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      Occupational stressors and work accidents among health workers

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          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.

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          Most cited references52

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          Job Demands, Job Decision Latitude, and Mental Strain: Implications for Job Redesign

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            Job strain, work place social support, and cardiovascular disease: a cross-sectional study of a random sample of the Swedish working population.

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              Extension of the modified Poisson regression model to prospective studies with correlated binary data.

              The Poisson regression model using a sandwich variance estimator has become a viable alternative to the logistic regression model for the analysis of prospective studies with independent binary outcomes. The primary advantage of this approach is that it readily provides covariate-adjusted risk ratios and associated standard errors. In this article, the model is extended to studies with correlated binary outcomes as arise in longitudinal or cluster randomization studies. The key step involves a cluster-level grouping strategy for the computation of the middle term in the sandwich estimator. For a single binary exposure variable without covariate adjustment, this approach results in risk ratio estimates and standard errors that are identical to those found in the survey sampling literature. Simulation results suggest that it is reliable for studies with correlated binary data, provided the total number of clusters is at least 50. Data from observational and cluster randomized studies are used to illustrate the methods.
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                Author and article information

                Journal
                Rev Saude Publica
                Rev Saude Publica
                rsp
                Revista de Saúde Pública
                Faculdade de Saúde Pública da Universidade de São Paulo
                0034-8910
                1518-8787
                02 December 2021
                2021
                : 55
                : 98
                Affiliations
                [I ] orgnameUniversidade Federal da Bahia orgdiv1Instituto de Saúde Coletiva orgdiv2Programa de Pós-Graduação em Saúde Coletiva Salvador BA Brasil originalUniversidade Federal da Bahia. Instituto de Saúde Coletiva. Programa de Pós-Graduação em Saúde Coletiva. Salvador, BA, Brasil
                [II ] orgnameUniversidade Estadual de Feira de Santana orgdiv1Departamento de Saúde Feira de Santana BA Brasil originalUniversidade Estadual de Feira de Santana. Departamento de Saúde. Feira de Santana, BA, Brasil
                [III ] orgnameUniversidade Federal da Bahia orgdiv1Faculdade de Medicina da Bahia orgdiv2Programa de Pós-Graduação em Saúde, Ambiente e Trabalho Salvador BA Brasil originalUniversidade Federal da Bahia. Faculdade de Medicina da Bahia. Programa de Pós-Graduação em Saúde, Ambiente e Trabalho. Salvador, BA, Brasil
                [IV ] orgnameUniversidade Estadual de Feira de Santana orgdiv1Programa de Pós-Graduação em Saúde Coletiva Feira de Santana BA Brasil originalUniversidade Estadual de Feira de Santana. Programa de Pós-Graduação em Saúde Coletiva. Feira de Santana, BA, Brasil
                [I ] Brasil originalUniversidade Federal da Bahia. Instituto de Saúde Coletiva. Programa de Pós-Graduação em Saúde Coletiva. Salvador, BA, Brasil
                [II ] Brasil originalUniversidade Estadual de Feira de Santana. Departamento de Saúde. Feira de Santana, BA, Brasil
                [III ] Brasil originalUniversidade Federal da Bahia. Faculdade de Medicina da Bahia. Programa de Pós-Graduação em Saúde, Ambiente e Trabalho. Salvador, BA, Brasil
                [IV ] Brasil originalUniversidade Estadual de Feira de Santana. Programa de Pós-Graduação em Saúde Coletiva. Feira de Santana, BA, Brasil
                Author notes
                Correspondence: Mariana Rabelo Gomes Universidade Federal da Bahia Instituto de Saúde Coletiva R. Basílio da Gama, s/n. Canela 40110-040, Salvador, BA, Brasil E-mail: rabelo.marianag@ 123456gmail.com

                Authors’ Contribution: Study design and planning: MRG, TMA, JFSS. Data analysis and interpretation: MRG, CCS, IL. Manuscript preparation or revision: MRG, TMA, JFSS, CCS, IL. Final version approval: MRG, TMA, JFSS, CCS, IL. Public responsibility for the content of the article: MRG, TMA, JFSS, CCS, IL.

                Conflict of Interest: The authors declare no conflict of interest.

                Correspondência: Mariana Rabelo Gomes Universidade Federal da Bahia Instituto de Saúde Coletiva R. Basílio da Gama, s/n. Canela 40110-040, Salvador, BA, Brasil E-mail: rabelo.marianag@gmail.com

                Contribuição dos Autores: Concepção e planejamento do estudo: MRG, TMA, JFSS. Análise e interpretação dos dados: MRG, CCS, IL. Elaboração ou revisão do manuscrito: MRG, TMA, JFSS, CCS, IL. Aprovação da versão final: MRG, TMA, JFSS, CCS, IL. Responsabilidade pública pelo conteúdo do artigo: MRG, TMA, JFSS, CCS, IL.

                Conflito de Interesses: Os autores declaram não haver conflito de interesses.

                Author information
                https://orcid.org/0000-0001-9875-7308
                https://orcid.org/0000-0003-2766-7799
                https://orcid.org/0000-0003-0448-8130
                https://orcid.org/0000-0002-6139-0984
                https://orcid.org/0000-0002-5760-5073
                Article
                00291
                10.11606/s1518-8787.2021055002938
                8664054
                808dc093-54e5-436d-8532-3d410eb6e73c

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 20 June 2020
                : 30 November 2020
                Page count
                Figures: 0, Tables: 8, Equations: 0, References: 42
                Funding
                Funded by: Fundação de Amparo à Pesquisa do Estado da Bahia
                Award ID: SUS0024/2009
                Funded by: Fundação de Amparo à Pesquisa do Estado da Bahia
                Award ID: SUS0022/2014
                Funded by: Conselho Nacional de Desenvolvimento Científico e Tecnológico
                Award ID: 480611/2010-6
                Funding: Fundação de Amparo à Pesquisa do Estado da Bahia (Bahia State Research Support Foundation) (Processes SUS0024/2009 and SUS0022/2014); and Conselho Nacional de Desenvolvimento Científico e Tecnológico (National Council for Scientific and Technological Development) (Process 480611/2010-6 Public Notice/Call: Public notice MCT/CNPq 14/2010).
                Categories
                Original Article

                health personnel, psychology,accidents, occupational, prevention & control,occupational exposure,containment of biohazards,inservice training

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