RESUMO Introdução/enquadramento/objetivos A produção de sal, sobretudo com métodos artesanais, não existe em todos os países, dadas as exigências climáticas e logísticas. Portugal apresenta alguma tradição nesse setor mas, ainda assim, a maioria dos profissionais a exercer na Saúde e Segurança Ocupacionais não tem experiência na área. Pretendeu-se com esta revisão resumir o que mais relevante e recente se publicou, de forma a melhorar a capacidade de atuação destes e a potenciar a produtividade, satisfação e bem-estar dos trabalhadores afetos. Metodologia Trata-se de uma Revisão Bibliográfica, iniciada através de uma pesquisa realizada em abril de 2023 nas bases de dados “CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive, MedicLatina e RCAAP”. Conteúdo As salinas podem ser interiores (afastadas do mar, usando água subterrânea com elevado conteúdo em sal) ou litorais. As primeiras são mais escassas em Portugal e apenas existem entre Lisboa e Coimbra. Ao longo do tempo, no nosso país, a evaporação era realizada pelo fogo e sol. Esta última acredita-se que foi desenvolvida pelos romanos que, de certa forma, criaram a primeira versão das salinas. A nível nacional há evidência de produção de sal desde o final do Neolítico, mas aqui mais frequente com a utilização do fogo. Por toda a Europa tem existido um declínio da produção artesanal de sal, versus industrial, mesmo em salinas marítimas (sobretudo na costa noroeste de França e, em Portugal, na costa ocidental). A produção artesanal no nosso país é mais prevalente na zona da Figueira da Foz. O produto obtido via artesanal tem mais qualidade, nomeadamente a nível de sabor e nutricionalmente (via industrial o paladar é um pouco mais metálico). Portugal é um grande produtor e consumidor de sal tradicional. As caraterísticas climáticas adequam-se à produção, devido aos verões com temperaturas elevadas frequentes e ventos fortes e quentes. O sal nacional era e é consumido noutros países europeus, por apresentar qualidade superior, mesmo tendo um preço mais elevado. A produção depende do clima, nomeadamente a insolação (número de horas ao sol), precipitação, temperatura, nebulosidade e ventos (que condicionam a evaporação). Ou seja, esta é mais intensa e rápida se a temperatura do ar for mais elevada, tal como com mais ventos secos (que geralmente são mais frequentes no Verão); a baixa precipitação também é favorável. A produção de sal tem vindo a aumentar, até pelas crescentes necessidades industriais. Para ser usado nesta última situação, deverá estar no patamar de 100% de pureza. Discussão e Conclusões Não se encontrou bibliografia que fizesse referência à dimensão da saúde e segurança ocupacionais neste setor profissional. Em função de experiência teórica e prática dos autores, descrevem-se os fatores de riscos e riscos mais relevantes do setor: radiação ultravioleta e eventual cancro de pele, cataratas e outras lesões associadas; desconforto térmico e eventual maior sinistralidade associada a descoordenação motora, pior ajuste cardiovascular, bem como desorientação e capacidade de tomar decisões; cargas e/ou posturas forçadas/mantidas e eventuais lesões músculo-esqueléticas, surgimento/agravamento de patologia herniária e queda de objetos e ao mesmo nível e eventuais equimoses, lacerações cutâneas e/ou fraturas. Seria interessante conhecer melhor o panorama nacional deste setor, através de estudos que estratificassem hierarquicamente o risco, descrevendo ainda com rigor as doenças profissionais e acidentes associados, bem como medidas mais eficazes para atenuar essas questões.

ABSTRACT Introduction/framework/objectives Salt production, especially using artisanal methods, does not exist in all countries, given the climatic and logistical requirements. Portugal has some tradition in this sector, but even so, most professionals working in Occupational Health and Safety have no experience in the area. The aim of this review was to summarize the most relevant and recent publications, to improve their performance capacity and enhance the productivity, satisfaction and well-being of the workers involved. Methodology This is a Bibliographic Review, initiated through a search carried out in April 2023 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 Salt pans can be inland (far from the sea, using groundwater with a high salt content) or coastal. The former are scarcer in Portugal and only exist between Lisbon and Coimbra. Over time, in our country, evaporation was carried out by fire and sun. The latter is believed to have been developed by the Romans who created the first version of salt flats. At national level there is evidence of salt production since the end of the Neolithic, but here more frequently with the use of fire. Throughout Europe there has been a decline in artisanal versus industrial salt production, even in sea salt pans (especially on the northwest coast of France and, in Portugal, on the western coasts). Artisanal production in our country is more prevalent in the Figueira da Foz area. The product obtained via artisanal production has better quality, particularly in terms of flavor and nutritionally (via industrial production the taste is more metallic). Portugal is a large producer and consumer of traditional salt. The climatic characteristics suit production, due to summers with frequent high temperatures and strong, hot winds. National salt was and is consumed in other European countries; for presenting superior quality, even though it is more expensive. Production depends on the climate, namely insolation (number of hours in the sun), precipitation, temperature, cloudiness and winds (which affect evaporation). In other words, this is more intense and faster if the air temperature is higher, such as with more dry winds (which are generally more frequent in summer); low precipitation is also favorable. Salt production has been increasing, due to growing industrial needs. To be used in this last situation, it must be at 100% purity. Discussion and Conclusions No bibliography was found that referred the dimension of occupational health and safety in this professional sector. Based on the authors' theoretical and practical experience, the most relevant risk factors and risks in the sector are described: ultraviolet radiation and possible skin cancer, cataracts and other associated injuries; thermal discomfort and eventual higher accident rates associated with motor incoordination, worse cardiovascular adjustment, as well as disorientation and ability to make decisions; forced/maintained loads and/or postures and possible musculoskeletal injuries, emergence/worsening of hernia pathology and falling objects at the same level and possible bruises, skin lacerations and/or fractures. It would be interesting to learn more about the national panorama of this sector, through studies that hierarchically stratify the risk, also accurately describing occupational illnesses and associated accidents, as well as more effective measures to mitigate these issues.

