DEVELOPMENT OF AN INNOVATIVE INDEX TO ASSESS WORKER’S HEALTH RISK: THE WHRI APPLIED TO AN OIL INDUSTRY IN BAHIA, BRAZIL

1. Lilian Monteiro Ferrari Viterbo - PhD Student in Ecology and Environmental Health in the Faculty of Sciences and Technology of the University Fernando Pessoa (Porto, Portugal), master in Health Technologies from the Bahiana School of Medicine and Public Health (Bahia, Brazil). Graduated in Nursing in the Salvador Catholic University, Brazil. North and Northeast Health Sector Manager at Petrobras and Researcher at the UFP Energy, Environment and Health Research Unit of the University Fernando Pessoa. Salvador, Bahia, Brazil. E-mail: lilianmferrari@gmail.com

2. Diogo Guedes Vidal - PhD Student in Ecology and Environmental Health in the Faculty of Sciences and Technology of the University Fernando Pessoa (Porto, Portugal), master in Sociology from the Faculty of Arts and Humanities of the University of Porto. Graduated in Sociology in the Faculty of Arts and Humanities of the University of Porto. Research Fellow at the UFP Energy, Environment and Health Research Unit of the University Fernando Pessoa and Collaborator Researcher at Bahiana School of Medicine and Public Health. Porto, Portugal. E-mail: diogovidal@ufp.edu.pt

3. André Santana Costa - Graduated in Nursing in the Federal University of Feira de Santana. Nurse work at Petrobras and Researcher at the UFP Energy, Environment and Health Research Unit of the University Fernando Pessoa. Salvador, Bahia, Brazil. E-mail: andresc@petrobras.com.br

4. Maria Alzira Pimenta Dinis - PhD in Earth Sciences Health in the Faculty of Sciences and Technology of the University Fernando Pessoa (Porto, Portugal), master in Materials Engineering in the Faculty of Engineering of the University of Porto. Graduated in Metallurgical Engineering in the Faculty of Engineering of the University of Porto. Associate Professor at University Fernando Pessoa and Researcher at the UFP Energy, Environment and Health Research Unit. Porto, Portugal. E-mail: madinis@ufp.edu.pt

5. Walter Leal Filho - Holds the Chairs of Climate Change Management at the Hamburg University of Applied Sciences (Germany), and Environment and Technology at Manchester Metropolitan University (UK). He directs the Research and Transfer Centre “Sustainability Development and Climate Change Management”. His main research interests are in the fields of sustainable development and climate change, also including aspects of climate change and health. He holds various doctoral degrees, such as the degrees of: Philosophy Doctor (PhD), Doctor of Sciences (DSc), Doctor of Philosophy (DPhil), Doctor of Education (DEd), Doctor of Letters (DL) for his works on environment, sustainable development and climate change. He directs the European School of Sustainability Science and Research at the Hamburg University of Applied Sciences, in Germany. E-mail: walter.leal2@haw-hamburg.de

SDGs	WHRI Indicator	UN Indicator	Brazil Indicator
2	Energy balance intake	2.7	ni
2	Simple carbohydrate intake	2.8	ni
3	Work environment health conditions	nci	nd
	Family relationships	nci	ni
	Social aspects - leisure	nci	ni
	Self-care level	nci	ni
	Dyslipidemia	23	ni
	Diabetes mellitus	23	uac
	Altered glycemia	3.23	ni
	Arterial hypertension	3.18	ni
	Blood pressure	23	ni
	Tobacco use	30	uac
	Musculoskeletal pathology	nci	uac
	Psychiatric pathology	28	ni
	Stress level and symptoms	28	ni
	Saturated lipids intake	3.23	ni
	Sodium mineral intake	3.24	ni
	Fibre intake	3.25	ni
	Alcohol use	3.19	uac
	Level of food knowledge	nci	ni
	Body weight condition	24	ni
	Altered triglycerides	23	ni
	Oral hygiene quality	nci	ni
	Periodontal condition	nci	ni
	Periodontal disease	nci	ni
	Caries	nci	ni
	Oral lesion on soft or hard tissues	nci	ni
	Bruxism	nci	ni
	Physical activity level	3.22	ni
	Contemplation stage for physical activity practice	nci	ni
	Feeling of pain	nci	ni
	Cardiorespiratory fitness	nci	ni
	Abdominal strength level	nci	ni
	Flexibility level	nci	ni
	Manual gripping force	nci	ni
	Age Group	nci	ni
6	Pests and vectors	nci	uac
6	Drinking water Quality	45	pr
8	Environmental hazards exposure (physical, chemical and biological agents)	57	uac
	Ergonomic risks - physical aspects	57	uac
	Ergonomic risks - organizational aspects	57	uac
	Work accident	nci	uac
	Work-related absenteeism	nci	ni
11	Air quality	69	nd

