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      O futuro do trabalho após a COVID-19: o papel incerto do teletrabalho no domicílio Translated title: The future of work after the COVID-19, the uncertain role of teleworking at home Translated title: El futuro del trabajo tras la COVID-19: el papel incierto del teletrabajo en el domicilio

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          Abstract

          Resumo Introdução: o teletrabalho no domicílio, uma das medidas adotadas para controlar a pandemia de COVID-19 e, ao mesmo tempo, manter o emprego, tem aumentado em vários países. Objetivo: refletir sobre o significado, a magnitude e as tendências do teletrabalho no domicílio, antes e durante a pandemia, enfatizando seus potenciais efeitos na saúde do trabalhador. Discussão: a precedente Convenção 177/1996 da Organização Internacional do Trabalho (OIT) sobre trabalho a domicílio e o acordo sobre teletrabalho entre agentes sociais na União Europeia, em 2002, apontam a dificuldade de regulamentar essa nova forma de organização do trabalho e da prevenção de possíveis lesões e doenças associadas, especialmente transtornos mentais e distúrbios musculoesqueléticos. São necessários estudos sobre os efeitos na saude dessa modalidade de trabalho para fornecer evidências científicas que embasarão normas em nível nacional e global. A inclusão de questões específicas e bem definidas, como as que a OIT propõe, em futuros levantamentos sobre as condições de trabalho, emprego e saúde poderá auxiliar tal objetivo e proporcionar uma oportunidade para observar os efeitos do teletrabalho no domicílio na saúde do trabalhador, bem como avaliar o impacto de uma necessária e urgente regulamentação.

          Translated abstract

          Abstract Introduction: teleworking at home, one of the mitigation measures adopted to control the COVID-19 pandemic, while attempting to maintain employment, has increased in many countries. Objective: to reflect on the meaning, magnitude and trends of teleworking at home, before and during the pandemic, focusing on its potential effects on the health of workers. Discussion: the precedent of Convention 177/1996 of the International Labour Organization (ILO) on home work, and the agreement on teleworking between social agents in the European Union of 2002, underscore the difficulties of regulating this new form of work organization, and the prevention of possible injuries and associated diseases, especially mental and musculoskeletal disorders. The investigation of its effects on health is a priority to base its regulation at the national and global level on scientific evidence. The incorporation of specific, well-defined questions, such as those proposed by the ILO, in questionnaires of future surveys on working conditions, employment and health may help in this objective and provide an opportunity to monitor the effects on health of teleworking at home, as well as evaluating the impact of its necessary and urgent regulation.

          Translated abstract

          Resumen Introducción: el teletrabajo en el domicilio, una de las medidas adoptadas para controlar la pandemia de COVID-19, y al mismo tiempo mantener el empleo, se ha incrementado en diversos países. Objetivos: reflexionar sobre el significado, la magnitud y las tendencias del teletrabajo en el domicilio, antes y durante la pandemia, focalizando en sus potenciales efectos sobre la salud de los trabajadores. Discusión: el antecedente del Convenio 177/1996 de la Organización Internacional del Trabajo (OIT) sobre trabajo a domicilio, y el acuerdo sobre teletrabajo entre agentes sociales en la Unión Europea de 2002, muestran la dificultad de regular esta nueva forma de organización del trabajo, y de la prevención de las posibles lesiones y enfermedades asociadas, especialmente los trastornos mentales y musculoesqueléticos. La investigación de sus efectos sobre la salud es una prioridad para fundamentar en evidencias científicas su regulación a nivel nacional y global. La incorporación de preguntas específicas, bien definidas, como las que propone la OIT, en cuestionarios de futuras encuestas sobre condiciones de trabajo, empleo y salud podrán ayudar en este objetivo y propiciar una oportunidad para monitorizar los efectos del teletrabajo en el domicilio sobre la salud, así como evaluar el impacto de su necesaria y urgente regulación.

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          Offline: COVID-19 is not a pandemic