RESUMO Introdução/enquadramento/objetivos Ao longo dos últimos anos a generalidade dos países foi desenvolvendo normas relativas à diminuição dos locais onde continua a ser possível fumar, nomeadamente em contexto laboral. Pretendeu-se com esta revisão resumir o que de mais recente se publicou sobre o tema. Metodologia Trata-se de uma Revisão Bibliográfica, iniciada através de uma pesquisa realizada em abril de 2023 nas bases de dados “CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive, MedicLatina e RCAAP”. Conteúdo O Tabagismo Passivo é definido como fumo de "segunda mão" que engloba uma mistura complexa de poluentes, permanecendo na poeira das superfícies locais onde se fumou, constituída pelos produtos tabágicos originais e os componentes originários pela respiração do consumidor direto, eventualmente reagindo a outros agentes presentes. Estes podem permanecer nas superfícies inertes, por vezes, por meses e a transmissão pode ocorrer pelo simples toque. Alguns investigadores estimam que existam neste contexto cerca de 4000 agentes químicos, dos quais 250 são tóxicos e 50 são inclusivamente carcinogénicos. O tabaco é uma das causas preveníveis de morte mundialmente e fator de risco modificável, por mecanismos que abarcam o dano de DNA, inflamação e stress oxidativo. Ele implica custos de saúde e de diminuição da produtividade laboral, em função das patologias associadas, nomeadamente cardiovascular, respiratória, oncológica, obstétrica e infeciosa. Discussão e Conclusões Ao longo das últimas décadas verificou-se, globalmente, uma diminuição ao Tabagismo Passivo, devido à introdução de normas cada vez mais restritivas em relação aos locais onde ainda é permitido fumar, na sociedade em geral e, obviamente, em contexto de trabalho também. Os artigos selecionados não realçaram muito o seguinte detalhe mas, criando-se áreas onde é permitido fumar na empresa, estas devem minimizar a exposição de todos os trabalhadores, tabagistas e, sobretudo, não fumadores. Seria desejável que os países/instituições onde as normas são menos restritivas e/ou cumpridas, tal se alterasse, de forma a todos os trabalhadores terem um ambiente laboral seguro. Para além disso, seria interessante perceber qual a opinião que os trabalhadores portugueses têm em relação a este tema, de que forma as normas são cumpridas nos seus locais de trabalho e quais as técnicas mais eficazes para obter mais sucesso neste contexto.

ABSTRACT Introduction/framework/objectives Over the last few years, most countries have developed standards relating to reducing the number of places where smoking continues to be possible, particularly in the workplace. This review was intended to summarize the most recent publications on the topic. Methodology This is a Bibliographic Review, initiated through a search carried out in April 2023 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 Passive Smoking is defined as "second-hand" smoke that encompasses a complex mixture of pollutants, remaining in the dust on local surfaces where it was smoked, consisting of the original tobacco products and the components originating in the direct consumer's breath, eventually reacting to other agents gifts. These can remain on inert surfaces, sometimes for months and transmission can occur by simple touch. Some researchers estimate that there are around 4000 chemical agents in this context, of which 250 are toxic and 50 are even carcinogenic. Tobacco is one of the preventable causes of death worldwide and a modifiable risk factor, through mechanisms that include DNA damage, inflammation and oxidative stress. It involves health costs and reduced labor productivity, due to associated pathologies, namely cardiovascular, respiratory, oncological, obstetric and infectious diseases. Discussion and Conclusions Over the last few decades, there has been a global decrease in passive smoke, due to the introduction of increasingly restrictive standards in relation to places where smoking is still permitted, in society in general and, obviously, in the workplace as well. The selected articles did not highlight the following detail much but, by creating areas where smoking is permitted in the company, these should minimize the exposure of all workers, smokers and, above all, non-smokers. It would be desirable for countries/institutions where standards are less restrictive and/or enforced to change, so that all workers have a safe working environment. Furthermore, it would be interesting to understand what opinion Portuguese workers have regarding this topic, how standards are complied with in their workplaces and what are the most effective techniques to achieve greater success in this context.

RESUMEN Una de las dificultades que afecta la salud ocupacional de los docentes universitarios en Ecuador son los riesgos laborales. El objetivo es analizar los riesgos laborales con la finalidad de fortalecer el bienestar ocupacional desde una mirada integral. Tipificamos los riesgos laborales en ergonómicos, psicosociales, y organizacionales para la toma de decisiones. Se sugieren políticas para la prevención de riesgos, creando un ambiente laboral adecuado, que den cuenta de una labor formativa de calidad. Se utilizaron métodos teóricos y empíricos del enfoque mixto de investigación, con una aproximación fáctica realizada por docentes de la Universidad Técnica Estatal de Quevedo, Ecuador.

