Dermatological evaluation of community health agents subjected to sun exposure in a Brazilian tropical region
DOI:
https://doi.org/10.15448/1980-6108.2016.4.23897Keywords:
occupational health, dermatology, sunscreening agents, family practice.Abstract
Aims: To investigate skin lesions associated with or aggravated by sun exposure in community health workers in two municipalities in the metropolitan region of Belém, State of Pará, Brazil, relating the lesions to some sociodemographic variables, and to assess the use of sun protection.
Methods: A cross-sectional study was carried out with 11 Family Health Centers in Belém and Ananindeua selected by non-probabilistic convenience sampling. All workers answered a questionnaire and were clinically examined for the presence of skin lesions caused by sun exposure, in addition to having sun exposure variables and their sociodemographic profile assessed. The data were analyzed by the chi-square test, Fisher’s exact test with Yates’ correction, and Student’s t test. A p value ≤ 0.05 was considered to be statistically significant.
Results: A total of 83 workers were assessed, most of whom were female (75.9%), aged between 30 and 40 years (44.6%), single (47%), with completed high school education (69.8%), and family income between 1 and 2 minimum wages (67.5%), working in the profession for over 10 years (48.2%). Among the respondents, 83% reported daily sun exposure in their working activity, 47% were exposed for more than four hours, and 73.5% were exposed to the sun at the most critical time (between 10 and 4 o’clock). 56.6% used some kind of protection against sun exposure, and 27.7% reported using sunscreen on a daily basis. The dermatologic evaluation also revealed that 97.6% of workers had many skin lesions caused by sun exposure. Melanosis was the most common diagnosis.
Conclusions: Skin lesions were frequent among community health workers and sun exposure during working hours appears to have played a remarkable role. Workers showed difficulty adopting protective behaviors. Occupational health policies and actions targeted at the prevention of aggravating factors among community health workers should be encouraged.
Downloads
References
Baptistini RA, Figueiredo TAM. Agente comunitário de saúde: desafios do trabalho na zona rural. Ambient Soc. 2014;17(2):53-70. http://dx.doi.org/10.1590/S1414-753X2014000200005
Bezerra AFB, Espírito Santo ACG, Batista Filho M. Concepções e práticas do agente comunitário na atenção à saúde do idoso. Rev Saúde Pública. 2005;39(5):809-15. http://dx.doi.org/10.1590/S0034-89102005000500017
Lima AG, Silva AMM, Soares CEC, Souza RAX, Souza MCMR. Fotoexposição solar e fotoproteção de agentes de saúde em município de Minas Gerais. Rev Eletr Enf. 2010;12(3):478-82. http://dx.doi.org/10.5216/ree.v12i3.6156
Sampaio SAP, Rivitti EA. Dermatologia. 3ª ed. São Paulo: Artes Médicas; 2008.
Fitzpatrick TB. The validity and practicality of sun-reactive skin types I through VI. Arch Dermatol. 1988;124(6):869-71. http://dx.doi.org/10.1001/archderm.1988.01670060015008
Nunes MO, Trad LB, Almeida BA, Homem CR, Melo MCIC. O agente comunitário de saúde: construção da identidade desse personagem híbrido e polifônico. Cad Saúde Pública. 2002;18(6):1639-46. http://dx.doi.org/10.1590/S0102-311X2002000600018
Vilela RAG, Silva RC, Jackson Filho JM. Poder de agir e sofrimento: estudo de caso sobre Agentes Comunitários de Saúde. Rev Bras Saúde Ocup. 2010;35(122):289-302. http://dx.doi.org/10.1590/S0303-76572010000200011
Santos KT, Saliba NA, Moimaz SAS, Arcieri RM, Carvalho ML. Agente comunitário de saúde: perfil adequado a realidade do Programa Saúde da Família?. Ciênc Saúde Coletiva. 2011;16 Suppl 1:1023-8. http://dx.doi.org/10.1590/S1413-81232011000700035
Barcellos CSN, Pandolfi M, Miotto MHMB. Perfil do Agente Comunitário de Saúde (ACS) de Vitória-ES. UFES Rev Odontol. 2006:8(1):21-8.
Ferraz L, Aerts DRGC. O cotidiano de trabalho do agente comunitário de saúde no PSF em Porto Alegre. Ciênc Saúde Coletiva. 2005;10(2):347-55. http://dx.doi.org/10.1590/S1413-81232005000200012
Fartasch M, Diepgen TL, Schmitt J, Drexler H. The relationship between occupational sun exposure and non-melanoma skin cancer: clinical basics, epidemiology, occupational disease evaluation, and prevention. Dtsch Arztebl Int. 2012 Oct;109(43):715-20.
