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Concepts and determination of reference values for human biomonitoring of environmental contaminants

KUNO, Rubia; ROQUETTI, Maria Helena; GOUVEIA, Nelson
Fonte: PAN AMER HEALTH ORGANIZATION Publicador: PAN AMER HEALTH ORGANIZATION
Tipo: Artigo de Revista Científica
POR
Relevância na Pesquisa
55.8%
Human biomonitoring (HBM) of environmental contaminants plays an important role in estimating exposure and evaluating risk, and thus it has been increasingly applied in the environmental field. The results of HBM must be compared with reference values ( RV). The term ""reference values"" has always been related to the interpretation of clinical laboratory tests. For physicians, RV indicate ""normal values"" or ""limits of normal""; in turn, toxicologists prefer the terms ""background values"" or ""baseline values"" to refer to the presence of contaminants in biological fluids. This discrepancy leads to the discussion concerning which should be the population selected to determine RV. Whereas clinical chemistry employs an altered health state as the main exclusion criterion to select a reference population ( that is, a ""healthy"" population would be selected), in environmental toxicology the exclusion criterion is the abnormal exposure to xenobiotics. Therefore, the choice of population to determine RV is based on the very purpose of the RV to be determined. The present paper discusses the concepts and methodology used to determine RV for biomarkers of chemical environmental contaminants.

Barriers to interventions aimed at promoting the health of health care workers in Brazil

REINHARDT, Erica Lui; FISCHER, Frida Marina
Fonte: PAN AMER HEALTH ORGANIZATION Publicador: PAN AMER HEALTH ORGANIZATION
Tipo: Artigo de Revista Científica
POR
Relevância na Pesquisa
65.88%
Objective. To search the literature for circumstances that impede injury and disease prevention and other activities intended to improve the health of the health care worker. Methods. The SciELO database was searched for articles published in 1967-2008. This was supplemented by a PubMed search for the period 1950-2008. The following key words were used to identify articles in English, Portuguese, and Spanish: work, health personnel, occupational, risks, diseases, ergonomics, work ability, quality of life, organization, accidents, work conditions, intervention, and administration. Articles on injury and disease prevention and occupational health in a health care setting in Latin America were selected, along with articles focused on health promotion in the health sector. Results. The following shortcomings were identified: activities lacked a sound theoretical foundation and were not integrated with the health services management; a failure to evaluate the effectiveness of the activity; health surveillance focused solely on a specific disease or injury; management not committed to the proposed activity; miscommunication; inability of workers to participate, or control the work environment; and, programs or efforts that were limited to changing the workers` behaviors. Conclusions. The literature shows that all the barriers identified by this study affect both the health care workers` health as well as their productivity.

Riscos ambientais para trabalhadores em uma Unidade Mista de Saúde; Environmental risks to workers at a Mixed Health Unit

Penatti, Juliana Trebi
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 19/10/2012 PT
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66%
Riscos ambientais (RA) podem ser causados por agentes biológicos, químicos, físicos e ergonômicos que, quando presentes nos ambientes de trabalho são capazes de causar danos à saúde do trabalhador em função de sua natureza, intensidade ou tempo de exposição. Especialmente em serviços de saúde, os RA relativos à exposição dos trabalhadores aos diferentes tipos de agentes presentes nesses ambientes, são de grande significado para a saúde ocupacional. O reconhecimento dos RA e a adoção de medidas para a prevenção e minimização desses riscos, devem ser sempre realizados, de forma a envolver tanto as instituições como os próprios trabalhadores, visando maior segurança ocupacional. Esta investigação objetivou avaliar a realidade de exposição a RA em uma Unidade Mista de Saúde (UMS) do interior do estado de São Paulo, a partir da percepção dos seus trabalhadores. Trata-se de uma pesquisa de campo, de caráter descritivo e exploratório, realizada por meio de abordagem quali-quantitativa. A coleta de dados foi feita por meio de entrevista, utilizando um roteiro constituído por perguntas semi-estruturadas e check-list, realizada com dois grupos distintos de sujeitos: um grupo constituído pelos trabalhadores das diferentes áreas de atuação do local selecionado e...