ABSTRACT One of the difficulties affecting the occupational health of university teachers in Ecuador is occupational hazards. The objective is to analyze occupational risks in order to strengthen occupational wellbeing from an integral point of view. We classify occupational risks into ergonomic, psychosocial, and organizational risks for decision-making. We suggest policies for risk prevention, creating an adequate work environment, which will provide quality training. Theoretical and empirical methods of the mixed research approach were used, with a factual approach carried out by teachers of the Universidad Técnica Estatal de Quevedo, Ecuador.

Resumen Los trabajadores agrícolas se exponen frecuentemente a los pesticidas, los cuales pueden afectar el sistema cardiovascular. El objetivo de la investigación fue revisar la asociación entre la exposición ocupacional a pesticidas, el desarrollo de enfermedades cardiovasculares y los biomarcadores utilizados en la vigilancia de la salud de los trabajadores. Para ello se realizó una revisión no sistemática de la literatura en tres bases de datos: Pubmed, Embase y Scopus, con ecuaciones de búsqueda elaboradas con los términos “agrochemicals”, “myocardial infarction”, “occupational exposure” y “farmers", y se incluyeron artículos publicados entre 2007 y 2022. Se encontró que los pesticidas causan elevación de las cifras de presión arterial en trabajadores expuestos y en mujeres embarazadas se relaciona con hipertensión gestacional y preeclampsia. Respecto al infarto agudo de miocardio (IAM), el contacto con los pesticidas clorpirifós, coumafós, carbofurano, pendimetalina, trifluralina y acilalanina aumentan el riesgo de IAM en mujeres, y entre los trabajadores masculinos la exposición a dibromuro de etileno, maneb/mancozeb y dimetil-ditiocarbamato de zinc se asoció con mayor mortalidad. La vigilancia epidemiológica se realiza principalmente con la medición de la actividad de la acetilcolinesterasa eritrocitaria (AChE). Se puede concluir que la exposición a pesticidas puede desencadenar enfermedades cardiovasculares agudas y crónicas, como elevación de las cifras de presión arterial, IAM fatal y no fatal. Los pesticidas dimetil ditiocarbamato de zinc, clorpirifós, coumafós, carbofurano, paratión y malatión son las sustancias que tienen mayor relación con el desarrollo de enfermedad cardiovascular.

Abstract Farmworkers are frequently exposed to pesticides, which can affect the cardiovascular system. The objective of the research was to review the association between occupational exposure to pesticides and the development of cardiovascular diseases, and the biomarkers used in monitoring the health of workers. For this, a non-systematic review of the literature was carried out in three databases: Pubmed, Embase and Scopus, with search equations prepared with the terms "agrochemicals", "myocardial infarction", "occupational exposure" and "farmers". Articles published between 2007 and 2022 were included. Pesticides were found to cause elevated blood pressure levels in exposed workers, and in pregnant women it is related to gestational hypertension and preeclampsia. Regarding acute myocardial infarction (AMI), contact the pesticides chlorpyrifos, coumaphos, carbofuran, pendimethalin, trifluralin, and acylalanine increased the risk of AMI in women, and among male workers exposure to ethylene dibromide, maneb/mancozeb, and zinc dimethyldithiocarbamate was associated with increased mortality. Epidemiological surveillance is mainly carried out by measuring erythrocyte acetylcholinesterase (AChE) activity. It can be concluded that exposure to pesticides can trigger acute and chronic cardiovascular diseases, such as elevated blood pressure, fatal and non-fatal AMI. Zinc dimethyl dithiocarbamate, chlorpyrifos, coumafos, carbofuran, parathion and malathion pesticides are the substances most closely related to the development of cardiovascular disease.

Frente a um cenário de aumento dos adoecimentos mentais relacionados ao trabalho, torna-se cada vez mais popular a expressão “riscos psicossociais no trabalho” para se referir a aspectos no trabalho que devem ser observados na preservação da saúde mental dos trabalhadores. Institutos de pesquisa públicos governamentais estabelecem definições sobre o que são estes riscos psicossociais e seus impactos na saúde e se tornam referência para a atuação em seus países. No entanto, constata-se nelas uma mistura entre os fatores causadores de violências, e os danos e agravos à saúde propriamente ditos. A partir dos estudos sobre saúde mental e trabalho presentes na literatura científica recente, destacamos na discussão do que são os riscos psicossociais, duas questões centrais não podem faltar: a organização do trabalho e seu impacto na subjetividade do trabalhador e as relações sociais que estruturam a sociedade e também estão presentes no cotidiano do trabalho, marcando e diferenciando socialmente trabalhadores e trabalhadoras, influenciando a distribuição de poder e de melhores e piores condições de trabalho conforme raça, classe social, gênero, capacidades, entre outras formas de separação e identificação de coletivos humanos.

We are facing a crisis of an increasing work-related mental illnesses, which makes the expression “psychosocial risks at work” increasingly popular to refer to aspects at work that must be observed to preserve workers' mental health. Public government research institutes establish definitions of what these psychosocial risks are and their impacts on health and become references for action in their countries. However, there is a mix between the factors that cause violence and the damage and health problems themselves. Based on studies on mental health and work present in recent scientific literature, we highlight two central issues cannot be missed: the organization of work and its impact on the worker's subjectivity and the social relations that structure the society marking and socially differentiating male and female workers, influencing the distribution of power and better and worse working conditions according to race, social class, gender, capabilities, among other forms of separation and identification of collectives humans.