          As the world approaches 1 million deaths from COVID-19, we must confront the fact that we are taking a far too narrow approach to managing this outbreak of a new coronavirus. We have viewed the cause of this crisis as an infectious disease. All of our interventions have focused on cutting lines of viral transmission, thereby controlling the spread of the pathogen. The “science” that has guided governments has been driven mostly by epidemic modellers and infectious disease specialists, who understandably frame the present health emergency in centuries-old terms of plague. But what we have learned so far tells us that the story of COVID-19 is not so simple. Two categories of disease are interacting within specific populations—infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and an array of non-communicable diseases (NCDs). These conditions are clustering within social groups according to patterns of inequality deeply embedded in our societies. The aggregation of these diseases on a background of social and economic disparity exacerbates the adverse effects of each separate disease. COVID-19 is not a pandemic. It is a syndemic. The syndemic nature of the threat we face means that a more nuanced approach is needed if we are to protect the health of our communities. © 2020 Peter Scholey Partnership/Getty Images 2020 Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. The notion of a syndemic was first conceived by Merrill Singer, an American medical anthropologist, in the 1990s. Writing in The Lancet in 2017, together with Emily Mendenhall and colleagues, Singer argued that a syndemic approach reveals biological and social interactions that are important for prognosis, treatment, and health policy. Limiting the harm caused by SARS-CoV-2 will demand far greater attention to NCDs and socioeconomic inequality than has hitherto been admitted. A syndemic is not merely a comorbidity. Syndemics are characterised by biological and social interactions between conditions and states, interactions that increase a person's susceptibility to harm or worsen their health outcomes. In the case of COVID-19, attacking NCDs will be a prerequisite for successful containment. As our recently published NCD Countdown 2030 showed, although premature mortality from NCDs is falling, the pace of change is too slow. The total number of people living with chronic diseases is growing. Addressing COVID-19 means addressing hypertension, obesity, diabetes, cardiovascular and chronic respiratory diseases, and cancer. Paying greater attention to NCDs is not an agenda only for richer nations. NCDs are a neglected cause of ill-health in poorer countries too. In their Lancet Commission, published last week, Gene Bukhman and Ana Mocumbi described an entity they called NCDI Poverty, adding injuries to a range of NCDs—conditions such as snake bites, epilepsy, renal disease, and sickle cell disease. For the poorest billion people in the world today, NCDIs make up over a third of their burden of disease. The Commission described how the availability of affordable, cost-effective interventions over the next decade could avert almost 5 million deaths among the world's poorest people. And that is without considering the reduced risks of dying from COVID-19. © 2020 Allison Michael Orenstein/Getty Images 2020 Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. The most important consequence of seeing COVID-19 as a syndemic is to underline its social origins. The vulnerability of older citizens; Black, Asian, and minority ethnic communities; and key workers who are commonly poorly paid with fewer welfare protections points to a truth so far barely acknowledged—namely, that no matter how effective a treatment or protective a vaccine, the pursuit of a purely biomedical solution to COVID-19 will fail. Unless governments devise policies and programmes to reverse profound disparities, our societies will never be truly COVID-19 secure. As Singer and colleagues wrote in 2017, “A syndemic approach provides a very different orientation to clinical medicine and public health by showing how an integrated approach to understanding and treating diseases can be far more successful than simply controlling epidemic disease or treating individual patients.” I would add one further advantage. Our societies need hope. The economic crisis that is advancing towards us will not be solved by a drug or a vaccine. Nothing less than national revival is needed. Approaching COVID-19 as a syndemic will invite a larger vision, one encompassing education, employment, housing, food, and environment. Viewing COVID-19 only as a pandemic excludes such a broader but necessary prospectus. © 2020 xavierarnau/Getty Images 2020 Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
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            A pandemia da COVID-19 e as mudanças no estilo de vida dos brasileiros adultos: um estudo transversal, 2020

            Resumo Objetivo Descrever as mudanças nos estilos de vida, quanto ao consumo de tabaco, bebidas alcoólicas, alimentação e atividade física, no período de restrição social consequente à pandemia da COVID-19. Métodos Estudo transversal realizado com dados do inquérito ConVid sobre comportamentos em saúde. Os dados foram coletados por meio de questionário on-line autopreenchido pelos participantes. Procedimentos de pós-estratificação foram empregados para o cálculo das prevalências e intervalos de confiança de 95%. Resultados Participaram 45.161 indivíduos com 18 ou mais anos de idade. Durante o período de restrição social, foi relatada diminuição da prática de atividade física e aumento do tempo em frente a telas, da ingestão de alimentos ultraprocessados, do número de cigarros fumados e do consumo de bebidas alcóolicas. Foram observadas diferenças segundo sexo e faixa etária. Conclusão Os resultados apontam uma piora dos estilos de vida e aumento de comportamentos de risco à saúde.
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              Working from home in the time of covid-19: how to best preserve occupational health?