Occupational exposure to aflatoxin (AFB1) in poultry production

Viegas, Susana; Veiga, Luísa; Malta-Vacas, Joana; Sabino, Raquel; Figueiredo, Paula; Almeida, Ana; Viegas, Carla
Fonte: International Congress on Environmental Health Publicador: International Congress on Environmental Health
Tipo: Conferência ou Objeto de Conferência
Publicado em /05/2012 ENG
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55.86%
Aflatoxin B1 (AFB1) has been recognized to cause cancer in the humans liver. Epidemiological and laboratory evidence also point towards the respiratory system as target for carcinogenesis. Exposure occurs mainly through food chain but inhalation represent an additional route of exposure. Agricultural workers have the greatest risk of occupational exposure due to their exposition to airborne aflatoxin through inhalation of dust.

Fungal contamination of poultries litter: a public health problem

Viegas, Carla; Carolino, Elisabete; Malta-Vacas, Joana; Sabino, Raquel; Viegas, Susana; Veríssimo, Cristina
Fonte: International Congress on Environmental Health Publicador: International Congress on Environmental Health
Tipo: Conferência ou Objeto de Conferência
Publicado em /05/2012 ENG
Relevância na Pesquisa
55.79%
Exposure to certain fungi can cause human illness. Fungi cause adverse human health effects through three specific mechanisms: generation of a harmful immune response (e.g., allergy or hypersensitivity pneumonitis); direct infection by the fungal organism; by toxic-irritant effects from mold byproducts, such as mycotoxins. In Portugal there is an increasingly industry of large facilities that produce whole chickens for domestic consumption and only few investigations have reported on fungal contamination of the poultry litter. The material used for poultry litter is varied but normally can be constitute by: pine shavings; sawdust of eucalyptus; other types of wood; peanut; coffee; sugar cane; straw; hay; grass; paper processed. Litter is one of the most contributive factors to fungal contamination in poultries. Spreading litter is one of the tasks that normally involve higher exposure of the poultry workers to dust, fungi and their metabolites, such as VOC’s and mycotoxins. After being used and removed from poultries, litter is ploughed into agricultural soils, being this practice potentially dangerous for the soil environment, as well for both humans and animals. The goal of this study was to characterize litter’s fungal contamination and also to report the incidence of keratinophilic and toxigenic fungi.

Web 3D for Public, Environmental and Occupational Health: Early Examples from Second Life®

Kamel Boulos, Maged N.; Ramloll, Rameshsharma; Jones, Ray; Toth-Cohen, Susan
Fonte: Molecular Diversity Preservation International (MDPI) Publicador: Molecular Diversity Preservation International (MDPI)
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
55.9%
Over the past three years (2006–2008), the medical/health and public health communities have shown a growing interest in using online 3D virtual worlds like Second Life® (http://secondlife.com/) for health education, community outreach, training and simulations purposes. 3D virtual worlds are seen as the precursors of ‘Web 3D’, the next major iteration of the Internet that will follow in the coming years. This paper provides a tour of several flagship Web 3D experiences in Second Life®, including Play2Train Islands (emergency preparedness training), the US Centers for Disease Control and Prevention—CDC Island (public health), Karuna Island (AIDS support and information), Tox Town at Virtual NLM Island (US National Library of Medicine - environmental health), and Jefferson’s Occupational Therapy Center. We also discuss the potential and future of Web 3D. These are still early days of 3D virtual worlds, and there are still many more untapped potentials and affordances of 3D virtual worlds that are yet to be explored, as the technology matures further and improves over the coming months and years.

Use of the Global Test Statistic as a Performance Measurement in a Reananlysis of Environmental Health Data

Dymova, Natalya; Hanumara, R. Choudary; Enander, Richard T.; Gagnon, Ronald N.
Fonte: American Public Health Association Publicador: American Public Health Association
Tipo: Artigo de Revista Científica
Publicado em /10/2009 EN
Relevância na Pesquisa
55.81%
Performance measurement is increasingly viewed as an essential component of environmental and public health protection programs. In characterizing program performance over time, investigators often observe multiple changes resulting from a single intervention across a range of categories. Although a variety of statistical tools allow evaluation of data one variable at a time, the global test statistic is uniquely suited for analyses of categories or groups of interrelated variables. Here we demonstrate how the global test statistic can be applied to environmental and occupational health data for the purpose of making overall statements on the success of targeted intervention strategies.