Ante un escenario de aumento de las enfermedades mentales relacionadas con el trabajo, la expresión “riesgos psicosociales en el trabajo” se está volviendo cada vez más popular para referirse a aspectos en el trabajo que deben ser observados para preservar la salud mental de los trabajadores. Los institutos de investigación de los gobiernos públicos establecen definiciones acerca de cuáles son estos riesgos psicosociales y sus impactos en la salud y se convierten en referentes para la acción en sus países. Sin embargo, existe una mezcla entre los factores que causan la violencia y los daños y problemas de salud mismos. Con base en estudios sobre salud mental y trabajo presentes en la literatura científica reciente, resaltamos en la discusión acerca de qué son los riesgos psicosociales, no pueden faltar dos temas centrales: la organización del trabajo y su impacto en la subjetividad del trabajador y que las relaciones sociales que estructuran la sociedad también están presentes en el trabajo cotidiano, marcando y diferenciando socialmente a trabajadores y trabajadoras, influyendo en la distribución del poder y en las mejores y peores condiciones laborales según raza, clase social, género, capacidades, entre otras formas de separación e identificación de colectivos humanos.

ABSTRACT Introduction: The importance of dietitians in dialysis units is indisputable and mandatory in Brazil, but little is known about the practices adopted by these professionals. Objective: To know practices adopted in routine nutritional care, focusing on nutritional assessment tools and treatment strategies for people at risk or diagnosed with malnutrition. Methodology: Electronic questionnaire disseminated on social media and messaging applications. It included questions that covered dietitians’ demographic and occupational profile characteristics and of the dialysis unit, use and frequency of nutritional assessment tools, nutritional intervention strategies in cases of risk or diagnosis of malnutrition, prescription and access to oral supplements. Results: Twenty four percent of the Brazilian dialysis units (n = 207) responded electronically. The most used nutritional assessment tools with or without a pre-established frequency were dietary surveys (96%) and Subjective Global Assessment (83%). The strategies in cases of risk or presence of malnutrition used most frequently (almost always/always) were instructions to increase energy and protein intake from foods (97%), and increasing the frequency of visits (88%). The frequency of prescribing commercial supplements with standard and specialized formulas was quite similar. The availability of dietary supplements by the public healthcare system to patients varied between regions. Conclusion: Most dietitians use various nutritional assessment tools and intervention strategies in cases of risk or malnutrition; however, the frequency of use of such tools and strategies varied substantially. Introduction Brazil professionals Objective care Methodology applications unit Results n 207 electronically preestablished pre established 96% 96 (96% 83%. 83 83% . (83%) almost always/always alwaysalways always 97%, 97 97% , (97%) 88%. 88 88% (88%) similar regions Conclusion however substantially 20 9 (96 8 (83% (97% (88% 2 (9 (83 (97 (88 ( (8

Resumo Introdução: A importância da atuação do nutricionista em unidades de diálise é indiscutível e obrigatória no Brasil, porém pouco sabemos sobre as práticas adotadas por esses profissionais. Objetivo: Conhecer práticas adotadas na rotina dos atendimentos nutricionais, com foco nas ferramentas de avaliação nutricional e nas estratégias de tratamento das pessoas com risco ou diagnóstico de desnutrição. Metodologia: Questionário eletrônico divulgado em mídias sociais e aplicativos de mensagens. Incluiu questões que abrangiam características do perfil demográfico e ocupacional do profissional e da unidade de diálise, utilização e frequência de ferramentas de avaliação nutricional, estratégias de intervenção nutricional em casos de risco ou diagnóstico de desnutrição e prescrição e acesso a suplementos alimentares orais. Resultados: Foram recebidos eletronicamente o equivalente a 24% das unidades de diálise brasileiras (n = 207). As ferramentas de avaliação nutricional mais utilizadas com ou sem frequência pré-estabelecida foram inquéritos dietéticos (96%) e Avaliação Global Subjetiva (83%). As estratégias em casos de risco ou presença de desnutrição utilizadas com mais frequência (quase sempre/sempre) foram a orientação de incremento energético e proteico por meio de alimentos (97%) e o aumento da periodicidade das visitas (88%). A frequência de prescrição de suplemento industrializado de fórmula padrão e especializada foi bastante semelhante. A disponibilização de suplementos alimentares pelo Sistema Único de Saúde aos pacientes variou entre as regiões. Conclusão: A maior parte dos nutricionistas utiliza diversas ferramentas de avaliação nutricional e estratégias de intervenção em casos de risco ou desnutrição, porém a frequência de utilização de tais ferramentas e estratégias foi bastante variada. Introdução Brasil profissionais Objetivo nutricionais Metodologia mensagens orais Resultados 24 n 207. 207 . 207) préestabelecida pré estabelecida 96% 96 (96% 83%. 83 83% (83%) quase sempre/sempre sempresempre sempre 97% 97 (97% 88%. 88 88% (88%) semelhante regiões Conclusão variada 2 20 9 (96 8 (83% (97 (88% (9 (83 (88 ( (8

