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Occupational hazards of Brazilian solid waste workers: a systematic literature review/ Riscos ocupacionais em trabalhadores da limpeza urbana no Brasil: uma revisao sistematica da literatura.

INTRODUCTION

Each year, about 1.3 billion tons of solid waste are generated worldwide. By 2025, this volume is expected to reach up to 2.2 billion tons annually, which is a cause of concern for governments and society (1).

Brazil is one of the nations that produces the largest amount of waste, following the increase of its population (currently 200.4million) each year (2). The country generates nearly 80 million tons of solid waste per year, being elected as the third largest waste producer in the planet (3). The situation is more concerning due to the fact that professionals involved with waste collection in the country do not receive the attention deserved by municipal authorities or attributable respect from the society (4).

In Brazil, the job of garbage professionals requires much effort to be accomplished, given the nature of the work, workplace conditions, besides predictable and unpredictable variables that follow their routine (5). It is contended that those professionals are exposed to a variety of occupational hazards (6), most of them not discussed within scientific literature in a context where such individuals face social stereotyping as an effect of cultural influences (7).

Thus, guided by the research question "What are the occupational hazards to which solid waste workers are exposed in Brazil?", a systematic review was conducted in order to identify occupational hazards that affect those professionals as well as factors associated with hazard minimization in this group.

METHODS

STUDY DESIGN AND SEARCH STRATEGY

A systematic review of national and international literature was conducted which aimed to identify occupational hazards that affect Brazilian waste workers, as well as the factors that contribute to the minimization of hazards in the given population.

Data were collected from November to December of 2016 in two distinct, respective stages (S1 and S2). For S1, three authors performed an independent search on the electronic databases: Scientific Electronic Library Online (ScIELO), Latin American and Caribbean Literature in Health Sciences (LILACS), and PubMed. On the other end of the spectrum, for S2, the three researchers searched gray literature studies through Google Scholar, considering the small number of publications on the topic yielded from the electronic search.

For both stages and all databases, the following search strategy and terms were used:

1. Waste worker AND Occupational hazard OR Occupational risk;

2. Solid waste worker AND Occupational hazard OR Occupational risk;

3. Garbage worker AND Occupational hazard OR Occupational risk; and

4. Waste management AND Occupational health OR Occupational hazard OR Occupational risk.

ELIGIBILITY CRITERIA

Complete studies published between 2006 and 2016 in English, Portuguese, or Spanish were considered for analysis as long as they had the primary purpose of examining occupational hazards in Brazilian waste workers. The authors did not include literature reviews or studies whose subjects were not legally employed waste professionals (i.e. homeless persons or individuals from non-governmental organizations collecting garbage for personal or community purposes). Studies on individuals involved in recycling were also not considered.

STUDY SELECTION AND DATA EXTRACTION

For the selection of studies, instructions provided by Moher et al. in Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement (8) were followed. Once eligible literature was identified, they were exported to Mendeley, a reference manager, in order to organize titles by author and year of publication, excluding duplicates.

Eligible studies were read in full text and relevant data were extracted. Reference lists were also assessed. Finally, quantitative and qualitative data were segregated into categories for analysis. Microsoft Office Excel was utilized for further graphic representation.

RESULTS

REVIEW OF PAPERS

For this systematic review, the electronic and gray literature search yielded a total of 76 documents, which gave us an initial idea of the small number of publications on the topic. Only 57 studies remained after exclusion of duplicates. Then, the literature was screened for relevance after reading their titles and abstracts, and 18 publications remained. However, not all of the remaining publications met the inclusion criteria, leaving the final number of studies to 12, which then had their reference lists screened with no more studies included (Figure 1).

STUDY CHARACTERISTICS

The few studies identified in the database search and in the gray literature are presented in chronological order and include information about author/year of publication, method, objective, and results. The selected papers were mostly cross-sectional studies (92%), with a quantitative approach (Chart 1).

In a chronological analysis, one study dealing with occupational hazards in urban waste collectors (9) was identified for the year of 2006. However, no studies on the topic published in 2007 were identified. In 2008, there was one publication (14) and for each of the two subsequent years there were two publications (10,15-17). It was possible to identify a single publication on the subject being published in 2011 (11) and two in the following year (18,19). In 2013, 2014, and 2015, there were no published studies on the topic. Nevertheless, for 2016, three studies were encountered (12,13,20). The fact points out a constancy in the number of published studies on occupational hazards in garbage workers.

