Greco PBT, Magnago TSBS, Prochnow A, Beck CLC, Tavares JP. Utilização do modelo demanda-controle de Karasek na América Latina: uma pesquisa bibliográfica. Rev Enferm UFSM. 2011;1(2):272. https://doi.org/10.5902/217976922566

Reis ALPP, Fernandes SRP, Gomes AF. Estresse e fatores psicossociais. Psicol Cienc Prof. 2010;30(4):712-25. https://doi.org/10.1590/S1414-98932010000400004

Karasek RA Jr. Job demands, job decision latitude, and mental strain: implications for job redesign. Adm Sci Q. 1979;24(2):285-308. https://doi.org/10.2307/2392498

Siegrist J. Adverse health effects of high-effort/low-reward conditions. J Occup Health Psychol. 1996;1(1):27-41. https://doi.org/10.1037//1076-8998.1.1.27

Araújo TM, Graça CC, Araújo E. Estresse ocupacional e saúde: contribuições do Modelo Demanda-Controle. Cienc Saude Coletiva. 2003;8(4):981-1003. https://doi.org/10.1590/S1413-81232003000400021

Johnson JV, Hall EM. Job strain, work place social support, and cardiovascular disease: a cross-sectional study of a random sample of the Swedish working population. Am J Public Health. 1988;78(10):1336-42. https://doi.org/10.2105/ajph.78.10.1336

Calnan M, Wadsworth E, May M, Smith A, Wainwright D. Job strain, effort-reward imbalance, and stress at work: competing or complementary models? Scand J Public Health. 2004;32(2):84-93. https://doi.org/10.1080/14034940310001668

Griep RH, Rotenberg L, Landsbergis P, Vasconcellos-Silva PR. Uso combinado de modelos de estresse no trabalho e a saúde auto-referida na enfermagem. Rev Saude Publica. 2011;45(1):145-52. https://doi.org/10.1590/S0034-89102011000100017

Kingdom SE, Smith AP. Combined effects of work-related stress in Her Majesty’s Coastguard (HMCG). Int Marit Health. 2012;63(1):63-70.

Yu SF, Nakata A, Gu GZ, Swanson NG, Zhou WH, He LH, et al. Co-effect of Demand-control-support model and effort-reward imbalance model on depression risk estimation in humans: findings from Henan Province of China. Biomed Environ Sci. 2013;26(12):962-71. https://doi.org/10.3967/bes2013.031

Araújo TM, Mattos AIS, Almeida MMG, Santos KOB. Aspectos psicossociais do trabalho e transtornos mentais comuns entre trabalhadores da saúde: contribuições da análise de modelos combinados. Rev Bras Epidemiol. 2016;19(3):645-57. https://doi.org/10.1590/1980-5497201600030014

Garcia LP, Facchini LA. Exposures to blood and body fluids in Brazilian primary health care. Occup Med (Lond). 2009;59(2):107-13. https://doi.org/10.1093/occmed/kqn174

Araújo TM, Karasek R. Validity and reliability of the job content questionnaire in formal and informal jobs in Brazil. Scand J Work Environ Health, Suppl. 2008;(6):52-9.

Griep RH, Rotenberg L, Vasconcellos AGG, Landsbergis P, Comaru CM, Alves MGM. The psychometric properties of demand-control and effort–reward imbalance scales among Brazilian nurses. Int Arch Occup Environ Health. 2009;82(10):1163-72. https://doi.org/10.1007/s00420-009-0460-3

Santana VS, Cunha S. Estudos transversais. In: Barreto ML, Almeida Filho N, organizadores. Epidemiologia e saúde: fundamentos, métodos e aplicações. Rio Janeiro: Guanabara Koogan; 2011. p. 186-93.

Checkoway H, Pearce N, Kriebel D. Research methods in occupational epidemiology. Oxford (UK): Oxford University Press; 2004. (Monographs in Epidemiology; Vol 34).