Resumo Nas últimas décadas, uma epidemia de doença renal crônica (DRC) tem sido associada a fatores ambientais e ocupacionais (estresse térmico decorrente de cargas de trabalho elevadas em altas temperaturas e exposição a produtos químicos, como agrotóxicos e metais), denominada DRC de origem não tradicional (DRCnt). Esta revisão descritiva tem como objetivo apresentar evidências recentes sobre estresse térmico, agrotóxicos e metais como possíveis causas de DRCnt e fornecer uma visão geral das estratégias brasileiras de regulamentação, fiscalização e vigilância sanitária relacionadas. Os trabalhadores brasileiros são comumente expostos a condições extremas de calor e outros fatores de risco de DRCnt, incluindo o aumento da exposição a agrotóxicos e metais. Além disso, há uma falta de regulamentação e fiscalização, políticas públicas e estratégias adequadas para proteger a saúde renal dos trabalhadores em relação aos principais fatores de risco. É provável que a DRCnt seja uma causa significativa de DRC no Brasil, uma vez que a etiologia da doença é desconhecida em muitos pacientes e diversas condições para seu desenvolvimento estão presentes no país. Estudos epidemiológicos devem ser realizados para explorar associações causais e estimar o impacto do calor, dos agrotóxicos e dos metais na DRCnt no Brasil. Além disso, as políticas públicas devem priorizar a redução da exposição dos trabalhadores e a promoção de sua saúde e segurança. décadas (DRC químicos metais, , metais) DRCnt. . (DRCnt) relacionadas disso Brasil país segurança (DRCnt

Abstract In the past decades, an epidemic of chronic kidney disease (CKD) has been associated with environmental and occupational factors (heat stress from high workloads in hot temperatures and exposure to chemicals, such as pesticides and metals), which has been termed CKD of non-traditional origin (CKDnt). This descriptive review aims to present recent evidence about heat stress, pesticides, and metals as possible causes of CKDnt and provide an overview of the related Brazilian regulation, enforcement, and health surveillance strategies. Brazilian workers are commonly exposed to extreme heat conditions and other CKDnt risk factors, including increasing exposure to pesticides and metals. Furthermore, there is a lack of adequate regulation (and enforcement), public policies, and strategies to protect the kidney health of workers, considering the main risk factors. CKDnt is likely to be a significant cause of CKD in Brazil, since CKD’s etiology is unknown in many patients and several conditions for its development are present in the country. Further epidemiological studies may be conducted to explore causal associations and estimate the impact of heat, pesticides, and metals on CKDnt in Brazil. Moreover, public policies should prioritize reducing workers´ exposure and promoting their health and safety. decades (CKD chemicals metals, , metals) nontraditional non traditional CKDnt. . (CKDnt) enforcement Furthermore enforcement) Brazil CKDs s country Moreover safety (CKDnt

ABSTRACT Introduction: The importance of dietitians in dialysis units is indisputable and mandatory in Brazil, but little is known about the practices adopted by these professionals. Objective: To know practices adopted in routine nutritional care, focusing on nutritional assessment tools and treatment strategies for people at risk or diagnosed with malnutrition. Methodology: Electronic questionnaire disseminated on social media and messaging applications. It included questions that covered dietitians’ demographic and occupational profile characteristics and of the dialysis unit, use and frequency of nutritional assessment tools, nutritional intervention strategies in cases of risk or diagnosis of malnutrition, prescription and access to oral supplements. Results: Twenty four percent of the Brazilian dialysis units (n = 207) responded electronically. The most used nutritional assessment tools with or without a pre-established frequency were dietary surveys (96%) and Subjective Global Assessment (83%). The strategies in cases of risk or presence of malnutrition used most frequently (almost always/always) were instructions to increase energy and protein intake from foods (97%), and increasing the frequency of visits (88%). The frequency of prescribing commercial supplements with standard and specialized formulas was quite similar. The availability of dietary supplements by the public healthcare system to patients varied between regions. Conclusion: Most dietitians use various nutritional assessment tools and intervention strategies in cases of risk or malnutrition; however, the frequency of use of such tools and strategies varied substantially. Introduction Brazil professionals Objective care Methodology applications unit Results n 207 electronically preestablished pre established 96% 96 (96% 83%. 83 83% . (83%) almost always/always alwaysalways always 97%, 97 97% , (97%) 88%. 88 88% (88%) similar regions Conclusion however substantially 20 9 (96 8 (83% (97% (88% 2 (9 (83 (97 (88 ( (8