All of the selected publications sought to identify the occupational hazards to which waste workers are exposed in several Brazilian cities. Others also discussed a variety of diseases resulting from that career, while a few of them also addressed how to minimize or prevent occupational hazards. With that being said, the thematic analysis was based on the following themes: types of occupational hazards in urban waste workers and hazard prevention measures.

DISCUSSION

OCCUPATIONAL HAZARD IN WASTE WORKERS

In developing countries, waste management procedures are characterized by a dominance of manual labor tasks, which therefore exposes waste professionals to a number of occupational hazards of variable nature, occurring at every stage of the waste management process (21,22).

Considering the possible occupational hazards in the workplace, the Brazilian Ministry of Labor designed a standardized set of colors to indicate the main potential risks to which workers are exposed in the various worksites. The colors are as follows: green is used to represent physical hazards, red for chemicals, brown for any biological hazard, yellow for ergonomic (or "human" factors), and blue to represent hazards related to accidents (23). The psychosocial hazard, which was also evidenced in the literature (18), used to be associated with the ergonomic hazard; however, it has been considered a new category (24), without a standardized color representation, therefore why the authors attributed to it the gray color.

From the analysis of the publications, it was observed that waste management workers are exposed to five main occupational hazards, besides psychosocial hazards. Figure 2 shows the percentage of occupational hazards in those workers based on how much evidence was encountered, considering the number of times that hazards were cited in eligible studies.

Thus, the most evidenced hazards experienced by garbage workers were those of biological nature and accidents, respectively. The most common events happening to those professionals in the workplace are presented in Chart 2.

BIOLOGICAL HAZARD

Biological hazard is the likelihood of exposure to microorganisms with potential to cause harm to the worker's health. Throughout the studies, it was identified that waste workers are exposed to contamination by viruses, bacteria (10,14,16-18), fungi (14,19), and parasites (9,12); all which can lead to acute or chronic infections, allergic reactions, and toxic reactions (23,25).

Garbage management workers are susceptible to several biological damages that lead to the acquisition of several infections (16-18). Sousa et al. (2015), attribute these infections not only to contact with waste, but to sewage and gallery contaminants that contain improperly discarded waste (26). Contamination with the hepatitis C virus and tetanus bacteria were also mentioned with gastroenteritis appearing more evident in those workers, therefore culminating an increase in diarrheal conditions (12,18).

In a study carried out in 2006, with a sample of 22 solid waste workers, it was identified the prevalence of 63.66% for parasites or commensals in those individuals, after a laboratorial analysis of feces. Of this percentage, 78.6% corresponded to protozoa while 21.4% to helminths (Entamoeba coli, Entamoeba hartmanni, Entamoeba histolytica, Endolimax nana, Ascaris lumbricoides, Trichuris trichiura, Strongyloides stercoralis) (9). For these studies, it is important to note the difference between such species. Helminths constitute any disease-causing organisms that live on a human or another animal and derive nourishment from their host (27), whereas a protozoa is defined as any parasitic single-celled organism that can divide only within a host organism (28).

Another study also performed similar analysis in 185 workers, identifying the presence of protozoan infection, with sweepers being the most affected (55.9%). In addition, the author identified the incidence of sinusitis in the last twelve months (between 14.7% and 37.8%) and pneumonia (between 8.8% and 22.2%), with waste truck drivers being the most affected. In the evaluation of the positivity for hepatitis B and leptospirosis, it was identified that the sweepers are the most affected (incidence between 20% and 25.7%, respectively) (10).

In a recent study, Santos (2016) identified the prevalence of soil transmitted helminthiasis above 35% in a sample of 163 workers in Piaui state, northeastern Brazil. The results were obtained from parasitological tests, with a prevalence of 25.15% for ascariasis, 7.36% for trichuriasis, and 9.82% for hookworm (12).

Another important aggravation reported in the literature was dermatitis, which can be from fungal origin as well as an immune reaction against antigens. Dermatitis was the complaint of 6% of the 16 individuals assessed in a study of 2008 (14). Yet, in a study with a larger sample of 97 individuals, Coelho (2012) identified a higher prevalence of dermatitis in waste workers (42%), occurring more commonly on the hands (19). Other diseases often found in those professionals are brucellosis, dengue fever, yellow fever, rabies, viral hepatitis (A, B, C, D, and E), leishmaniosis, and cysticercosis (29).

