Vilma Sousa Santana

Bio: Vilma Sousa Santana is an academic researcher from Federal University of Bahia. The author has contributed to research in topics: Occupational safety and health & Population. The author has an hindex of 30, co-authored 125 publications receiving 2624 citations. Previous affiliations of Vilma Sousa Santana include University of North Carolina at Chapel Hill.

Joint effects of smoking, noise exposure and age on hearing loss

Abstract: Background Smoking has been shown to have adverse effects on hearing, but it's unclear whether smoking interacts with known causes of hearing loss such as noise exposure and ageing. Aims To examine the hypothesis that smoking, noise and age jointly affect hearing acuity. Methods This cross-sectional study was carried out in 535 male adult workers of a metal processing factory. Pure-tone audiometric tests were utilized to assess hearing loss. Noise exposure assessment was based on a job exposure matrix constructed with industrial hygienist scoring and job titles. Each participant answered questionnaires about socio-demographic, life-style, occupational and health-related data. Analysis of the possible underlying biological model was undertaken assessing departures from additivity using measures of the size of the interaction present. Results Age and occupational noise exposures were, separately, positively associated with hearing loss. For all the factors combined the estimated effect on hearing loss was higher than the sum of the effects from each isolated variable, especially for smoking and noise among those 20-40 years of age, and for smoking and age among those non-exposed to occupational noise. Conclusions The synergistic effect of smoking, noise exposure and age on hearing loss, found in this study, is consistent with the biological interaction. Furthermore, it is possible that distinct ototoxic substances in the chemical composition of mainstream smoke may synergistically affect hearing when in combination with noise exposure, which needs to be examined in future studies.

Employment conditions and health inequalities.

Abstract: Main Messages 3 Executive Summary 4 Introduction 7 Main Employment Conditions 8 Country Typology of Employment Relations 9

Unemployment, informal work, precarious employment, child labor, slavery, and health inequalities: pathways and mechanisms.

Abstract: The study explores the pathways and mechanisms of the relation between employment conditions and health inequalities. A significant amount of published research has proved that workers in several risky types of labor--precarious employment, unemployment, informal labor, child and bonded labor--are exposed to behavioral, psychosocial, and physio-pathological pathways leading to physical and mental health problems. Other pathways, linking employment to health inequalities, are closely connected to hazardous working conditions (material and social deprivation, lack of social protection, and job insecurity), excessive demands, and unattainable work effort, with little power and few rewards (in salaries, fringe benefits, or job stability). Differences across countries in the social contexts and types of jobs result in varying pathways, but the general conceptual model suggests that formal and informal power relations between employees and employers can determine health conditions. In addition, welfare state regimes (unionization and employment protection) can increase or decrease the risk of mortality, morbidity, and occupational injury. In a multilevel context, however, these micro- and macro-level pathways have yet to be fully studied, especially in middle- and low-income countries. The authors recommend some future areas of study on the pathways leading to employment-related health inequalities, using worldwide standard definitions of the different forms of labor, authentic data, and a theoretical framework.

Introduction to the who commission on social determinants of health employment conditions network (EMCONET) study, with a glossary on employment relations.

Abstract: Although the conditions and power relations of employment are known to be crucial health determinants for workers and their families, the nature of these relations and their effects on health have yet to be fully researched. Several types of employment--precarious employment in developed countries; informal sectors, child labor, slavery, and bonded labor in developing countries--expose workers to risky working conditions. Hazardous work and occupation-related diseases kill approximately 1,500 workers, globally, every day. Growing scientific evidence suggests that particular employment conditions, such as job insecurity and precarious employment, create adverse health effects; yet the limited number of studies and the poor quality of their methods prevent our understanding, globally, the complexity of employer-employee power relations, working conditions, levels of social protections, and the reality of employment-related health inequalities. This article introduces a special section on employment-related health inequalities, derived from the EMCONET approach, which focuses on (1) describing major methods and sources of information; (2) presenting theoretical models at the micro and macro levels; (3) presenting a typology of labor markets and welfare states worldwide; (4) describing the main findings in employment policies, including four key points for implementing strategies; and (5) suggesting new research developments, a policy agenda, and recommendations. This introduction includes a glossary of terms in the emerging area of employment conditions and health inequalities.

Acidentes de trabalho no Brasil entre 1994 e 2004: uma revisão

Abstract: Neste estudo sintetizam-se achados epidemiologicos sobre acidentes de trabalho fatais e nao-fatais para populacoes brasileiras, entre 1994 e 2004, periodo pos II Conferencia Nacional de Saude do Trabalhador. Os estudos foram identificados em pesquisa nas bases Scielo e Medline, limitando-se a trabalhos completos disponiveis. Verificou-se que embora o coeficiente de mortalidade por acidentes de trabalho seja elevado, entre 1990 e 2003 caiu 56,5%. Todavia, a letalidade aumentou (0,18% em 1970 para 1,07%) ate 1999, quando passou a declinar (0,70% em 2003). A incidencia cumulativa anual de acidentes de trabalho nao-fatais tambem vem reduzindo, mas discretamente, em especial, para os menos graves. Nao houve alteracao para os acidentes incapacitantes. Pesquisas populacionais mostram que a incidencia cumulativa anual varia entre 3% e 6%. Trabalhadores rurais tem o dobro do risco do que os de area urbana. A construcao civil, industria da celulose, servicos domesticos estao entre os grupos de maior risco para acidentes nao-fatais. A subnotificacao de obitos se concentrou entre 70% e 90%. Indica-se a necessidade de uma redefinicao das politicas de protecao ao trabalhador tomando como base o conhecimento produzido sobre este evitavel problema de saude.

