Consumo de medicamentos e automedicação entre trabalhadores em turnos fixos: prevalência e fatores associados

Abstract

Studies have shown that some diseases are highly prevalent in shift workers, such as nutritional, metabolic, gastrointestinal, psychological and sleep disorders. In addition, it has been documented a high occurrence of various symptoms among these workers, such as pain, insomnia, sleepiness, heartburn, fatigue, weight gain, weight loss and irritability. Therefore, we hypothesized that shift workers consume more medications than people who work on regular times. The aim of this study was to evaluate the use of medications between workers who work in different shifts. A total of 1,099 shift workers of a Brazilian poultry processing agribusiness who had not been previously reported chronic diseases were included in the study. All volunteers worked 10 hours daily in one of the following shifts: early morning, day, evening and night shift. A questionnaire was used to assess sociodemographic characteristics, medical history and lifestyle habits (patterns of sleep, physical activity and tobacco use). The use of medication - including self-medication was evaluated by self-reported daily habitual use. It was also measured the waist circumference, weight and height, and the body mass index (BMI) was calculated. Of the total, 67% of workers reported to consume any medication every day. The most consumed daily medication classes were: analgesics (45.9%), muscle relaxants (44.2%), hormones (17.3%), antacids (15.3%), non-steroidal anti-inflammatory (8,1% ) and hypnotics (2.6%). The prevalence of self-medication was higher between evening workers (54.8%), followed by early morning (51.9%), night (51.5%) and day workers (34.3%) (p <0.001). Night shift workers had, in relation to workers from other shifts: lower median of total sleep hours (p <0.001), higher frequency of workers with inadequate sleep pattern (p <0.001), higher median of waist circumference (p = 0.004), higher frequency of smokers (p = 0.002) and a higher frequency of sedentary (p = 0.006). Multivariate logistic regression analysis indicated that night shift is positively associated to the use of muscle relaxants (OR = 1.39, 95% CI 1.03-2.07, p = 0.034) and hypnotics (OR = 1.45 , 95% CI 1.55-2.08, p = 0.003); work in the early morning shift is positively associated to the use of muscle relaxants (OR = 1.40, 95% CI 1.02-1.93, p = 0.037), poor sleep pattern is positively associated to the use of muscle relaxants (OR = 1.60, 95% CI 1.59-1.99; p = 0.032) and hypnotics (OR = 1.55, 95% CI 1.56-2.06; p = 0.003); being female is positively associated to the consumption of analgesics (OR = 2.80, 95% CI 2.11-3.73, p = 0.001), muscle relaxants (OR = 1.93, 95% CI 1.44-2,59, p = 0.001), hormones (OR = 4.50, 95% CI 14.01-737.2, p = 0.001) and antacids (OR = 2.58, 95% CI: 1.61-4.12, p = 0.001); and being obese is positively associated to the consumption of muscle relaxants (OR = 1.51, 95% CI 1.07-2.13, p = 0.019). These results demonstrate that shift workers have a high consumption of medications, and the self-medication practice and consumption muscle relaxants, hormones, antacids and hypnotics were dependent on the shift work. These results pointed to the need to carry out intervention programs related to improvement of the health quality and proper use of medications in these workers.