Resumo Introdução: A importância da atuação do nutricionista em unidades de diálise é indiscutível e obrigatória no Brasil, porém pouco sabemos sobre as práticas adotadas por esses profissionais. Objetivo: Conhecer práticas adotadas na rotina dos atendimentos nutricionais, com foco nas ferramentas de avaliação nutricional e nas estratégias de tratamento das pessoas com risco ou diagnóstico de desnutrição. Metodologia: Questionário eletrônico divulgado em mídias sociais e aplicativos de mensagens. Incluiu questões que abrangiam características do perfil demográfico e ocupacional do profissional e da unidade de diálise, utilização e frequência de ferramentas de avaliação nutricional, estratégias de intervenção nutricional em casos de risco ou diagnóstico de desnutrição e prescrição e acesso a suplementos alimentares orais. Resultados: Foram recebidos eletronicamente o equivalente a 24% das unidades de diálise brasileiras (n = 207). As ferramentas de avaliação nutricional mais utilizadas com ou sem frequência pré-estabelecida foram inquéritos dietéticos (96%) e Avaliação Global Subjetiva (83%). As estratégias em casos de risco ou presença de desnutrição utilizadas com mais frequência (quase sempre/sempre) foram a orientação de incremento energético e proteico por meio de alimentos (97%) e o aumento da periodicidade das visitas (88%). A frequência de prescrição de suplemento industrializado de fórmula padrão e especializada foi bastante semelhante. A disponibilização de suplementos alimentares pelo Sistema Único de Saúde aos pacientes variou entre as regiões. Conclusão: A maior parte dos nutricionistas utiliza diversas ferramentas de avaliação nutricional e estratégias de intervenção em casos de risco ou desnutrição, porém a frequência de utilização de tais ferramentas e estratégias foi bastante variada. Introdução Brasil profissionais Objetivo nutricionais Metodologia mensagens orais Resultados 24 n 207. 207 . 207) préestabelecida pré estabelecida 96% 96 (96% 83%. 83 83% (83%) quase sempre/sempre sempresempre sempre 97% 97 (97% 88%. 88 88% (88%) semelhante regiões Conclusão variada 2 20 9 (96 8 (83% (97 (88% (9 (83 (88 ( (8

Abstract Introduction Teachers are a high-risk group for the development of vocal dysfunction, as they use voice extensively in their profession. Objective To know the prevalence and risk factors associated with voice strain in teachers. Methods A cross-sectional study was conducted among schoolteachers in Chitwan, Nepal. The Voice Handicap Index questionnaire was used as a survey tool. Result A total of 315 teachers were enrolled in the study. The mean age of the participants was of 36.7 years. Teachers from public schools, primary grade classes, > 50 pupils in the classroom, > 24 hours of classes per week, dust in class, and recurrent tonsil problems were associated with various degrees of vocal handicap. Conclusion There is a high prevalence of voice disorder among teachers. A holistic approach, which includes teacher education regarding voice care during their work and management of their voice handicap by taking into consideration different risk factors, must be adopted. highrisk dysfunction profession crosssectional cross sectional Chitwan Nepal tool 31 367 36 7 36. years schools 5 classroom 2 week class approach adopted 3

Abstract The People's self-concept contributes to their sense of identity, and if associated with methods that promote the involvement of participants, we develop knowledge that promotes causes and social change. Introduction: In recent decades, the scientific community has identified a high prevalence of work-related musculoskeletal disorders in nurses, as a result of work processes, high physical demands, workspaces, and the emotional and sometimes stressful association of clinical contexts. Obstetric nurses, due to their specific work, have been a group that has been little studied and, above all, little involved in research processes. Research Objective: This study aims to identify the self-perception of Obstetric nurses regarding daily activities in the labour context, which are self-perceived as high risk for work-related musculoskeletal disorders. Methodology: A qualitative approach was used, utilising an empowering research method - Photovoice. Twenty who work full time in the delivery room took part. Photographic records were presented by the Obstetric nurses and their self-perceptions were shared through interviews. The interviews and photographs were then transcribed, analysed and categorised. Results: The average number of years as a Obstetric nurses was 14.4 years, but with 24.8 years working as a nurse. Twenty-two work activities with a potential risk to health were photographically recorded.

Abstract Introduction. The new era of surgery is increasingly dependent on technology, and an example of this is the widespread use of electrocautery as a primary part of surgical practice. Surgical smoke is a byproduct of the dissection and coagulation of tissues produced by energy equipment, which represents multiple potential health risks for the surgical group; however, the dangers caused by cumulative exposure have been minimized. Methods. A critical analysis was carried out from a reflective position of the available information, establishing the possible risks related to exposure to surgical smoke. Discussion. The imperative need to establish national normative guidelines and standardized recommendations to comply with the demands given by the occupational health and work safety management systems, whose main objective is to make effective the use of appropriate surgical masks, implementation of environmental epidemiological surveillance program in the operating room, prioritizing the constant use of vacuum cleaners and evacuation systems, and carrying out educational awareness programs aimed at the personnel involved. Likewise, there is concern about the need for new studies to more precisely define the danger of this aerosol. Conclusion. It is recommended to responsibly use all existing preventive strategies to intervene in operating rooms to minimize the forgotten risks of surgical smoke.

Resumen Introducción. La nueva era de la cirugía es cada vez más dependiente de la tecnología, y un ejemplo de ello es el uso generalizado de electrocauterio como parte primordial de la práctica quirúrgica. El humo quirúrgico es un subproducto de la disección y la coagulación de los tejidos producidas por los equipos de energía, que representa múltiples riesgos potenciales para la salud del grupo quirúrgico, sin embargo, se han minimizado los peligros causados por la exposición de manera frecuente y acumulativa a este aerosol. Métodos. Se realizó un análisis crítico, desde una posición reflexiva de la información disponible, estableciendo los posibles riesgos relacionados con la exposición al humo quirúrgico. Discusión. Es visible la necesidad imperativa de establecer directrices nacionales, pautas normativas y recomendaciones estandarizadas para cumplir con las exigencias dadas por los sistemas de gestión en salud ocupacional y seguridad del trabajo, cuyo objetivo principal es hacer efectivo el uso de mascarillas quirúrgicas apropiadas, la implementación de programa de vigilancia epidemiológica ambiental en sala de cirugía, la priorización del uso constante de aspiradores y sistemas de evacuación, y la ejecución de programas educativos de sensibilización dirigidos al personal implicado. De igual manera, se abre la inquietud de la necesidad de nuevos estudios para definir con mayor precisión el peligro de este aerosol. Conclusión. Se recomienda de manera responsable utilizar todas las estrategias preventivas existentes para intervenir en salas de cirugía los riesgos minimizados y olvidados del humo quirúrgico.

