Primary care health professionals’ perception and knowledge on notification of noise-induced hearing loss in Curitiba - Paraná

Pedroso, Hugo Carlos; Gonçalves, Cláudia Giglio de Oliveira

doi:10.1590/2317-1782/20162015264

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Original Articles • CoDAS 28 (05) • Sep-Oct 2016 • https://doi.org/10.1590/2317-1782/20162015264 copy

Primary care health professionals’ perception and knowledge on notification of noise-induced hearing loss in Curitiba - Paraná

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

The article aims to analyze the perception and knowledge of health professionals working in primary health care networks in the Municipality of Curitiba – Paraná, regarding the compulsory notification of Induced Hearing Loss Noise (NIHL) in the National Notifiable Diseases Information System (SINAN).

Methods

We performed a transversal cohort study in Curitiba, analyzing perception and knowledge of health professionals working in the primary health care networks in the Municipality of Curitiba, regarding the compulsory notification of NIHL in SINAN, from 2007 to 2014, featuring the reported cases and exploring the situational analysis of the NIHL notification, through a questionnaire and a structured news conference.

Results

The primary care professionals’ survey showed that 50% were doctors and the predominant age group was 26-30 years, with 56.2% reported as being able to identify health problems related to work, but only 43.7% feel able to identify cases of NIHL.

Conclusion

It was found that health professionals know the features and feel able to identify cases of NIHL, but still do not report suspected NIHL cases and do not consider occupational health an institutionalized program that is part of the service.

Keywords:
Noise-induced Hearing Loss; Hearing; Disease Notification; Occupational Health; Primary Care

Profile	n	%
Profession:
Nurse	10	20.8
Audiologist	14	29.2
Physician	24	50
Age group (years):
26-35	19	39.6
36-45	13	27.1
46-55	12	25
56 +	4	8.3
Job/ position:
Technical	42	87.5
Management	6	12.5
Workplace:
Municipal Health Center	3	6.3
Sanitation District	7	14.5
Clinic	25	52.1
Other municipal bodies	3	6.3
Specialist:
Yes	40	83.3
No	8	16.7
Masters Degree:
Yes	3	6.3
No	45	93.7

Question	n	%
Do you know the characteristics for NIHL?
Yes	27	56.2
No	9	18.8
Not always	11	22.9
Ignored	1	2.1
Are you able to identify cases of NIHL?
Yes	21	43.7
No	11	22.9
Not always	15	31.2
Ignored	1	2.1
In cases with suspected NIHL do you complete the notification in SINAN?
Yes	18	37.5
No	25	52.1
Ignored	5	10.4

Categories	Reported situation
Facilities:
Accessibility to services	- access, proximity to the population, nearest health facility, Cidade Industrial de Curitiba (CIC)
Availability of service to workers	- periodic exams, audiometer tests, initial consultation, some complementary exams, referrals to occupational medicine specialists, orientation
Management/ technical support	- monthly meetings with the group, support the institution in injury prevention and protection of workers' health, service time, multidisciplinary health team, proximity to the Sanitary District manager, electronic medical records available for notification
Professional training	- have a doctor at the clinic who also works in other services, such as occupational medicine, skilled professionals, versatile professionals, working in a company linked to various public agencies, diagnosis and guidance are performed by me (trained)
Difficulties:
Insufficient professional training	- physician, concerned only with the diagnosis, does not know the work environment, lack of training and knowledge, “these ideas should be better disseminated,” not concerned about getting more detail on the problem as presented by the patient
Lack of management support	- number of professional and reduced time of notification bureaucracy and some tests, work organization, flow and programs, lack of interest of the board and the corporation itself, physical space, demand pressure, absenteeism, extended sick leave
Professional discontentment	- the Municipal Health Department does not care for its workers, lack of policy aimed at worker health
Uncertainty of notification	- legal requirements

Categories	Reported situation
Lack of knowledge about the notification of NIHL	- Unaware of such a notification, lack of guidance on how to do it, I do not know if it is notified, workers are sometimes not governed by the Labor Code, difficulty of some bodies to perform notification when the doctor calls (process)
Not recognizing occupational health of as part of the service	- As the health of the worker is not focused on by the Municipal Health Units, have to refer to UST/ HT, does not provide occupation care, never had a case, I do not attend workers directly, it is not my job, do not know the worker's difficulties in my work
Difficulty in characterizing NIHL (diagnosis)	- Without audiometry it is difficult to characterize NIHL, lack of data on the location of the work and noise measurement
Difficulties with the computerized reporting system	- Lack of computerized facilities, do not know if there is this system implemented at work and do not know the notification process, bureaucracy in filling out notification
Uncertainty	- difficulty in acceptance of reporting by employers, resistance and fear

Variable/ Year	2007	2008	2009	2010	2011	2012	2013	2014	Total	%
Gender:
Male	3	1	9	5	2	18	0	2	40	90.9
Female	0	0	0	0	2	2	0	0	4	9.1
Age group (years):
20-34	0	0	2	1	0	1	0	0	4	9.1
35-49	1	1	6	4	0	2	0	0	14	31.8
50-64	2	0	1	0	2	11	0	2	18	41
65-79	0	0	0	0	2	5	0	0	7	15.9
80 e +	0	0	0	0	0	1	0	0	1	2.2
Education level:
Left Blank	3	1	1	0	1	5	0	0	11	25
Primary incomplete	0	0	0	0	0	5	0	0	5	11.4
Primary complete	0	0	0	0	1	1	0	0	2	4.6
Middle school incomplete	0	0	0	0	2	4	0	2	8	18.1
Middle school complete	0	0	6	5	0	0	0	0	11	25
High school incomplete	0	0	0	0	0	2	0	0	2	4.6
High school complete	0	0	2	0	0	2	0	0	4	9.1
College complete	0	0	0	0	0	1	0	0	1	2.2
Job Registration:
Left Blank	0	0	0	0	0	1	0	0	1	2.2
Registered	3	1	9	5	1	4	0	0	23	52.3
Independent contractor	0	0	0	0	0	5	0	2	7	15.9
Public servant	0	0	0	0	0	1	0	0	1	2.2
Retired	0	0	0	0	3	8	0	0	11	25
Other	0	0	0	0	0	1	0	0	1	2.2
Notification source:
CEREST	3	1	9	5	0	0	0	0	18	41
Hospital de Clinicas	0	0	0	0	4	20	0	0	24	54.5
University Clinic	0	0	0	0	0	0	0	2	2	4.5

CNAE 2.1	n	%
Manufacturing	18	40.90
Other Service Activities	9	20.44
Extractive Industries	6	13.64
Transport	4	9.10
Fishery	2	4.54
Trade	2	4.54
Real Estate activities	1	2.28
Human Health and Social Services	1	2.28
Public administration	1	2.28
LARGE BRAZILIAN OCCUPATION GROUP:
Production of industrial goods and services (manual)	16	36.36
Repair and maintenance services	14	31.82
Production of industrial goods and services	8	18.18
Agricultural, forestry and fishery	4	9.10
Administrative services	2	4.54
TOTAL	44	100

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[1] Conflict of interests: nothing to declare.