Este estudio tiene como objetivo evaluar la prevalencia del dolor cervical y los factores asociados entre agricultores que producen tabaco. Se realizó un estudio transversal en el que participaron 2.469 agricultores que producen tabaco en el sur de Brasil. Para la caracterización del dolor cervical se utilizó una adaptación del cuestionario nórdico para síntomas musculoesqueléticos. El análisis multivariante se realizó mediante la regresión de Poisson, siguiendo un modelo teórico jerárquico. La prevalencia del dolor cervical en el año previo entre la población estudiada fue del 7,4%. Las variables que se asociaron con el dolor cervical entre las mujeres trabajadoras fueron la edad, el consumo de tabaco, el enfardado del tabaco, el uso de motosierras pesadas, trabajar en un ritmo intenso o acelerado y la enfermedad del tabaco verde, mientras que, entre los varones, fueron la edad, el uso de motosierras pesadas, el trabajo sentado en el suelo, la intoxicación por plaguicidas y la enfermedad del tabaco verde. El estudio refuerza la importancia de las cargas de trabajo ergonómicas y fisiológicas en la determinación del dolor cervical. Se necesitan estudios futuros para comprender el papel de la exposición a los plaguicidas y a la nicotina en los problemas musculoesqueléticos. La mecanización de la cosecha del tabaco podría reducir la exposición ergonómica y química, mejorando así la salud de los agricultores.
Palabras clave: Dolor Cervical, Salud Laboral, Agricultura, Tabaco, Salud Rural, Brasil
1. Anuário Brasileiro do Tabaco. Santa Cruz do Sul: Editora Gazeta Santa Cruz; 2018.
2. Pinzke S. Comparison of working conditions and prevalence of musculoskeletal symptoms among dairy farmers in Southern Sweden over a 25-year period. Front. Public Health. 2016;4:1-12.
3. Milosavljevic S, Bagheri N, Vasiljev RM, Mcbride DI, Rehn B. Does daily exposure to whole-body vibration and mechanical shock relate to the prevalence of low back and neck pain in a rural workforce? Annals of Occupational Hygiene. 2012;56(1):10-17.
4. Jonsson BG, Persson J, Kilbom Å. Disorders of the cervicobrachial region among female workers in the electronics industry: A two-year follow up. International Journal of Industrial Ergonomic. 1988;3:1-12.
5. Nachemson AL, Jonsson E, (ed.). Neck and back pain: The scientific evidence of causes, diagnosis, and treatment. Philadelphia: Lippincott Williams & Wilkins; 2000.
6. Ohlsson K, Attewell RG, Pålsson B, Karlsson B, Balogh I, Johnsson B, Ahlm A, Skerfving S. Repetitive industrial work and neck and upper limb disorders in females. American Journal of Industrial Medicine. 1995;27(5):731-747.
7. Banibrata D. Gender differences in prevalence of musculoskeletal disorders among the rice farmers of West Bengal, India. Work. 2015;50(2):229-240.
8. Riquinho DL, Hennington EA. Sistema integrado de produção do tabaco: saúde, trabalho e condições de vida de trabalhadores rurais no Sul do Brasil. Cadernos de Saúde Pública. 2016;32(12):e00072415.
9. Heemann F. O cultivo do fumo e condições de saúde e segurança dos trabalhadores rurais. [Dissertation of Master in Engenharia de Produção]. Porto Alegre: Universidade Federal do Rio Grande do Sul; 2009.
10. Fassa AG, Faria NMX, Meucci RD, Fiori NS, Miranda VI, Facchini LA. Green tobacco sickness among tobacco farmers in southern Brazil. American Journal of Industrial Medicine. 2014;57:726-735.
11. Mota e Silva MS, Carvalho MGC, Moreira JC, Barreto EO, Farias KF, Nascimento CA, Silva FMN, Andrade TG, Luiz RR, Moura Neto RS, Ribeiro FL. Green tobacco sickness among Brazilian farm workers and genetic polymorphisms. BMC Research Notes. 2018;11(20):2-5.
12. Instituto Brasileiro de Geografia e Estatística. Pesquisa Nacional por Amostra de Domicilios: síntese de indicadores 2009 [Internet]. 2010 [citado 11 feb 2019]. Disponible en: https://tinyurl.com/y9dto984
13. Barbosa Filho FH, Pessôa SA. Pessoal ocupado e jornada de trabalho: uma releitura da evolução da produtividade no Brasil. Revista Brasileira de Economia. 2014;68(2):149-169.
14. Faria NM, Rosa JA, Facchini LA. Poisoning by pesticides among family fruit farmers, Bento Gonçalves, Southern Brazil. Revista de Saúde Pública. 2009;43(2):335-344.
15. Arcury TA, Vallejos QM, Schulz MR, Feldman SR, Fleischer Jr AB, Verma A, Quandt SA. Green tobacco sickness and skin integrity among migrant Latino farmworkers. American Journal of Industrial Medicine. 2008;51(3):195-203.
16. Kuorinka I, Jonsson B, Kilbom A, Vinterberg H, Biering-Sørensen F, Andersson G, Jørgensen K. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Applied Ergonomics. 1987;18(3):233-237.
17. Pinheiro FA, Trócolli BT, Carvalho CV. Validação do Questionário Nórdico de Sintomas Osteomusculares como medida de morbidade. Revista de Saúde Pública. 2002;36(3):307-312.
18. Meucci RD, Fassa AG, Paniz VM, Silva MC, Wegman DH. Increase of chronic low back pain prevalence in a medium-sized city of southern Brazil. BMC Musculoskeletal Disorders. 2013;14:155.
19. Carvalho MP, Schmidt LG, Soares MCF. Musculoskeletal disorders and their influence on the quality of life of the dockworker: a cross-sectional study. Work. 2016;53(4):805-812.