Occupational Health, Mercury Exposure, and Environmental Justice: Learning From Experiences in Tanzania

Spiegel, Samuel J.
Fonte: American Public Health Association Publicador: American Public Health Association
Tipo: Artigo de Revista Científica
Publicado em /11/2009 EN
Relevância na Pesquisa
65.97%
Mercury is a potent neurotoxin that is used by poverty-driven miners to extract gold in more than 50 countries. This article examines efforts of the United Nations to address occupational health and environmental justice amid these challenges, focusing on a 3-year campaign in one of the fastest-growing mining communities in Tanzania. By providing an integrative analysis of environmental health risks, labor practices, public health policies, and drivers of social inequity and marginalization, this study highlights the need for interdisciplinary public health approaches that support community development by strengthening local capacities. It illustrates why, to ensure that the needs of vulnerable populations are met, environmental justice and public health paradigms have to expand beyond the conventionally narrow attention paid to toxic exposure and emissions issues.

The Boston Safe Shops Model: An Integrated Approach to Community Environmental and Occupational Health

Roelofs, Cora; Shoemaker, Paul; Skogstrom, Tiffany; Acevedo, Persio; Kendrick, Jumaane; Nguyen, Nancie
Fonte: American Public Health Association Publicador: American Public Health Association
Tipo: Artigo de Revista Científica
Publicado em /04/2010 EN
Relevância na Pesquisa
75.97%
Small, immigrant-owned businesses, such as auto repair shops and nail salons, often face barriers to environmental and occupational health compliance and may be a source of neighborhood pollution complaints. The Boston Public Health Commission established the Safe Shops Project to improve safety and environmental practices in such businesses using a community partnership model that incorporates enforcement inspection findings, worker training, technical assistance, and referral to health care and business resources. This integrated technical assistance approach has led to improved occupational health and environmental conditions, adoption of pollution prevention technologies, novel problem-solving, and dozens of health screenings and insurance referrals for workers and their neighbors.

Quantification of Shared Air: A Social and Environmental Determinant of Airborne Disease Transmission

Wood, Robin; Morrow, Carl; Ginsberg, Samuel; Piccoli, Elizabeth; Kalil, Darryl; Sassi, Angelina; Walensky, Rochelle P.; Andrews, Jason R.
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
EN_US
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55.79%
Background: Tuberculosis is endemic in Cape Town, South Africa where a majority of the population become tuberculosis infected before adulthood. While social contact patterns impacting tuberculosis and other respiratory disease spread have been studied, the environmental determinants driving airborne transmission have not been quantified. Methods: Indoor carbon dioxide levels above outdoor levels reflect the balance of exhaled breath by room occupants and ventilation. We developed a portable monitor to continuously sample carbon dioxide levels, which were combined with social contact diary records to estimate daily rebreathed litres. A pilot study established the practicality of monitor use up to 48-hours. We then estimated the daily volumes of air rebreathed by adolescents living in a crowded township. Results: One hundred eight daily records were obtained from 63 adolescents aged between 12- and 20-years. Forty-five lived in wooden shacks and 18 in brick-built homes with a median household of 4 members (range 2–9). Mean daily volume of rebreathed air was 120.6 (standard error: 8.0) litres/day, with location contributions from household (48%), school (44%), visited households (4%), transport (0.5%) and other locations (3.4%). Independent predictors of daily rebreathed volumes included household type (p = 0.002)...

Environmental and Occupational Health Protection Laws

Ashford, Nicholas; Caldart, Charles
Fonte: MIT - Massachusetts Institute of Technology Publicador: MIT - Massachusetts Institute of Technology
Tipo: Artigo de Revista Científica
EN_US
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66.03%
The manufacturing, processing, and use of chemicals and materials in industrial workplaces are often accompanied by environmental, health, and safety hazards and risks. Occupational and environmental factors cause or exacerbate major diseases of the respiratory, cardiovascular, reproductive, and nervous systems and cause systemic poisoning and some cancers and birth defects. Occupational and environmental disease and injury place heavy economic and social burdens on workers, employers, citizens, and taxpayers. Government intervention to address those issues largely takes the form of regulatory standards promulgated under the authority of federal legislation. This article addresses the major regulatory systems (or regimes) designed to protect public and worker health from chemicals discharged from sources that pollute the air, water, ground, and/or workplace in the United States. The European Union and other developed countries use similar approaches.; Clean Air Act; Clean Water Act; Comprehensive Environmental Response, Compensation, and Liability Act; Environmental health; Environmental legislation; Hazardous waste; Occupational heath; Occupational safety; Occupational Safety and Health Act; Pollution; Resource Conservation and Recovery Act; Safe Drinking Water Act; Toxic substances; Toxic Substances Control Act; Worker health and safety

