Trabalhador de 40 anos de idade desenvolve atividades laborativas em processo de controle de bombeamento de petróleo há 2 anos. Em sua história ocupacional, consta que realizou atividade de limpeza de tanques de combustíveis por 8 anos. Fez admissional e periódicos com avaliação clínica e exames complementares, incluindo hemograma completo, transaminases (AST e ALT), gama glutamil transferase, bilirrubinas totais e frações e LDH, todos com valores dentro da normalidade. Apresenta queixas de mialgia generalizada refratária a medicamentos. O Médico do Trabalho deverá utilizar as orientações contidas nas NR-7, NR-15, Anexos 13 e 13 A, e na Portaria nº 776/04, do Acordo do Benzeno, para nortear sua investigação diagnóstica em trabalhador suspeito de doença ocupacional.

Nesse caso, as principais patologias que devem entrar em diagnóstico diferencial são

As atividades nas quais há poeiras respiráveis, cujas medições as identificaram como aerodispersoides fibrogênicos, com partículas que se situam abaixo de 10 micra e que podem ser inaladas pelas vias respiratórias dos trabalhadores, necessitam receber EPI específico com treinamento. Essa concessão de EPI deve ser associada aos exames médicos complementares indicados pela NR-7 e inseridos no planejamento no PCMSO. Nesse contexto, considere os exames relacionados abaixo.

I - Espirometria computadorizada

II - Espirometria por Técnica da American Thoracic Society

III - Espirometria simples

IV - Ressonância magnética de tórax

V - Telerradiografia de tórax em AP

VI - Telerradiografia do tórax em padrão OIT

São indicados pela NR-7 APENAS os exames

Diversas substâncias químicas podem estar presentes nos processos produtivos. O Médico do Trabalho deve realizar detalhado levantamento da história ocupacional do trabalhador para identificar os produtos químicos aos quais o profissional já foi submetido e dar continuidade no controle de sua saúde. Para tal, o Médico do Trabalho deve conhecer os principais processos produtivos e os produtos químicos. Nesse contexto, as substâncias químicas que são descritas como insalubres na NR-15, Anexos 13 e 13 A, são:

Trabalhadores que realizam tarefas de transporte manual de cargas de forma habitual e permanente devem ser avaliados pelo Médico do Trabalho tanto nos aspectos clínicos quanto na aplicação da fórmula para o cálculo do LPR (Limite de Peso Recomendado). Essa fórmula foi elaborada pela NIOSH (National Institute for Occupational Safety and Health) e inserida pelo Ministério do Trabalho e Emprego no Manual de Aplicação da NR-17, com a finalidade de identificar o limite fisiológico dos trabalhadores para o esforço físico em transportes manuais de carga.

Nessa perspectiva, considere os fatores a seguir.

Fazem parte dessa fórmula APENAS os fatores

Experts Try to Gauge Health Effects of Gulf Oil Spill

Wednesday, June 23, 2010

WEDNESDAY, June 23 (HealthDay News) - This Tuesday and Wednesday, a high-ranking group of expert government advisors is meeting to outline and anticipate potential health risks from the Gulf oil spill - and find ways to minimize them.

The workshop, convened by the Institute of Medicine (IOM) at the request of the U.S. Department of Health and Human Services, will not issue any formal recommendations, but is intended to spur debate on the ongoing spill.

“We know that there are several contaminations. We know that there are several groups of people — workers, volunteers, people living in the area,” said Dr. Maureen Lichtveld, a panel member and professor and chair of the department of environmental health sciences at Tulane University School of Public Health and Tropical Medicine in New Orleans. “We’re going to discuss what the opportunities are for exposure and what the potential short- and long-term health effects are. That’s the essence of the workshop, to look at what we know and what are the gaps in science,” Lichtveld explained.

High on the agenda: discussions of who is most at risk from the oil spill, which started when BP’s Deepwater Horizon rig exploded and sank in the Gulf of Mexico on April 20, killing 11 workers. The spill has already greatly outdistanced the 1989 Exxon Valdez spill in magnitude.

“Volunteers will be at the highest risk,” one panel member, Paul Lioy of the University of Medicine & Dentistry of New Jersey and Rutgers University, stated at the conference. He was referring largely to the 17,000 U.S. National Guard members who are being deployed to help with the clean-up effort.

Many lack extensive training in the types of hazards — chemical and otherwise — that they’ll be facing, he said. That might even include the poisonous snakes that inhabit coastal swamps, Lioy noted. Many National Guard members are “not professionally trained. They may be lawyers, accountants, your next-door neighbor,” he pointed out.

Seamen and rescue workers, residents living in close proximity to the disaster, people eating fish and seafood, tourists and beach-goers will also face some risk going forward, Dr. Nalini Sathiakumar, an occupational epidemiologist and pediatrician at the University of Alabama at Birmingham, added during the conference.

Many of the ailments, including nausea, headache and dizziness, are already evident, especially in clean-up workers, some of whom have had to be hospitalized.

“Petroleum has inherent hazards and I would say the people at greatest risk are the ones actively working in the region right now,” added Dr. Jeff Kalina, associate medical director of the emergency department at The Methodist Hospital in Houston. “If petroleum gets into the lungs, it can cause quite a bit of damage to the lungs [including] pneumonitis, or inflammation of the lungs.”

“There are concerns for workers near the source. They do have protective equipment on but do they need respirators?” added Robert Emery, vice president for safety, health, environment and risk management at the University of Texas Health Science Center at Houston.

Physical contact with volatile organic compounds (VOCs) and with solvents can cause skin problems as well as eye irritation, said Sathiakumar, who noted that VOCs can also cause neurological symptoms such as confusion and weakness of the extremities.

“Some of the risks are quite apparent and some we don’t know about yet,” said Kalina. “We don’t know what’s going to happen six months or a year from now.”

Copyright (c) 2010 HealthDay. All rights reserved.

http://www.nlm.nih.gov/medlineplus/news/fullstory_100305.html,

retrieved on September 9th, 2010.

Based on the information in the text, it is INCORRECT to say that