The Body in Pain: The Making and Unmaking of the World.

Abstract: basic research and clinical data in an attempt to derive a cohesive model which explains the behavioral effects of the drug. Johnson is an experimental psychologist, and his work underlies many of the chapters which suggest that lithium decreases the behavioral response to novel external stimuli. He then utilizes this foundation to propose a cognitive model for lithium's anti-manic action, its inhibition of violent impulsivity, and its prophylactic effects in recurrent depression. Previous formulations which were clinically based, such as that of Mabel Blake Cohen and her associates, stressed the primacy of depression and noted the \"manic defense\" as an attempt to ward off intolerable depression. In direct contrast, Johnson views mania as the primary disturbance in bipolar disorder. He considers depression in bipolar disease as an over-zealous homeostatic inhibitory responsf to a maniaassociated cognitive overload. Consistent with this, he believes, lit lum exerts its anti-manic effect by decreasing cognitive processing in a manner analogous to his animal studies. Johnson also suggests that lithium exerts its prophylactic effect in recurrent depressions by treating subclinical mania. These concepts are supported by the work of Johnson's associate, Kukopulos, to whom the book is dedicated. The bulk of the research which describes the cognitive disturbance in mania is complex, however, and uncomfortably open to multiple interpretations. Recognized as a preliminary effort, Johnson's formulation may help to guide further research. Although Johnson clearly traces lithium actions through a broad range of subjects, his discussion of the neurophysiological aspects of this drug is notably spotty. In particular, Johnson ignores the work of Svensson, DeMontigny, Aghajanian, and others who suggest that serotonergic systems may play an important role in the antidepressant actions of lithium. As a result, he fails to discuss one of the most important current uses of lithium: as an agent used in conjunction with antidepressant medications to increase treatment response in medication-resistant forms of depression. Lithium augmentation of antidepressant medication also challenges the formulation presented by Johnson. This formulation suggests that lithium should have no therapeutic value in patients, such as those with endogenous depression, who already \"under-process\" cognitive information. The omission of lithium augmentation in depression is clearly unfortunate in this text. Overall, this volume demonstrates the benefits of a single-authored text. It it clearly organized and readable. The bibliography is also broad and useful. In this book, Johnson primarily addresses a research audience, and his model seems designed to stimulate thought rather than to improve clinical technique. In this capacity, his book will be of most interest to behavioral psychologists. Other books, focusing purely on clinical data, may be more useful to clinicians. Nevertheless, the clear organization, the large bibliography, and the thoughtful presentation may make this text a useful addition to a clinical library as well.

Racism as a Determinant of Health: A Systematic Review and Meta-Analysis

Abstract: Despite a growing body of epidemiological evidence in recent years documenting the health impacts of racism, the cumulative evidence base has yet to be synthesized in a comprehensive meta-analysis focused specifically on racism as a determinant of health. This meta-analysis reviewed the literature focusing on the relationship between reported racism and mental and physical health outcomes. Data from 293 studies reported in 333 articles published between 1983 and 2013, and conducted predominately in the U.S., were analysed using random effects models and mean weighted effect sizes. Racism was associated with poorer mental health (negative mental health: r = -.23, 95% CI [-.24,-.21], k = 227; positive mental health: r = -.13, 95% CI [-.16,-.10], k = 113), including depression, anxiety, psychological stress and various other outcomes. Racism was also associated with poorer general health (r = -.13 (95% CI [-.18,-.09], k = 30), and poorer physical health (r = -.09, 95% CI [-.12,-.06], k = 50). Moderation effects were found for some outcomes with regard to study and exposure characteristics. Effect sizes of racism on mental health were stronger in cross-sectional compared with longitudinal data and in non-representative samples compared with representative samples. Age, sex, birthplace and education level did not moderate the effects of racism on health. Ethnicity significantly moderated the effect of racism on negative mental health and physical health: the association between racism and negative mental health was significantly stronger for Asian American and Latino(a) American participants compared with African American participants, and the association between racism and physical health was significantly stronger for Latino(a) American participants compared with African American participants. Protocol PROSPERO registration number: CRD42013005464.

The consequences of perceived discrimination for psychological well-being: A meta-analytic review.

Abstract: In 2 meta-analyses, we examined the relationship between perceived discrimination and psychological well-being and tested a number of moderators of that relationship. In Meta-Analysis 1 (328 independent effect sizes, N = 144,246), we examined correlational data measuring both perceived discrimination and psychological well-being (e.g., self-esteem, depression, anxiety, psychological distress, life satisfaction). Using a random-effects model, the mean weighted effect size was significantly negative, indicating harm (r = -.23). Effect sizes were larger for disadvantaged groups (r = -.24) compared to advantaged groups (r = -.10), larger for children compared to adults, larger for perceptions of personal discrimination compared to group discrimination, and weaker for racism and sexism compared to other stigmas. The negative relationship was significant across different operationalizations of well-being but was somewhat weaker for positive outcomes (e.g., self-esteem, positive affect) than for negative outcomes (e.g., depression, anxiety, negative affect). Importantly, the effect size was significantly negative even in longitudinal studies that controlled for prior levels of well-being (r = -.15). In Meta-Analysis 2 (54 independent effect sizes, N = 2,640), we examined experimental data from studies manipulating perceptions of discrimination and measuring well-being. We found that the effect of discrimination on well-being was significantly negative for studies that manipulated general perceptions of discrimination (d = -.25), but effects did not differ from 0 when attributions to discrimination for a specific negative event were compared to personal attributions (d = .06). Overall, results support the idea that the pervasiveness of perceived discrimination is fundamental to its harmful effects on psychological well-being.