Le Programme Hors Normes en santé au travail : représentations d’infirmières du secteur public

Moretti, Sandra
Fonte: Université de Montréal Publicador: Université de Montréal
Tipo: Thèse ou Mémoire numérique / Electronic Thesis or Dissertation
FR
Relevância na Pesquisa
55.9%
Depuis 2006, le Programme Hors Normes (PHN) dicte une nouvelle marche à suivre que doivent privilégier les équipes de santé au travail (SAT) lorsque des travailleurs sont exposés à des concentrations environnementales de produits chimiques supérieures aux valeurs d’exposition admissibles, c’est-à-dire à des « hors normes ». Le PHN encadre les activités de signalements des hors normes aux instances concernées et demande des suivis plus rigoureux en établissements. Ce faisant, il redéfinit les rôles des infirmières et des membres des équipes SAT. Dans le but de mieux comprendre l’implication des infirmières dans le cadre du PHN, sept entretiens individuels semi-dirigés ont été réalisés afin d’explorer et de décrire leurs représentations. L’analyse qualitative de ces représentations, par catégorisation et comparaisons constantes des discours, révèle que les infirmières se représentent de diverses façons leur pratique dans le cadre du PHN. En effet, les résultats de l’étude montrent qu’afin de comprendre l’implication des infirmières dans ce programme d’intervention, il importe de considérer les quatre éléments suivants : l’organisation du travail, les aspects relationnels (dynamique de relations)...

Cotton, health and environment: a case study of self-regulation

Gunningham, Neil
Fonte: Universidade Nacional da Austrália Publicador: Universidade Nacional da Austrália
Tipo: Working/Technical Paper Formato: 413181 bytes; 374 bytes; application/pdf; application/octet-stream
EN_AU
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55.93%
The Australian cotton industry confronts a range of serious occupational health and environmental challenges, many of which relate to the use and misuse of agricultural chemicals. This article asks which policy instruments are likely to be most effective and efficient in addressing those challenges? Is government regulation a credible option or would industry self-regulation achieve better results? Is there a role for safety. Health and environmental management systems or is some other option, or combination of options, likely to achieve better economic and health and environmental outcomes? More broadly, given the substantial threats to the cotton industry's legitimacy (and indirectly to its economic viability) resulting from its tarnished environmental image, how might the industry best preserve its 'social license' and rebuild trust and credibility with key stakeholders? The answers to these questions will have broader resonance than to the cotton industry alone. The industry provides a classic example of the health and environmental challenges that confront high input, intensively irrigated agriculture and other industries that have aroused a high degree of public concern concerning their health and environmental impact. The ways it has reacted to the pressures it faced and sought through voluntary environmental management arrangements (VEMAs)...

Analyse d’implantation d’un système de gestion intégrée en environnement et en santé et sécurité du travail

Savary, Saôde
Fonte: Université de Montréal Publicador: Université de Montréal
Tipo: Thèse ou Mémoire numérique / Electronic Thesis or Dissertation
FR
Relevância na Pesquisa
56.07%
Les systèmes de gestion intégrée en environnement et en santé et sécurité du travail (SGI) sont un nouveau paradigme de gestion dans les organisations modernes. Ces systèmes sont construits à partir des normes ISO 14001 et d’OHSAS 18001, basées sur la prévention des risques et le principe de précaution. La littérature sur les SGI témoigne d’un marasme conceptuel prédominant depuis plus de 10 ans; elle insiste sur l’urgence d’un consensus taxinomique et conceptuel afin de définir les systèmes de gestion intégrée et de différencier le mécanisme d’intégration de celui de l’implantation. Cette lacune conceptuelle enlise les connaissances dans un fossé épistémologique, retardant ainsi le débat dans ce nouveau champ d’études. Les rares connaissances dont nous disposons dans ce domaine proviennent de quelques études théoriques et de six études empiriques, toutes préoccupées par la compatibilité des multiples systèmes et des avantages économiques de leur intégration. Les évidences engendrées par ces études sont insuffisantes pour appréhender la dynamique du nouveau paradigme dont les effets demeurent peu connus. Cette situation révèle l’urgence d’agir dans un contexte où l’utilisation des SGI se multiplie...

