Riscos Ocupacionais em Unidades de Alimentação e Nutrição Escolares

Abstract

The analysis of the exposure to occupational risks of food handlers in School Food Services (SFS), managed by the School Food Program (PNAE), is essential for elaborating public policies for health promotion. Thus, the objective of this study was to analyze factors associated with exposure to occupational risks in SFS in a county in the state of Bahia. This cross-sectional, exploratory study consisted of nine stages: 1. elaboration of instruments following the literature review and regulatory standards of the Ministry of Labor; 2. evaluation of the instruments by the specialists using the Delphi Technique; 3. a semantic analysis by focus group composed of food handlers; 4. evaluation of SFS good practices using a checklist of good practices in school feeding (GPSFS); 5. identification of SFS's physical areas; 6. identification of sociodemographic and work characteristics, attitudes, and level of knowledge in food hygiene of food handlers; 7. food handlers’ perception of exposure to occupational risk; 8. anthropometric assessment and presence of comorbidities in food handlers; 9. exposure of food handlers to occupational hazards and environmental comfort measures at SFS. The analysis of variance, Student's T-Test, and Pearson's Chi-square were used for statistical analysis. The tests were performed using the Statistical Package for Science - SPSS version 26.0®. Four instruments were developed with the participation of experts (CVC ≥0.80), and of these, two were submitted to semantic analysis in a focus group, obtaining 80% agreement for each item. 159 SFS and 142 food handlers participated in the study. The classification of the sanitary situation of the SFS was of Regular Health Risk in 74.8% (n=119) and 25.2% (n=40) in High Health Risk. At least 98% of the SFS did not have areas for receiving food, pre-preparing meat, and storing waste. Most handlers were female (98.6%). Regarding attitudes, 1.4% (n=2) of the food handlers were classified as Unsatisfactory, 8.5% (n=12) Satisfactory with Restriction and 90.1% (n=128) Satisfactory. The knowledge level of 6.3% (n=9) of the food handlers was Unsatisfactory, 27.5% (n=39) Satisfactory with Restriction and 66.2% (n=94) Satisfactory. Regarding the Perception of Exposure to Occupational Risk: 0.7% (n=1) had a Very Low Perception (0 to 1.5); 20.4% (n=29) had Low Perception (1.51 to 2.5); 41.5% (59) had Fair Perception (2.51 to 3.5) and 37.3% (n=53) had Good Perception (3.51 to 4.5). There was a statistically significant association between the Perceived Occupational Risk Exposure score with work characteristics: type of employment contract (0.004) and time working in school meals (p=0.029). Also, there was a statistically significant association with comorbidities/symptoms: musculoskeletal problems (0.001), presence of edema (p<0.001) and headaches (p<0.001). The anthropometric assessment identified an average of 30.2 kg/m2 for BMI. Regarding the classification of SFS to occupational risks, 22.6% (36) presented High Occupational Risk, 76.1% (122) Very High Occupational Risk, and 1.3% (2) Regular Occupational Risk. In order to fulfill the objective of the SFS and to prevent exposure to occupational risk, it is necessary to adapt the physical structure for the adoption of good manufacturing practices, distribution of Personal Protective Equipment (PPE), training on food hygiene, and exposure to occupational risks with the use of active methodologies.