Yet, in the context of biological hazards, although not mentioned in the studies found, prions also constitute infectious agents of relevance in waste management. Those protein-composed agents are found to be the cause of occupational diseases in some studies (30).

ACCIDENT HAZARD

The risk of accidents--understood as any probability of exposure to a factor that places the worker in a vulnerable situation, affecting their physical integrity and well-being seems to be a cause of great concern in such professionals (23). An accident is defined as a sudden and unexpected event that can cause damage not only to the worker, but also to the property or work environment (31).

In solid waste workers, accident hazards originate from a variety of causes. The literature points out that those workers are exposed to injuries from sharp objects such as glasses, syringes, nails, spikes, and thorns (11,14). Some authors (15,18,20) also evidence the risk of slips and falls.

Authors also concluded that waste collectors are exposed to the risk of being run over, which according to Pedrosa (2010) is mentioned by 16% of the 96 individuals interviewed in in his survey (16). Other hazards include animal attacks, especially dog attack (15), press, and amputations through equipment used at work (20).

CHEMICAL, ERGONOMIC, AND PSYCHOSOCIAL HAZARDS

Professionals involved in waste management are also susceptible to chemical hazards, when there is a likelihood of contact with chemical agents, including substances, compounds, or products capable of penetrating the body through the respiratory tract, skin contact, or ingestion (32). In this regard, workers are exposed to manure, smoke, and other toxic substances that are erroneously discarded in the trash, such as pesticides, oils, and batteries (11,20,26).

Ergonomic hazard is another occupational health risk affecting solid waste workers, which consists in the probability of a treat to the musculoskeletal system due to different factors, such as inadequate posture, excessive weight, excessive or repetitive physical exertion, among others (23,33). The literature has shown that those individuals have suffered from postural, spinal, and muscle strain problems as a result of the weight they have to carry, as well as the repetitiveness and effort required to perform the functions at work throughout a long shift (13,18).

In relation to the physical hazard, being the possibility of damage due to exposure to the different forms of energy, it was verified that waste management professionals suffer strong exposure to solar radiation, with intense heat or cold alongside exposure to climatic changes. In addition, they are subject to noise and intense vibrations caused by work equipment, therefore leading to hearing loss (14,18,26).

Finally, one of the least explored hazards in occupational health (24), psychosocial hazard has been evidenced in recently published literature (26). From the literature analyzed, the authors were able to identify that waste workers continue to suffer from a historical discrimination, with the devaluation of their work by society, government, and employees, along with precarious working conditions, and an overall lack of training (18,26).

PREVENTION OF OCCUPATIONAL HAZARDS IN SOLID WASTE WORKERS

In a context where there are several occupational hazards affecting solid waste professionals with different etiologies, the use of Personal Protective Equipment (PPE) has been the most effective in contributing to the minimization or elimination of exposure. However, it is a fact of negligence on the part of workers or even employers towards the use and mandatory compliance of PPE, respectively (15,17,18). In addition, it is of the utmost importance that there be ongoing guidance programs for workers on the correct use of PPE and handling of urban waste (20).

Orientation to the population towards the proper disposal of domestic waste seems to be another factor contributing to minimization of occupational hazards in garbage workers (11). In this way, by combining these actions, the occupational risks can be reduced (26).

LIMITATIONS OF THE STUDY

This study has some limitations derived from the fact that there are few national or international publications on occupational hazards affecting Brazilian solid waste workers available on electronic databases. For this reason, the authors included gray literature studies (undergraduate or master's degree paper), none of which negatively affect the quality of this review, based on validation by at least two individuals holding a Master's degree.

Another limitation refers to the generality of the results, which may be compromised since they represent only Brazilian data and are certainly consequences of policy and culture specific to the country. Nevertheless, considering the fact that most developing countries use the same procedures for waste management, mostly involving manual labor, the conclusions obtained through this study can be similar to the ones from future studies conducted in other developing countries.

CONCLUSION

From the analysis of the literature, it was possible to identify that solid waste workers are exposed to the five main occupational hazards. According to theis nature, they are classified as follows: biological, accidental, chemical, ergonomical, and psychosocial hazards. In order to contribute to the minimization and/or elimination of many of these risks, it is necessary to identify the importance of the combination of the guided use of PPE, training to the worker, and orientation to the population on the proper disposal of trash.

