Doenças ocupacionais da prática odontológica: implicações na saúde dos cirurgiões-dentistas da Rede Sistema Único de Saúde - SUS

Abstract

INTRODUCTION: Work is a significant factor and of considerable expression in contemporary life, fundamental in social integration, a source of pleasure and personal fulfillment and, paradoxically, it can also be constituted as a source of illness. The diseases produced, acquired or triggered by the exercise of the craft of the worker or due to special working conditions are called occupational diseases. The dentist is exposed to the disease process caused by occupational risks, intrinsic to dental practice, in its physical, chemical, ergonomic, biological and also psychological aspects, which may lead to temporary or permanent absence from work. There is a consensus to include dentistry as an unhealthy profession, subject to numerous occupational risks, high workload, intense pace, high productivity goals, combined with low professional rates, double working hours and expansion of outsourced and precarious employment relationships. In addition, there is, in a public health context, insufficient resources and diminutive working conditions in contrast to the immense dental needs of the community, generators of physical and emotional overload. OBJECTIVE: To analyze the prevalence and distribution of occupational diseases and the main factors associated with work impediment that affect dentists’ health in the municipal system of the Unified Health System-SUS. METHODOLOGY: Cross-sectional study developed in the SUS network of the municipality, consisting of 156 CDs, of which: 72 statutory workers, who have a permanent position in their job and their work relationship is regimented by the Unified Legal Labor regime; and 84 are hired employees, being regimented by the Consolidation of Labor Laws (Social Organization - OS). An intentional sample was used, with 96 (61.50%) dentists participating in the study, of which 72 (100%) were statutory and 24 (28.57%) of hired employees. Two data collection instruments were used: (1) a self-administered questionnaire, to identify the sociodemographic and occupational profile, the self-reported Occupational Diseases by the dentists, characteristic of their work life and the absence resulting from occupational and non-occupational diseases; and (2) indirect survey (secondary data sources), research with the human resources and occupational medicine sectors, for investigation on the number of sick leaves due to the largest occupational diseases groups, according to the International Classification of Diseases and Related Health Problems (CID). The formal leaves of 96 (100%) of the dentists were investigated and 90 (93.75%) dentists answered the questionnaire. RESULTS: It stands out as a profile of the dentists participating in the study, female gender, married marital status, post-graduates (specialists), with the statutory age group being pre-elderly (50 to 59 years old) while the hired employees are in the middle-aged adults category (40-49 years). Both work, concurrently, between the public and private spheres, with a high workload of clinical care practice, between 7 to 9 hours daily. There is a greater dedication of hired employees in the public sphere (8 hours / day) and statutory workers have a greater number of hours dedicated to the private sphere (4 to 5.8 hours / day). The dentist’s work absence corresponds to (n = 868; 59%) for Non-Occupational Diseases (DNO) and (n = 592; 41%) for Occupational Diseases (DO). The group of prevalent occupational diseases responsible for the formal leaves from the dentists is of the Musculoskeletal System and connective tissue (Work-Related Musculoskeletal Disorders), for statutory (n = 263; 47.8%) and hired employees (n = 9; 21.4%). Then, for the statutory workers, the diseases that stand out are from the group of Mental and Behavioral Disorders (n = 79; 14.4%); while for hired workers, Nervous System Diseases were more prevalent (n = 9; 21. 4%). The self-reported Occupational Diseases by statutory and hired dentists, was similar and coincident with the present diseases of formal leaves. However, the perception of hired employees, upon the self-reported diseases, in the face of Mental and Behavioral Disorders and Diseases of the Digestive System, does not reflect a corresponding formal leave, resulting in a significant disproportion between the perception of illness and the formal leave from the hired employees. The absence from work is associated with the employment relationship, with statutory opting for formal registration, while hired employees opt for informal registration, fearing loss of benefits and management demerit. FINAL CONSIDERATIONS: It became evident that the dentists are subject to numerous occupational risks, for confirmation of the prevalence of occupational diseases and overload, in addition to physical, critically, psychological, stands out. The practice of informal leave of absence from hired employees is recurrent, with the opposite behavior occurring for statutory workers, using formal (registered) leaves and consequent legal protection of their work activities. The study corroborates with the diagnosis and the consequent adoption of precise and promotional measures to health and to prevent occupational diseases, necessary for the consolidation of actions in the field of work management, with the intention of avoiding / minimizing occupational risks and increasing worker protection.

KEY WORDS: Occupational Disease; Dentists; Worker's health; Absenteeism, Dental Practice.