Banca de DEFESA: WILER DE PAULA DIAS

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
STUDENT : WILER DE PAULA DIAS
DATE: 18/03/2024
TIME: 14:00
LOCAL: Sala 05 do Instituto de Saúde Coletiva da UFBA
TITLE:

HOMELESS PEOPLE IN SALVADOR/BA: occupational profile and prevalence of work accidents

KEY WORDS:

Epidemiological Survey; Homeless Population; Occupational Health Surveillance; Occupational Health; Occupational Accidents

PAGES: 101
BIG AREA: Ciências da Saúde
AREA: Saúde Coletiva
SUMMARY:

Introduction: Homeless individuals (HIs) form a vulnerable group that historically is faced with poor socioeconomic conditions, such as poverty, lack of adequate housing, and deprivation of social rights. In Brazil, HIs are often male, black, with low educational levels, and of working age. HIs have no source of formal income and enjoy little or no social assistance, forcing them to resort into some form of informal economic activities commonly referred to as "corre" to survive. "Corre" can be considered as any type of labor activity that generates income to meet fundamental subsistence needs, usually food and hygiene. However, these activities are often carried out in unhealthy conditions, predisposing them to multiple physical, chemical, ergonomic agents in addition to exhausting working hours etc., thereby posing health risks and the occurrence of occupational accidents (OAs). In the country, there is limited information on the occupational profile, work process, frequency of OAs, and the health consequences of HIs. These knowledge gaps hinder the formulation of adequate public policies, especially professional training, that could mitigate the daily challenges faced by nearly 236 thousand current homeless people in Brazil. Objective: To describe the socio-occupational profile, prevalence of OAs, and the associated factors among HIs in Salvador/BA, from 2021 to 2022. Methodology: Observational cross-sectional epidemiological study, with a convenience sample of HIs aged ≥18 years, in public places or housed in municipal shelter units in the municipality of Salvador/BA, with data collection from September 2021 to February 2022. A total of 529 individuals participated, from four municipal geographic areas (Health Districts) chosen based on a history of high concentration of HIs, while also aligning with the structure of municipal street clinic teams. Structured questionnaires were individually administered by an interviewing team, using cell phones and tablets containing REDCap software. In addition to sociodemographic and occupational variables, among others, participants were asked about their history of OAs, using the question: "Have you ever had any work-related accident?" as the outcome indicator. The study was approved by the Research Ethics Committee of the Gonçalo Moniz Institute of the Oswaldo Cruz Foundation (IGM/Fiocruz) with protocol No. 42517021.0.0000.0040 in compliance with the resolutions 466/12 and 510/16. All participants provided consent and signed the free and Informed Consent Form (ICF). Initially, descriptive analyses of the demographic and occupational profile, as well as OAs prevalence were performed. In the crude analysis, Prevalence Ratios (PR) and 95% confidence intervals (95% CI) were calculated, also possible associations were identified using Pearson's Chi-square test. In the multivariate analysis, Quasi-Poisson regression was applied, considering robust variance and stepwise procedure for model adjustments, while controlling for multicollinearity and confounding biases. A value of p <0.05 was adopted for result interpretation. Data set construction, organization, and cleaning, as well as statistical analyses, were performed using RStudio software, version 4.2.3 (x64). Results: The predominant sociodemographic and occupational profile corresponded to cisgender men (70.9%), black individuals (91.6%), no education or only primary education (73%), engaged in scavenging activities (30.9%), sales (28.3%), and general services (20%). Among the respondents, the frequency of engaging in "corre" activities ranged from 66.7% to 95.8%, depending on the category analyzed. Surprisingly, when asked if they were working, this variation was much lower, between 12.0% and 45.2%. Regarding the outcome OAs, the overall prevalence was 31.4%, with statistically significant association for age group ≥50 years (PR: 1.13; 95% CI: 1.03-1.25), working ≥13 hours/day (PR:1.11; 95% CI: 1.01-1.23), and experiencing violence during "corre" activities (PR:1.17; 95% CI: 1.09-1.25). Conclusions: Low frequencies of HIs were identified who recognize their activities as "work", referring to them as “corre”. Groups with higher probabilities of experiencing OAs are represented by individuals aged ≥50 years, working ≥13 hours/day, and reporting violence during work or "corre" activities. There is a lack of recognition of interpersonal violence as OAs, leading to occupational vulnerability. In addition to recognizing HIs activities as work, training, formal opportunities, and policies for social/professional reintegration are needed to reduce the time spent in homelessness.

COMMITTEE MEMBERS:
Presidente - 3145830 - CLEBER CREMONESE
Externo ao Programa - 1224175 - FERNANDO RIBAS FEIJO - nullInterna - 1226136 - JOILDA SILVA NERY
Interna - 2058901 - KIONNA OLIVEIRA BERNARDES SANTOS