20. Victora CG, Huttly SR, Fuchs SC, Olinto MT. The role of conceptual frameworks in epidemiological analysis: a hierarchical approach. International Journal of Epidemiology. 1997;26(1):224-227.
21. Jo H, Baek S, Park HW, Lee SA, Moon J, Yang JE, Kim KS, Kim JY, Kang EK. Farmers’ cohort for agricultural work-related musculoskeletal disorders (FARM) study: study design, methods, and baseline characteristics of enrolled subjects. Journal of Epidemiology. 2016;26(1):50-56.
22. Xiao H, McCurdy SA, Stoecklin-Marois MT, Li CS, Schenker MB. Agricultural work and chronic musculoskeletal pain among latino farm workers: The MICASA study. American Journal of Industrial Medicine. 2013;56:216-225.
23. Lima RG. Desenvolvimento e relações de trabalho na fumicultura sul-brasileira. Sociologias. 2007;9(18):190-225.
24. Brandth B, Haugen MS. Rural Masculinity. In: Shucksmith M, Brown DL, (eds.). Routledge International Handbook of Rural Studies. London: Routledge; 2016. p. 412-423.
25. Cush P, Macken-Walsh A. Reconstituting male identities through joint farming ventures in Ireland. Sociologia Ruralis. 2018;58(4):726-744.
26. Picavet HSJ, Schouten JSAG. Musculoskeletal pain in the Netherlands: prevalences, consequences and risk groups, the DMC3-study. Pain. 2003;102(1-2):167-178.
27. Leroux I, Dionne CE, Bourbonnais R, Brisson C. Prevalence of musculoskeletal pain and associated factors in the Quebec work population. International Archives of Occupational and Environmental Health. 2005;78(5):379-386.
28. Fillingim RB, Edwards RR, Powell T. Sex-dependent effects of reported familial pain history on recent pain complaints and experimental pain responses. Pain. 2000;86(1-2):87-94.
29. Bernard BP. Musculoskeletal disorders and workplace factors: A critical review of epidemiological evidence for work-related musculoskeletal disorders of the neck, upper extremity, and low back pain. Cincinnati: NIOSH publication; 1997.
30. Silva A, Mattiello SM, Oliveira e Silva L, Walsh IAP. O trabalho e as LER/DORT. In: Melo MT. Trabalhador em turno: fadiga. São Paulo: Atheneu; 2013. p 41-50.
31. Tynes T, Aagestad C, Thorsen SV, Andersen LL, Perkio-Makela M, Pinilla García FJ, Blanco LG, Vermeylen G, Parent-Thirion A, Hooftman W, Houtman I, Liebers F, Burr H, Formazin M. Physical working conditions as covered in European monitoring questionnaires. BMC Public Health. 2017;17:544.
32. Mayer J, Kraus T, Ochsmann E. Longitudinal evidence for the association between work-related physical exposures and neck and/or shoulder complaints: a systematic review. International Archives of Occupational and Environmental Health. 2012;85(6):587-603.
33. Härmä M. Workhours in relation to work stress, recovery and health. Scandinavian Journal of Work, Environment & Health. 2006;32(6):502-514.
34. Punnett L, Wegman DH. Work-related musculoskeletal disorders: the epidemiologic evidence and the debate. Journal of Electromyography and Kinesiology. 2004;14:13-23.
35. Dembe AE, Erickson JB, Delbos RG, Banks SM. The impact of overtime and long work hours on occupational injuries and illness: new evidence from the United States. Occupational & Environmental Medicine. 2005;62(9):588-597.
36. Boksem MA, Tops M. Mental fatigue: costs and benefits. Brain Research Reviews. 2008;59(1):125-139.
37. Goldenberg DL. Fibromyalgia, chronic fatigue syndrome, and myofascial pain syndrome. Current Opinion in Rheumatology. 1994;6(2):223-233.
38. Yoo SJ, Park SJ, Kim BS, Lee K, Lim HS, Kim JS, Kim IS. Airborne nicotine concentrations in the workplaces of tobacco farmers. Journal of Preventive Medicine & Public Health. 2014;47(3):144-149.
39. Holm S, Nachemson A. A nutrition of the intervertebral disc: acute effects of cigarette smoking: An experimental animal study. Upsala Journal of Medical Sciences. 1988;93(1):91-99.
40. Tomizawa M, Casida JE. Neonicotinoid insecticide toxicology: mechanisms of selective action. Annual Review of Pharmacology and Toxicology. 2005;45:247-268.
41. Meucci RD, Fassa AG, Faria NMX, Fiori NS. Chronic low back pain among tobacco farmers in southern Brazil. International Journal of Occupational and Environmental Health. 2015;21(1):66-73.
42. Riquinho DL, Hennington EA. Health, environment and working conditions in tabacco cultivation: a review of the literature. Ciência & Saúde Coletiva. 2012;17(6):1587-1600.
43. Steenland K, Jenkins B, Ames RG, O’Malley M, Chrislip D, Russo J. Chronic neurological sequelae to organophosphate pesticide poisoning. American Journal of Public Health. 1994;84(5):731-736.
44. London L, Beseler C, Bouchard MF, Bellinger DC, Colosio C, Grandjean P, Harari R, Kootbodien T, Kromhout H, Little F, Meijster T, Moretto A, Rohlman DS, Stallones L. Neurobehavioral and neurodevelopmental effects of pesticide exposures. Neurotoxicology. 2012;33(4):887-896.
45. Brasil, Ministério da Saúde, Secretaria de Gestão Estratégica e Participativa, Departamento de Apoio à Gestão Participativa. Política nacional de saúde integral das populações do campo e da floresta. Brasília: Editora do Ministério da Saúde; 2013.