There are still few studies on occupational hazard in solid waste workers, which probably reflects the historical and social stereotyping faced by those professionals. Thus, the authors should emphasize the need for more evidence-based research that could serve as a subsidy for the development and implementation of public policies that are favorable to the reduction of occupational risks in the group studied.

DOI: I05327/ZI679443520I70056

Received: 07/13/2017

Accepted: 09/25/2017

Financial source: none

REFERENCES

(1.) World Bank. What a waste: a global review of solid waste management [Internet]. Washington: WB, 2016 [cited Dec 11, 2016]. Available from: https://openknowledge.worldbank.org/handle/10986/17388

(2.) Brazilian Institute of Geography and Statistics. Census 2010 [Internet]. Brasilia: IBGE, 2015 [cited Dec 13, 2016]. Available from: http://www.censo2010.ibge.gov.br/

(3.) Brazilian Association of Public Hygiene and Special Waste Companies. 2015 Overview [Internet]. Sao Paulo: IBGE; 2015 [cited Jan 10, 2017]. Available from: http://www.abrelpe.org.br/panorama_apresentacao.cfm

(4.) Gomes CC, Oliveira RS. Public cleaning agents: a study on the relationship pleasure / pain in the workplace. Psicol Cienc Prof. 2013;33:138-53.

(5.) Vasconcelos RC, Lima FPA, Camarotto JA, Abreu ACMS, Coutinho Filho AOS. Aspects of the complexity of domestic waste collection: management of street work variability. Gest Prod. 2008;15:407-19.

(6.) Ravindra K, Kaur K, Mor S. Occupational exposure to the municipal solid waste workers in Chandigarh, India. Waste Manag Res. 2016;34:1192-95.

(7.) Leal NSB, Soares MFS, Rocha IT, Ribeiro CG. The attitude of academics in relation to urban cleaning workers. Psicol Cienc Prof. 2013;33:946-63.

(8.) Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6:e1000097.

(9.) Nunes ALBP, Cunha AMO, Marcal Junior O. Garbage collectors and intestinal parasitosis: the role played by social representations in its prevention. Cienc Educ. 2006;12:25-38.

(10.) Graudenz GS. Infectious and inflammatory indicators among urban waste workers in Sao Paulo. Rev Bras Saude Ocup. 2009;34:106-14.

(11.) Lazzari MA, Reis CB. Urban garbage collectors in the municipality of Dourados (MS) and their perception towards biological hazards in their work process. Cienc Saude Coletiva. 2011;16:3437-42.

(12.) Santos CAN. Geohelminthiasis in public waste workers in the city of Parnaiba-Piaui: prevalence and risk factors [Master's thesis]. Rio de Janeiro: Escola Nacional de Saude Publica Sergio Arouca; 2016.

(13.) Galdino SJ, Malysz ST. Occupational hazards in urban, solid waste collectors. Rev Percurso. 2016;8:187-205.

(14.) Oliveira GA, Santos HI. Occupational health evaluation in garbage workers from Hidrolandia, Goias [Undergraduate study completion paper]. Goiania: Universidade Catolica de Goias; 2008.

(15.) Silva CC, Silva DC, Charrone G, Lopes JD, Souza PR. Domiciliary waste collection in Muzambinho: analysis of occupational health [Undergraduate study completion paper]. Muzambinho: Instituto Federal de Educacao, Ciencia e Tecnologia do Sul de Minas; 2009.

(16.) Pedrosa FP, Gomes AA, Mafra AS, Albuquerque EZR, Pelentir MGSA. Occupational health in solid waste professionals of Boa Vista, RR. Annals ENEGEP. Boa Vista: Federal Council of Engineering and Agronomy; 2010.

(17.) Pinho LM, Neves EB. Accidents at work in a company of urban waste collection. Cad Saude Colet. 2010;18:243-51.

(18.) Oliveira APS, Zandonadi FB, Castro JM. Evaluation of occupational risks among workers from the household solid waste collection in the city of Sinop-MT. University of Cuiaba. 2015;1(1)1-26.

(19.) Coelho MM. Working conditions and occupational health of urban waste workers [Master's thesis]. Goiania: Pontificia Universidade Catolica de Goias; 2012.