              In response to the covid-19 pandemic, many countries have adopted a broad spectrum of containment measures, from recommendations to stay at home to quarantines of large geographic regions. As part of this response, corporations and governments alike have strongly encouraged workers to telecommute where possible. More than 3.4 billion people in 84 countries have been confined to their homes, as estimated in late March 2020, which potentially translates to many millions of workers temporarily exposed to telecommuting. Since 2000, the emergence of digital and broadband internet has facilitated the development of home telework. Despite limited research interest on its impact on occupational health, several health benefits and risks of telework have been identified in academic or grey literature (table 1) (for a review see Ref. 1). Table 1 Health impacts of telework, specificity of pandemic covid-19-related containment and key prevention measures for employers Family of risk Effect of telework Amplification or reduction in the context of covid-19-related containment Key prevention measures for employers Risks associated with transportation Decreased None – Risks associated with home working environment Increased risks associated with housing (fire, and slip, trip and fall hazards, temperature conditions) Amplified (lack of anticipation) Diffusion of simple, pragmatic security messages Increased risks associated with workstation (musculoskeletal pain) Ambiguous (potentially amplified due to the lack of anticipation, poorly suited home working environment and reduced physical activity, but short duration of exposure) Diffusion of simple, pragmatic messages on ergonomics5; financial contribution to adapted equipment (adjustable chair and computer station); promotion of physical activity Psychosocial risks Increased risks of social isolation in the professional sphere Reduced (universalisation of telework) Adoption of virtual collective working periods (teleconferences) Increased risk of blurring of boundaries between work and home time Potentially amplified by the multiplication of non-work-related tasks such as caring for children and facilitating home schooling Adapt working time and schedule for workers ensuring home childcare Behavioural risks (diet, sleep, addiction)   Ambiguous Amplified (confinement, covid-linked anxiety) Allow and promote teleconsultations with occupational practitioners Assessing how health risks and benefits of telework are affected by its sudden, large-scale uptake in the context of covid-19 is key to best preserve occupational health. The current pandemic context carries several specificities. First, the sudden shift to teleworking could not have been anticipated by workers or employers, so the safety of the home working environment has not necessarily been ensured. However, for many the uptake of telework will be temporary, so a limited duration of exposure may mitigate risks of injury or pain associated with the home environment, or risks of musculoskeletal disorders associated with unergonomic workstations.2 Second, in many organisations telework has temporarily switched from the exception to the rule. This may reduce isolation risks associated with social distancing in the workplace setting that teleworkers face in normal times. Conversely, widespread school closures have forced many parents to telework and mind their children at the same time, including having to plan for schooling at home or online. These overlapping responsibilities amplify psychosocial risks associated with unstructured working time.3 Third, the current uptake of telework has occurred in an anxiety-provoking context linked to the pandemic. This is likely to worsen telework-associated psychosocial and behavioural risks, especially those associated with addictions. Among workers with psychological frailties, isolation may also lead to decompensation with more difficult psychiatric care. Taken together, these suggest that the covid-19 pandemic may exacerbate occupational hazards beyond the more obvious examples of healthcare settings or other jobs on the front line.4 For employers, maximising health benefits of teleworking in times of containment while minimising its negative impacts constitutes a continuity in their duty to preserve the health of their employees. To do so, they should provide key messages specifically tailored to an unanticipated and anxiety-provoking context in which employees may struggle to adapt their homes and lifestyles to telework.5 They should also allow teleconsultations as well as systems for listening to employee complaints with occupational practitioners to provide employees with optimised working conditions despite the pandemic circumstances. Companies are increasingly recognised as an integral player in outbreak management.6 They also have a role to play in minimising the unintended health consequences of outbreak control measures.
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                Author and article information

                Journal
                rbso
                Revista Brasileira de Saúde Ocupacional
                Rev. bras. saúde ocup.
                Fundação Jorge Duprat Figueiredo de Segurança e Medicina do Trabalho - FUNDACENTRO (São Paulo, SP, Brazil )
                0303-7657
                2317-6369
                2021
                : 46
                : e31
                Affiliations
                [2] Buenos Aires Buenos Aires orgnameUniversidad Nacional de Avellaneda orgdiv1Grupo de Estudios en Salud Ambiental y Laboral Argentina
                [6] Heredia Heredia orgnameUniversidad Nacional orgdiv1Instituto Regional de Estudios en Sustancias Tóxicas orgdiv2Programa Salud, Trabajo y Ambiente Costa Rica
                [7] Cidade do Panamá orgnameUniversidad de Panamá Panamá
                [1] Barcelona Cataluña orgnameUniversitat Pompeu Fabra orgdiv1Centro de Investigación en Salud Laboral Spain
                [4] Santiago Santiago de Chile orgnamePontificia Universidad Católica de Chile orgdiv1Departamento de Salud Pública Chile
                [3] Buenos Aires Buenos Aires orgnameUniversidad de Buenos Aires orgdiv1Superintendencia de Riesgos del Trabajo Argentina
                [5] Tegucigalpa orgnameUniversidad Nacional Autónoma de Honduras Honduras
                [8] Houston orgnameThe University of Texas orgdiv1Health Science Center at Houston orgdiv2School of Public Health Estados Unidos da América
                Article
                S0303-76572021000101401 S0303-7657(21)04600001401
                10.1590/2317-6369000037820
                53a836e1-a6d7-4b6b-bffe-9af85e94c50f

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 07 November 2020
                : 25 January 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 40, Pages: 0
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                SciELO Brazil

                Categories
                Ensaio / Dossiê COVID-19 e Saúde do Trabalhador

                COVID-19,teletrabalho,saúde do trabalhador,inquéritos,telework,occupational health,surveys,teletrabajo,salud ocupacional,encuestas

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