Schmitt J, Seidler A, Diepgen TL, Bauer A. Occupational ultraviolet light exposure increases the risk for the development of cutaneous squamous cell carcinoma: a systematic review and meta-analysis. Br J Dermatol. 2011;164(2):291-307. http://dx.doi.org/10.1111/j.1365-2133.2010.10118.x
Diepgen TL, Fartasch M, Drexler H, Schmitt J. Occupational skin cancer induced by ultraviolet radiation and its prevention. Br J Dermatol. 2012;167 Suppl 2:76-84. http://dx.doi.org/10.1111/j.1365-2133.2012.11090.x
Flor J, Davolos MR, Correa MA. Protetores solares. Quím Nova. 2007;30(1):153-8. http://dx.doi.org/10.1590/S0100-40422007000100027
Scarlett WL. Ultraviolet radiation: sun exposure, tanning beds, and vitamin D levels. What you need to know and how to decrease the risk of skin cancer. J Am Osteopath Assoc. 2003;103(8):371-5.
Popim RC, Corrente JE, Marino JAG, Souza CA. Câncer de pele: uso de medidas preventivas e perfil demográfico de um grupo de risco na cidade de Botucatu. Ciênc Saúde Coletiva. 2008;13(4):1331-6. http://dx.doi.org/10.1590/S1413-81232008000400030
Cheng S, Lian S, Hao Y, Kang N, Li S, Nie Y, Zhang F. Sun-exposure knowledge and protection behavior in a North Chinese population: a questionnaire-based study. Photodermatol Photoimmunol Photomed. 2010 Aug;26(4):177-81. http://dx.doi.org/10.1111/j.1600-0781.2010.00513.x
Bardini G, Lourenço D, Fissmer MC. Avaliação do conhecimento e hábitos de pacientes dermatológicos em relação ao câncer de pele. Arq Catarin Med. 2012;41:56-63.
Sánchez G, Nova J, Rodriguez-Hernandez AE, Medina RD, Solorzano-Restrepo C, Gonzalez J, Olmos M, Godfrey K, Arevalo-Rodriguez I. Sun protection for preventing basal cell and squamous cell skin cancers. Cochrane Database Syst Rev. 2016 Jul 25;7:CD011161. http://dx.doi.org/10.1002/14651858.cd011161.pub2
Sittart JAS, Zanardi FHT. Prevalência das dermatoses em pacientes da 4ª idade. Rev Soc Bras Clin Med. 2008;6(4):125-9.
Dinato SLM, Oliva R, Dinato MM, Macedo-Soares A, Bernardo WM. Prevalência de dermatoses em idosos residentes em instituição de longa permanência. Rev Ass Med Bras. 2008;54(6):543-7. http://dx.doi.org/10.1590/S0104-42302008000600020
Bezerra SMFMC, Sotto MN, Orii NM, Alves C, Duarte AJS. Efeitos da radiação solar crônica prolongada sobre o sistema imunológico de pescadores profissionais em Recife (PE), Brasil. An Bras Dermatol. 2011;86(2):222-33. http://dx.doi.org/10.1590/S0365-05962011000200004
Miot LDB, Miot HA, Silva MG, Marques MEA. Fisiopatologia do melasma. An Bras Dermatol. 2009;84(6):623-35. http://dx.doi.org/10.1590/S0365-05962009000600008
Ritter CG. Melasma extra-facial: avaliação clínica, histopatológica e imuno-histoquímica em estudo caso-controle [dissertation]. [Porto Alegre]: Faculdade de Medicina, Universidade Federal do Rio Grande do Sul; 2011. 83 p.
Pichardo R, Vallejos Q, Feldman SR, Schulz MR, Verma A, Quandt SA, Arcury TA. The prevalence of melasma and its association with quality of life in adult male Latino migrant workers. Int J Dermatol. 2009;48(1):22-6.http://dx.doi.org/10.1111/j.1365-4632.2009.03778.x
Downloads
Published
How to Cite
Issue
Section
License
Copyright
The submission of originals to Scientia Medica implies the transfer by the authors of the right for publication. Authors retain copyright and grant the journal right of first publication. If the authors wish to include the same data into another publication, they must cite Scientia Medica as the site of original publication.
Creative Commons License
Except where otherwise specified, material published in this journal is licensed under a Creative Commons Attribution 4.0 International license, which allows unrestricted use, distribution and reproduction in any medium, provided the original publication is correctly cited.