RESUMEN Introducción: la salud mental es crucial para el bienestar y el rendimiento académico de los estudiantes universitarios. Los estudiantes de Kinesiología y Fisioterapia enfrentan desafíos únicos que pueden afectar su salud mental. Objetivo: determinar la frecuencia de trastornos mentales comunes en estudiantes de kinesiología y fisioterapia de la Universidad Nacional de Asunción. Metodología: se trata de un estudio observacional, descriptivo y transversal. La muestra no probabilística estuvo compuesta por 150 estudiantes de Kinesiología y Fisioterapia de la Universidad Nacional de Asunción. Se recogieron datos sociodemográficos, académicos, ocupacionales, de estilo de vida y psicopatológicos mediante la Escala de Depresión, Ansiedad y Estrés - 21 (DASS-21). El análisis se realizó mediante Jamovi con regresión logística binomial multivariada. Resultados: la frecuencia de depresión, ansiedad y estrés fue del 61,3 %, 72 % y 54,7 %, respectivamente. Los factores importantes para la depresión incluyeron ser un estudiante irregular, trabajar y no realizar actividad física. Para la ansiedad, fueron significativos ser estudiante irregular y ser mujer. Respecto al estrés, se encontraron relevantes ser estudiante irregular, trabajar y no realizar actividad física. Los modelos resultantes tuvieron clasificaciones correctas del 90,2 %, 88 % y 72 % para depresión, ansiedad y estrés, respectivamente. Conclusión: Este estudio reveló una alta frecuencia de depresión, ansiedad y estrés entre estudiantes de kinesiología y fisioterapia, lo que se asoció significativamente con irregularidad académica, empleo y falta de actividad física. Estos hallazgos subrayan la necesidad de implementar estrategias de intervención y programas de apoyo que aborden estos factores de riesgo para promover la salud mental y el bienestar de los futuros profesionales de la salud.

ABSTRACT Introduction: mental health is crucial for university students’ well-being and academic performance. Kinesiology and Physical Therapy students face unique challenges that can affect their mental health. Objective: to determine the frequency of common mental disorders in kinesiology and physical therapy students at the Universidad Nacional de Asunción. Methodology: this was an observational and descriptive cross-sectional study. The nonprobabilistic sample included 150 Kinesiology and Physiotherapy students from the Universidad Nacional de Asunción. Sociodemographic, academic, occupational, lifestyle, and psychopathological data were collected using the Depression, Anxiety and Stress Scale - 21 (DASS-21). The analysis was performed using Jamovi with multivariate binomial logistic regression. Results: the frequency of depression, anxiety, and stress was 61.3 %, 72 %, and 54.7 %, respectively. The significant factors for depression included being an irregular student, working, and not engaging in physical activity. For anxiety, being an irregular student and being a woman were significant. Regarding stress, being an irregular student, working, and not engaging in physical activity were found to be relevant. The resulting models had correct classifications of 90.2 %, 88 %, and 72 % for depression, anxiety, and stress, respectively. Conclusion: this study revealed a high frequency of depression, anxiety, and stress among kinesiology and physical therapy students, which was significantly associated with academic irregularity, employment, and a lack of physical activity. These findings underscore the need to implement intervention strategies and support programs that address these risk factors in order to promote the mental health and well-being of future health professionals.

ABSTRACT The present study focuses on vibration exposure and its impact on occupational health, contrasting the results with previous research. Workers in a specific workshop were investigated, assessing their vibration exposure, working hours and risk perception. A mixed approach was used, collecting data through structured surveys and inferential statistical analysis. The results indicate that 80% of the workers are exposed to vibration to some extent, with 10% exposed half the time and 6% almost always. However, no significant correlations were found between vibration exposure and other factors such as musculoskeletal health or reduced work activity. These discrepancies with previous research suggest demographic and occupational variations among the samples studied. It is concluded that it is critical to address musculoskeletal health in a comprehensive manner, implementing effective control measures to prevent mechanical vibration-related injuries.

RESUMEN Este trabajo aborda los desafíos del estrés laboral en docentes universitarios, analizando su impacto en la salud mental y el desempeño laboral. El objetivo es identificar las causas y consecuencias del estrés en este grupo y proponer medidas para mitigarlo. Se realizó una investigación no experimental con enfoque mixto, utilizando análisis descriptivo y relacional. Se aplicaron encuestas a 31 docentes, utilizando el cuestionario alemán Effort-Reward Imbalance y la escala de ansiedad de Zung. Los resultados muestran una correlación entre la carga laboral, la falta de reconocimiento y el nivel de estrés. Se concluye que es necesario abordar los factores psicosociales en el entorno laboral para promover un ambiente saludable y apoyar el bienestar de los docentes, lo que a su vez beneficiará la calidad educativa.