(20.) Carvalho VF, Silva MD, Silva LMS, Borges CJ, Silva LA, Robazzi MLCC. Occupational risks and work accidents: perceptions of garbage collectores. Rev Enfer UFPE On Line. 2016;10(4):1185-93.

(21.) Bleck D, Wettberg W. Waste collection in developing countries: tackling occupational safety and health hazards at their source. Waste Manag. 2012;32(11):20 09-17.

(22.) Jerie S. Occupational risks associated with solid waste management in the informal sector of Gweru, Zimbabwe. J Environ Public Health. 2016;2016:1-14.

(23.) Brazil. Brazilian Ministry of Labor. Regulatory standards [Internet]. Brasilia: MT, 2015 [cited Dec 13, 2016]. Available from: http:// trabalho.gov.br/seguranca-e-saude-no-trabalho/normatizacao/ normas-regulamentadoras

(24.) Reis P. The eSocial and biomechanical and organizational ergonomic risks, including psychosocial risks. Does it have to be this way? [Internet]. Unidade: ASIST, 2015 [cited Nov 30, 2016]. Available from: http://www.sis.com.br/postagem.cfm?post=o-esocial-e-osriscos-ergonomicos-biomecanicos-e-organizacionais- incluindo- os-psicossociais-precisa-ser-assim

(25.) Jorge Duprat Figueiredo Foundation of Medicine and Occupational Health. Biological hazards [Internet]. National Technical Center/ SP. Brasilia: FUNDACENTRO, 2015 [cited Nov 29, 2016]. Available from: http://www.fundacentro.gov.br

(26.) Sousa MNA, Pereira AKL, Lira MS, Pinto KHS, Andrade M. Occupational hazards in urban waste workers. Rev COOPEX. 2015;6(1):1-11.

(27.) MedicineNet. Medical Definition of Helminth [Internet]. San Clemente: MN, 2016 [cited Nov 29, 2016]. Available from: http:// www.medicinenet.com/script/main/art.asp?articlekey=12321

(28.) MedicineNet. Medical definition of protozoa [Internet]. San Clemente: MN, 2016 [cited Nov 29, 2016]. Available from: http:// www.medicinenet.com/script/main/art.asp?articlekey=5091

(29.) Grijo JC, Nunes N. Biological hazards and occupational diseases in urban waste workers [Specialization thesis]. Coronel Fabriciano: Centro Universitario do Leste de Minas Gerais; 2014.

(30.) Pustiglione M, Torres RAT, Sa EC. Doencas causadas por prions and probable occupational nexus. Rev Bras Med Trab. 2014;12(2):96-9.

(31.) Brazil. Brazilian Ministry of Labor. Legislation: Regulatory standard 32 [Internet]. Brasilia: MT, 2015 [cited Dec 13, 2016]. Available from: http://trabalho.gov.br/images/Documentos/SST/NR/NR32.pdf

(32.) Brazil. Brazilian Ministry of Labor. Regulatory standard 9 [Internet]. Brasilia: MT, 2015 [cited Dec 13, 2016]. Available from: http://trabalho. gov.br/images/Documentos/SST/NR/NR09/NR-09-2016.pdf

(33.) Brazil. Brazilian Ministry of Labor. Regulatory standard 17: Ergonomics [Internet]. Brasilia: MT, 2015 [cited Dec 13, 2016]. Available from: http://trabalho.gov.br/images/Documentos/SST/NR/NR17.pdf

Corresponding author: Miguel Henrique Pereira-de-Paiva--Avenida Rio Poti, n. 2.381, Bairro de Fatima--ZIP CODE: 64999-999--Teresina (PI), Brazil E-mail: miguelhppaiva@gmail.com

Miguel Henrique Pereira-de-Paiva [1,3], Maria da Conceicao Calassa-Albuquerque [1], Emily Elizabeth Latham [3], Cleanto Furtado-Bezerra [2], Anderson da-Silva-Sousa [4], Liege Cunha-e-Silva-de-Araujo [1], Mayara Rafaela dos-Reis [1], Rogerio Ferreira-Luz [5]

Project performed at Faculdade Integral Diferencial (FACID)--Teresina (PI), Brazil.