Reconstrução de coortes : metodos, tecnicas e interfaces com a vigilancia em saude do trabalhador; Reconstruction of cohorts : methods, techniques and interfaces with workers' health surveillance

Marcos Oliveira Sabino
Fonte: Biblioteca Digital da Unicamp Publicador: Biblioteca Digital da Unicamp
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 16/02/2009 PT
Relevância na Pesquisa
56%
O reconhecimento das condições de produção e dos ambientes e processos de trabalho, e suas repercussões sobre a saude e vida dos trabalhadores e populações potencialmente afetadas representa elemento fundamental para as politicas de saúde publica, meio ambiente e sustentabilidade. Estudos de coortes ocupacionais podem contribuir para tal objetivo. O presente estudo buscou reconhecer a logistica de estrategias, metodos, tecnicas e elementos significativos para a recuperacao de dados e informações necessarias a reconstrução de coortes ocupacionais no contexto brasileiro. Realizou-se uma revisao sistematica da literatura sobre reconstrução de coortes ocupacionais nacionais e estudo do caso Shell-Cyanamid-Basf, ocorrido em Paulinia/SP. Foram identificados e explorados desafios metodologicos, as principais variaveis, dados e informações relacionadas, os atores sociais e sua atuação, concluindo-se pela indicação de acoes sistematizadas e de estrategias combinadas de busca, e pelo reconhecimento da importancia do protagonismo dos trabalhadores nas varias etapas do processo de reconstrução das coortes ocupacionais como ações fundamentais e qualificadoras desses estudos e dos processos de atenção e vigilância a saude dos trabalhadores; The establishment of Public Policies towards Public and Environmental Health and Sustainability depends fundamentally on the recognition of how the means of production and the work processes impact over life and health of workers and the general population. Studies of occupational cohorts may contribute to such objectives. The present study aimed at recognizing the logistics of strategies...

Exploratory Study on Occupational Health Exposure to Chemical Agents, in a Public Hospital in Valencia, Venezuela. Preliminar Assessment; Condiciones de exposición ocupacional a agentes químicos en un hospital público de Valencia, Venezuela. Evaluación preliminar

Rojas, Maritza; Rivero, Exila; Espino, Carlos
Fonte: Universidade do Rosário Publicador: Universidade do Rosário
Tipo: Artigo de Revista Científica Formato: application/pdf
Publicado em 18/05/2010 SPA
Relevância na Pesquisa
55.84%
Descriptive study that identified chemical agents (AQ) use and training on risk management and waste disposal techniques in a public Hospital in Valencia. A questionnaire was answered by 48 workers. Information obtained was: personal data, occupational history, AQ used; knowledge of risk management and waste disposal. There were 16 occupations from 12 “High Risk” areas. “Adult emergency” was the one with more workers (11 individuals), followed by “sterilization” and “clinical laboratory” (7 each) and oncology (5). The remained areas had less than 8.3% workers. The most used anesthetic agents were: Halothane, Enfluorane and Isofluorane 4.17% each and main antineoplastics used were: Doxorubicin 16.67% and Paclitaxel, 5-Fluoracil and Etoposide, 8.33% each. The most mentioned substances were: alcohol (70.8%) and Chlorine (64.6%). None of the answers regarding knowledge of AQ’ risk management and waste disposal was satisfactory. Statistical associations between training and several variables such as age, time in their job and being or not a professional, resulted non-significant. The correlation between training and the knowledge of AQ’s management was significant (p < 0.001). Participants showed that their knowledge about chemical occupational risk factors they are exposed to is still insufficient. Therefore...