Coutinho LMS, Scazufca M, Menezes PR. Methods for estimating prevalence ratios in cross-sectional studies. Rev Saude Publica. 2008;42(6):992-8. https://doi.org/10.1590/S0034-89102008000600003

Zou GY, Donner A. Extension of the modified Poisson regression model to prospective studies with correlated binary data. Stat Methods Med Res. 2013;22(6):661-70. https://doi.org/10.1177/0962280211427759

Bastos LS, Oliveira RVC, Velasque LS. Obtaining adjusted prevalence ratios from logistic regression models in cross-sectional studies. Cad Saude Publica. 2015;31:487-95. https://doi.org/10.1590/0102-311X00175413

Tipple AFV, Silva EAC, Teles SA, Mendonça KM, Silva AC, Melo DS. Acidente com material biológico no atendimento pré-hospitalar móvel: realidade para trabalhadores da saúde e não saúde. Rev Bras Enferm. 2013;66(3):378-84. https://doi.org/10.1590/S0034-71672013000300012

Paiva MHRS, Oliveira AC. Fatores determinantes e condutas pós-acidente com material biológico entre profissionais do atendimento pré-hospitalar. Rev Bras Enferm. 2011;64(2):268-73. https://doi.org/10.1590/S0034-71672011000200008

Monteiro CM, Benatti MCC, Rodrigues RCM. Acidente do trabalho e qualidade de vida relacionada à saúde: um estudo em três hospitais. Rev Lat Am Enfermagem. 2009;17(1):101-7. https://doi.org/10.1590/S0104-11692009000100016

Ferreira MD, Pimenta FR, Facchin LT, Gir E, Canini SRMS. Subnotificação de acidentes biológicos pela enfermagem de um hospital universitário. Cienc Enferm. 2015;21(2):21-9. https://doi.org/10.4067/S0717-95532015000200003

Useche SA, Gómez V, Cendales B, Alonso F. Working conditions, job strain, and traffic safety among three groups of public transport drivers. Saf Health Work. 2018;9(4):454-61. https://doi.org/10.1016/j.shaw.2018.01.003

Suominen S, Vahtera J, Korkeila K, Helenius H, Kivimäki M, Koskenvuo M. Job strain, life events, and sickness absence: a longitudinal cohort study in a random population sample. J Occup Environ Med. 2007;49(9):990-6. https://doi.org/10.1097/JOM.0b013e3181343e2b

Virtanen M, Vahtera J, Pentti J, Honkonen T, Elovainio M, Kivimäki M. Job strain and psychologic distress: influence on sickness absence among Finnish employees. Am J Prev Med. 2007;33(3):182-7. https://doi.org/10.1016/j.amepre.2007.05.003

Lu ML, Nakata A, Park JB, Swanson NG. Workplace psychosocial factors associated with work-related injury absence: a study from a nationally representative sample of Korean workers. Int J Behav Med. 2014;21(1):42-52. https://doi.org/10.1007/s12529-013-9325-y

Oliveira EB, Souza NVM, Chagas SCS, Lima LSV, Correa RA. Esforço e recompensa no trabalho do enfermeiro residente em unidades especializadas. Rev Enferm UERJ. 2013;21(2):13-8.

Siegrist J, Li J. Associations of extrinsic and intrinsic components of work stress with health: a systematic review of evidence on the effort-reward imbalance model. Int J Environ Res Public Health. 2016;13(4):432. https://doi.org/10.3390/ijerph13040432

Areosa J, Dwyer T. Acidentes de trabalho: uma abordagem sociológica. Config Rev Cienc Soc. 2010;(7):107-28. https://doi.org/10.4000/configuracoes.213

Söderfeldt B, Söderfeldt M, Muntaner C, O’Campo P, Warg LE, Ohlson CG. Psychosocial work environment in human service organizations: a conceptual analysis and development of the demand-control model. Soc Sci Med. 1996;42(9):1217-26. https://doi.org/10.1016/0277-9536(95)00231-6

Griep RH, Rotenberg L, Chor D, Toivanen S, Landsbergis P. Beyond simple approaches to studying the association between work characteristics and absenteeism: combining the DCS and ERI models. Work Stress. 2010;24(2):179-95. https://doi.org/10.1080/02678373.2010.493083

Shah D. Healthy worker effect phenomenon. Indian J Occup Environ Med. 2009;13(2):77-9. https://doi.org/10.4103/0019-5278.55123

Published

2021-12-17

Issue

Section

Original Articles

How to Cite

Gomes, M. R., Araújo, T. M. de, Soares, J. F. de S. ., Sousa, C. C. de ., & Lua, I. (2021). Occupational stressors and work accidents among health workers. Revista De Saúde Pública, 55, 98. https://doi.org/10.11606/s1518-8787.2021055002938