[1] Nursing Department, Faculdade Integral Diferencial (FACID)--Teresina (PI), Brazil,

[2] Nursing Department, Faculdade de Ciencias Humanas, Saude, Exatas e Juridicas de Teresina--Teresina (PI), Brazil,

[3] Nursing Department, Walsh University--North Canton (OH), United States,

[4] Nursing Department, Faculdade de Saude, Ciencias Humanas e Tecnologicas do Piaui--Teresina (PI), Brazil,

[5] Nursing Department, Universidade Estadual do Piaui (UNESPI)--Teresina (PI), Brazil,
Figure 1. Flowchart for the review of papers.

Inclusion         Records identified through      Duplicates excluded
                     electronic and gray                (n = 79)
                      literature search
                           (n = 76)

Eligibility          Titles and abstracts          Records excluded
                           Screened                    (n = 38)
                           (n = 57)

Screening             Full text articles         Records excluded with
                         assessed for              reasons (n = 7):
                     eligibility (n = 19)
                                                  * Literature review
                                                        (n = 2)

                                                * Primary purpose not
                                                  being occupational
                                                    hazards (n = 2)

                                                 * Subjects not being
                                                   legally employed
                                                      solid waste
                                                   workers (n = 3)
Identification         Studies included
                           (n = 12)

Source: adapted from Moher et al., 20098.

Figure 2. Literature evidence for studies on occupational
hazards in waste workers.

Biological hazard     36%
Accident hazard       27%
Chemical hazard       14%
Ergonomic hazard       9%
Physical hazard        9%
Psychosocial hazard    5%

Note: Table made from pie chart.

Chart 1. Results from electronic database and gray
literature search displayed in chronological order.

Author/Year              Method                   Objective
of publication

Database studies

Nunes et al.,            Cross-sectional study    Investigation of
2006 (9)                                          prevalence of
                                                  enteroparasitosis
                                                  among waste
                                                  collectors in
                                                  Patrocinio, MG

Graudenz,                Cross-sectional study    Comparison of health
2009 (10)                                         aggravation due to
                                                  contact with solid
                                                  waste among waste
                                                  professionals in Sao
                                                  Paulo, SP.

Lazzari and Reis,        Cross-sectional study    Identification of
2011 (11)                                         biological hazards
                                                  affecting urban,
                                                  in Dourados, MS.
                                                  solid waste
                                                  professionals

Santos,                  Cross-sectional study    Estimation of
2016 (12)                                         prevalence, infection
                                                  degree, and factors
                                                  associated with
                                                  helminth infections
                                                  in urban garbage
                                                  workers in Parnaiba,
                                                  PI.

Galdino and Malysz,      Cross-sectional study    Identification of
2016 (13)                                         occupational hazards
                                                  in waste workers in
                                                  the municipality of
                                                  Mambore, PR.

                               Gray literature studies

Oliveira and Santos,     Discussion paper         Evaluation of
2008 (14)                                         occupational health
                                                  problems affecting
                                                  solid management
                                                  professionals in
                                                  Hidrolandia, GO.

Silva et al.,            Cross-sectional study    Analysis of work
2009 (15)                                         conditions in waste
                                                  collectors of
                                                  Muzambinho, MG.

Pedrosa et al.,          Cross-sectional study    Identification of the
2010 (16)                                         main occupational
                                                  hazards to which
                                                  solid waste
                                                  collectors are
                                                  exposed in Boa Vista,
                                                  RR.

Pinho and Neves,         Cross-sectional study    Identification of
2010 (17)                                         possible risk factors
                                                  related to the
                                                  occurrence of
                                                  occupational
                                                  accidents in urban
                                                  waste collectors in
                                                  Rio de Janeiro, RJ.

Oliveira et al.,         Cross-sectional study    Identification and
2015 (18)                                         evaluation of
                                                  occupational hazards
                                                  in garbage workers in
                                                  Sinop, MT.

Coelho,                  Cross-sectional study    Identification of
2012 (19)                                         socioeconomic profile
                                                  and working
                                                  conditions, and
                                                  occupational health
                                                  with an emphasis on
                                                  the occurrence of
                                                  dermatosis in waste
                                                  professionals in
                                                  Morrinhos, GO.

Carvalho et al.,         Cross-sectional study    Identification of the
2016 (20)                                         perception of solid
                                                  waste professionals
                                                  of Jatai, GO towards
                                                  occupational hazards
                                                  exposed in the
                                                  workplace to which
                                                  they are

Author/Year              Results
of publication

Database studies

Nunes et al.,            22 individuals participated. Among the 14
2006 (9)                 cases of parasite or commensal infections,
                         78.6% were caused by protozoa, while 21.4%
                         were caused by helminths.