RESUMEN Introducción: La infección posterior a la vacunación por COVID-19 es una preocupación del panorama de salud, presentándose a pesar de la inmunización en los países desarrollados. Se ha observado una correlación entre no estar vacunado y la presencia de infección, incrementándose por factores de riesgo presentes de origen laboral, así como aquellos inherentes a la persona. Objetivo: Determinar la frecuencia de casos de COVID 19 en trabajadores vacunados en un hospital durante el 2021-2022. Material y métodos: Estudio transversal en el personal que labora en el Hospital General de Zona 30 que presentó infección posterior a la vacunación por COVID-19 durante el período de 2021-2022. Las variables estudiadas fueron: edad, sexo, índice de masa corporal, servicio asignado, actividad extralaboral remunerada, grado de riesgo de infección por COVID 19 de la actividad extralaboral remunerada y manejo de la infección posterior a la vacunación. Resultados: Fueron identificados 141 trabajadores enfermos por COVID-19. Predominaron: las mujeres con el 71,6 %, promedio de meses transcurridos desde esquema completo de vacunación de 7,03 meses, actividad de riesgo muy alto 94,7 %, manejo ambulatorio 96,5 %, comorbilidades: obesidad 34,8 % e hipertensión 18,4 %. Conclusiones: Posterior a recibir la vacunación, los infectados por COVID 19 presentaron un cuadro clínico leve, a pesar de presentar comorbilidades. Se muestra un panorama alentador sobre el efecto de la vacunación en el personal ocupacionalmente expuesto.

ABSTRACT Introduction: After vaccination infection by COVID-19 is a growing worry in health overview, happening even after the immunization of first world countries. There is a correlation between not being vaccinated and the presence of the infection, increasing by the presence of job-related factors, as well as those inherent to each person. Objective: Determine the frequency of cases of COVID-19 in vaccinated workers in a hospital during 2021-2022. Methods: Cross sectional study in workers of the Zone 30´s General Hospital, who developed post-vaccination infection with COVID-19 during the period 2021-2022. The variables studied were: age, sex, body mass index, assigned service, paid extra-work activity, degree of risk of infection by COVID 19 from paid extra-work activity and post-vaccination infection management. Results: Identified 141 workers sick from COVID-19, predominated: women by 71.6%, average of months elapsed since full vaccine coverage is 7.03 months, work risk very high 94.7%, outpatient treatment 96.5%, comorbidities: obesity 34.8%, and high blood pressure 18.4%. Conclusions: The proportion of infected workers caused by COVID-19 post-vaccination was low, showing that vaccination schedules are a viable option for spread control.

RESUMEN Introducción: La tuberculosis es una enfermedad de interés en salud laboral y existe una mayor probabilidad de infección y enfermedad en los trabajadores de la salud que en la población general. Esto sucede como consecuencia de la exposición a factores de riesgo ocupacionales y al déficit de implementación de las medidas de control de tuberculosis. Objetivo: Determinar la relación de los factores sociodemográficos, ocupacionales, conocimientos y prácticas sobre la tuberculosis con el uso adecuado del respirador N95 en los trabajadores de la salud de un hospital de la ciudad de Bogotá, Colombia. Métodos: Estudio de tipo cuantitativo y diseño transversal. Se realizó un muestreo aleatorio simple estratificado por ocupación y área de trabajo. Se utilizaron estadísticos descriptivos y pruebas no-paramétricas que se evaluaron a un nivel significancia del 5 % (P< 0,05). Resultados: Participaron 250 trabajadores de la salud. Los niveles educativos de universitario y posgradual (P< 0,001), las ocupaciones de enfermero, médico especialista, médico general y bacteriólogo (P< 0,001), las áreas de trabajo de hospitalización, cuidado intensivo adultos y urgencias (P= 0,034), se asociaron con el uso adecuado del respirador N95. Los conocimientos correctos sobre la tuberculosis (P< 0,001), se relacionaron con el uso adecuado del respirador N95. Conclusiones: Mediante acciones educativas se recomienda fortalecer los conocimientos y prácticas de los trabajadores de la salud sobre la tuberculosis y el uso adecuado del respirador N95, en especial hacia las ocupaciones de auxiliar de enfermería y otros auxiliares y tecnólogos de la salud, dado que estadísticamente mostraron un menor uso adecuado del respirador N95.

ABSTRACT Introduction: Tuberculosis is a disease of interest in occupational health and there is a greater probability of infection and disease in health workers than in the general population. This happens as a consequence of exposure to occupational risk factors and the lack of implementation of tuberculosis control measures. Objective: Determine the relationship of sociodemographic, occupational factors, knowledge and practices about tuberculosis with the appropriate use of the N95 respirator in health workers in a hospital in the city of Bogotá, Colombia. Methods: Quantitative study and cross-sectional design. A simple random sampling stratified by occupation and work area was carried out. Descriptive statistics and non-parametric tests were used and were evaluated at a significance level of 5% (P < 0.05). Results: 250 health workers participated. The educational levels of university and postgraduate (P < 0.001), the occupations of nurse, specialist doctor, general practitioner and bacteriologist (P < 0.001), the work areas of hospitalization, adult intensive care and emergencies (P = 0.034), were associated with the proper use of the N95 respirator. Correct knowledge about tuberculosis (P < 0.001) was related to the proper use of the N95 respirator. Conclusions: Through educational actions, it´s recommended to strengthen the knowledge and practices of health workers about tuberculosis and the proper use of the N95 respirator, especially towards the occupations of nursing assistant and other health assistants and technologists, given that statistically showed less adequate use of the N95 respirator.