Partnerships for Environmental and Occupational Justice: Contributions to Research, Capacity and Public Health

Baron, Sherry; Sinclair, Raymond; Payne-Sturges, Devon; Phelps, Jerry; Zenick, Harold; Collman, Gwen W.; O'Fallon, Liam R.
Fonte: American Public Health Association Publicador: American Public Health Association
Tipo: Artigo de Revista Científica
Publicado em /11/2009 EN
Relevância na Pesquisa
65.98%
In 1994, the National Institute of Environmental Health Sciences (NIEHS) initiated a program to address communication gaps between community residents, researchers and health care providers in the context of disproportionate environmental exposures. Over 13 years, together with the Environmental Protection Agency and National Institute for Occupational Health and Safety, NIEHS funded 54 environmental justice projects. Here we examine the methods used and outcomes produced based on data gathered from summaries submitted for annual grantees' meetings. Data highlight how projects fulfilled program objectives of improving community awareness and capacity and the positive public health and public policy outcomes achieved. Our findings underscore the importance of community participation in developing effective, culturally sensitive interventions and emphasize the importance of systematic program planning and evaluation.

Bibliometric analysis of regional Latin America's scientific output in Public Health through SCImago Journal & Country Rank

Zacca-Gonz??lez, Grisel; Chinchilla-Rodr??guez, Zaida; Vargas-Quesada, Benjam??n; Moya Aneg??n, F??lix de
Fonte: Biomed Central Publicador: Biomed Central
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
55.8%
Background: In the greater framework of the essential functions of Public Health, our focus is on a systematic, objective, external evaluation of Latin American scientific output, to compare its publications in the area of Public Health with those of other major geographic zones. We aim to describe the regional distribution of output in Public Health, and the level of visibility and specialization, for Latin America; it can then be characterized and compared in the international context. Methods: The primary source of information was the Scopus database, using the category ???Public Health, Environmental and Occupational Health???, in the period 1996???2011. Data were obtained through the portal of SCImago Journal and Country Rank. Using a set of qualitative (citation-based), quantitative (document recount) and collaborative (authors from more than one country) indicators, we derived complementary data. The methodology serves as an analytical tool for researchers and scientific policy-makers. Results: The contribution of Latin America to the arsenal of world science lies more or less midway on the international scale in terms of its output and visibility. Revealed as its greatest strengths are the high level of specialization in Public Health and the sustained growth of output. The main limitations identified were a relative decrease in collaboration and low visibility. Conclusions: Collaboration is a key factor behind the development of scientific activity in Latin America. Although this finding can be useful for formulating research policy in Latin American countries...

Environmental lead exposure: a public health problem of global dimensions

Tong,Shilu; Schirnding,Yasmin E. von; Prapamontol,Tippawan
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2000 EN
Relevância na Pesquisa
55.95%
Lead is the most abundant of the heavy metals in the Earth’s crust. It has been used since prehistoric times, and has become widely distributed and mobilized in the environment. Exposure to and uptake of this non-essential element have consequently increased. Both occupational and environmental exposures to lead remain a serious problem in many developing and industrializing countries, as well as in some developed countries. In most developed countries, however, introduction of lead into the human environment has decreased in recent years, largely due to public health campaigns and a decline in its commercial usage, particularly in petrol. Acute lead poisoning has become rare in such countries, but chronic exposure to low levels of the metal is still a public health issue, especially among some minorities and socioeconomically disadvantaged groups. In developing countries, awareness of the public health impact of exposure to lead is growing but relatively few of these countries have introduced policies and regulations for significantly combating the problem. This article reviews the nature and importance of environmental exposure to lead in developing and developed countries, outlining past actions, and indicating requirements for future policy responses and interventions.

Globalization and occupational health: a perspective from southern Africa

Loewenson,Rene
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2001 EN
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75.89%
Increased world trade has generally benefited industrialized or strong economies and marginalized those that are weak. This paper examines the impact of globalization on employment trends and occupational health, drawing on examples from southern Africa. While the share of world trade to the world's poorest countries has decreased, workers in these countries increasingly find themselves in insecure, poor-quality jobs, sometimes involving technologies which are obsolete or banned in industrialized countries. The occupational illness which results is generally less visible and not adequately recognized as a problem in low-income countries. Those outside the workplace can also be affected through, for example, work-related environmental pollution and poor living conditions. In order to reduce the adverse effects of global trade reforms on occupational health, stronger social protection measures must be built into production and trade activities, including improved recognition, prevention, and management of work-related ill-health. Furthermore, the success of production and trade systems should be judged on how well they satisfy both economic growth and population health.