Graudenz,                185 subjects participated. Prevalence
2009 (10)                protozoa infection was 55.9%, sinusitis
                         14.7-37.8%, pneumonia 8.8-22.2%, hepatitis B
                         20%, and leptospirosis 25.7%.

Lazzari and Reis,        42 workers participated. Occupational hazards
2011 (11)                identified were: cuts and perforations with
                         glass, syringes, thorns; bite of dogs; and
                         contact with noxious substances. Such risks
                         diminish with orientation to the population
                         about appropriate waste disposal.

Santos,                  163 participants. Overall prevalence of
2016 (12)                helminth infection was 35.58% being the main:
                         ascaridiasis (25.15%), trichuriasis (7.36%),
                         and hookworm (9.82%).

Galdino and Malysz,      7 individuals involved. Constant exposure to
2016 (13)                biological agents and ergonomic issues
                         reported. Personal Protective Equipment (PPE)
                         showed to be effective in preventing
                         occupational hazards.

                               Gray literature studies

Oliveira and Santos,     16 workers participated. Dermatitis
2008 (14)                prevalence was 6%. Posture, spine, and arm
                         problems were identified. Flu, diarrhea, and
                         acute respiratory infections were also
                         diagnosed. Cuts and perforations were
                         present. Issue related to low adherence to
                         PPE were found.

Silva et al.,            Three out of six individuals interviewed do
2009 (15)                not use PPE. Risks identified through reports
                         were: run over, cuts, and perforations, dog
                         attacks, muscle strains, falling off the
                         truck.

Pedrosa et al.,          96 participants. Evidence of cutting,
2010 (16)                slipping, falling, injury, run over, and
                         contamination from infectious agents.

Pinho and Neves,         36 workers participated. Prevalence of
2010 (17)                trampling of 16%. Main lesions identified:
                         cuts, skin injuries, falls, and constant
                         exposure to biological agents. Contributing
                         factors to increase accidents: non-
                         lack of attention, and absence of PPE.
                         compliance with safety norms and procedures,

Oliveira et al.,         53 individuals participated. Solid waste
2015 (18)                workers exposed to physical, chemical,
                         biological, ergonomic, psychosocial, and
                         accident hazards. Non-compliance with safety
                         standards, lack of attention, and absence of
                         PPE are contributing factors to occupational
                         hazards

Coelho,                  97 workers. 42% of the subjects reported
2012 (19)                having been affected by occupational
                         dermatosis, being the hand the most affected
                         area.

Carvalho et al.,         17 participants. 82.4% suffered some type of
2016 (20)                accident, among which: trampling; fall,
                         fracture, and press in a truck; perforations
                         and cuts; chemical accidents (batteries,
                         oils, leachate, and other household waste);
                         dog attacks. Noncompliance with the use of
                         PPE was identified.

Chart 2. Classification of the main occupational hazards to
which waste workers are exposed according to their nature as
evidenced in the literature.

Physical hazard        Chemical hazard        Biological hazard

Excessive noise,       Dusts, gases,          Viruses, bacteria,
vibration, odor,       vapors, substances,    fungi, and parasites
solar radiation, and   compounds, and         (9,10,12-14,16-20).
rainfall (14,18).      chemicals in
                       general (11,18-20).

Physical hazard        Ergonomic hazard       Accident hazard

Excessive noise,       Intense and            Cuts and
vibration, odor,       repetitive physical    perforation, slips,
solar radiation, and   exertion, inadequate   falls, animal
rainfall (14,18).      posture, and long      attacks, rundown,
                       working hours          press, and
                       (13,14,18)             amputation (11,14-18,20).

Physical hazard        Psychosocial hazard

Excessive noise,       Devaluation at work,
vibration, odor,       lack of training,
solar radiation, and   and disrespect of
rainfall (14,18).      society (18).
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Title Annotation:SYSTEMATIC REVIEWS AND META-ANALYSIS
Author:Pereira-de-Paiva, Miguel Henrique; Calassa-Albuquerque, Maria da Conceicao; Latham, Emily Elizabeth;
Publication:Revista Brasileira de Medicina do Trabalho
Date:Dec 1, 2017
Words:4556
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