Dimension	W	Indicator Code	Indicator	Ci	Ai
Dimension	W	Indicator Code	Indicator	Ci	I01	I02	I03	I04	I05	I06	I07
Personal factor	0	G01	Age group
Dentistry	1	O02	Oral hygiene quality
		O03	Periodontal condition	0
		O04	Periodontal disease	1	O02	M06
		O05	Caries	0	N02
		O06	Oral lesion on soft or hard tissues	0	M06	N06
		O07	Bruxism		M09
Nutrition	2	N01	Energy balance intake		P01
		N02	Simple carbohydrate intake	0
		N03	Saturated lipids intake	0
		N04	Sodium mineral intake	0
		N05	Fibre intake
		N06	Alcohol use	0	E05	E06
		N07	Level of food knowledge
		N08	Body weight condition
		N09	Altered triglycerides	0	N06
Physical education	3	P01	Physical activity level		E06	E07
		P02	Contemplation stage for physical activity practice	1
		P03	Feeling of pain	2	M07	E02
		P04	Cardiorespiratory fitness
		P05	Abdominal strength level
		P06	Flexibility level
		P07	Manual gripping force
Nursing	4	E01	Environmental hazards exposure (physical, chemical and biological agents)	1
		E02	Ergonomic risks - physical aspects	1
		E03	Ergonomic risks - organizational aspects
		E04	Work environment health conditions	0
		E05	Family relationships
		E06	Social aspects - leisure
		E07	Self-care level	1	E05
		E08	Pests and vectors		E04
		E09	Drinking water Quality		E04
		E10	Air quality		E04
		E11	Work accident		E01	E02
		E12	Work-related absenteeism		P03
Medicine	5	M01	Dyslipidemia	0	N03	N09
		M02	Diabetes mellitus	2	N02	P01	E05	E07	M04	M06	O06
		M03	Altered glycemia	1	N02	P01	E05	E07
		M04	Arterial hypertension	0	N04	P01	E05	E07
		M05	Altered blood pressure	1	N04	P01	E05	E07
		M06	Use of tobacco	1
		M07	Musculoskeletal pathology	0
		M08	Psychiatric pathology	1
		M09	Stress level and symptoms	0	N06

Age Group	Is
As ≥ 60	0
50 ≤ As < 60	1
40 ≤ As < 50	2
30 ≤ As < 40	3
As < 30	4

Indicator Code	Sub-Index
E01	3
E02	1
E03	3
E04	1
E05	1
E06	3
E07	3
E08	1
E09	2
E10	3
E11	4
E12	1

Dimension	Mr
Medicine	0.9678
Nursing	0.9608
Physical education	0.9599
Nutrition	0.3889
Dentistry	0.9637
∑Mr	4.2411

	Population N (%)	Sample n (%)	p
Sex			> 0.05
Male	1 117 (87.6)	884 (91.6)
Female	158 (12.4)	81 (8.4)
Age Group
≤ 29	50 (3.9)	44 (4.6)
30 to 39	350 (27.5)	261 (27.0)
40 to 49	245 (19.2)	209 (21.7)
50 to 59	556 (43.6)	410 (42.5)
≥ 60	74 (5.8)	41 (4.2)
Total	1275	965

Risk range	WHRI reference value
Low	WHRI < 0.530
Moderate	0.530 ≤ WHRI < 0.662
High	≥ 0.662

	n = 965			p
	Low-risk	Moderate-risk	High-risk
	WHRI < 0.530	*0.530 ≤ WHRI* < 0.662**	≥ 0.662
	n (%)	n (%)	n (%)
Sex
Male	644 (72.9)	191 (21.6)	49 (5.5)	0.002
Female	73 (90.1)	8 (9.9)	0 (0.0)	0.002
Age group
≤ 29	44 (100)	0 (0.0)	0 (0.0)	0.000
30 to 39	247 (94.6)	13 (5.0)	1 (0.0)
40 to 49	173 (82.8)	33 (15.8)	3 (1.4)
50 to 59	233 (56.8)	143 (34.9)	34 (8.3)
≥ 60	20 (48.8)	10 (24.4)	11 (26.8)
Education
Incomplete intermediate level	29 (51.8)	19 (33.9)	8 (14.3)	0.002
Complete intermediate level	438 (75.3)	116 (19.9)	28 (4.8)
Incomplete higher level	28 (84.8)	4 (12.1)	1 (3.0)
Complete higher level	124 (78.5)	28 (17.7)	6 (3.8)
Complete higher level with postgraduate degree	32 (84.2)	6 (15.8)	0 (0.0)

Dimension	Code	Age group	Risk Range			p
Dimension	Code	Age group	Low	Medium	High	p
Dentistry	O02	Oral hygiene quality	4 (36.9)	2 (44.7)	2 (61.2)	0.001
	O03	Periodontal condition	4 (41.2)	1 (41.2)	1 (57.1)	0.001
	O04	Periodontal disease	3 (55.6)	2 (50.0)	2 (42.9)	0.126
	O05	Caries	1 (46.1)	1 (63.6)	1 (60.0)	0.001
	O06	Oral lesion on soft or hard tissues	4 (100)	4 (100)	1 (100)	0.480
	O07	Bruxism	2 (54.2)	3 (47.3)	2 (60.0)	0.335
Nutrition	N01	Energy balance intake	3 (54.0)	2 (48.7)	2 (53.1)	0.001
	N02	Simple carbohydrate intake	3 (78.1)	3 (68.3)	3 (65.3)	0.001
	N03	Saturated lipids intake	3 (93.6)	3 (91.0)	3 (87.8)	0.201
	N04	Sodium mineral intake	3 (98.5)	3 (98.0)	3 (100)	0.902
	N05	Fibre intake	3 (69.8)	3 (57.3)	3 (61.2)	0.002
	N06	Alcohol use	3 (57.9)	3 (51.3)	3 (38.8)	0.003
	N07	Level of food knowledge	3 (59.5)	2 (56.3)	2 (57.1)	0.001
	N08	Body weight condition	2 (47.3)	2 (45.7)	2 (49.0)	0.002
	N09	Altered triglycerides	3 (67.9)	3 (43.4)	1 (40.8)	0.001
Physical education	P01	Physical activity level	3 (44.8)	0 (40.2)	0 (65.3)	0.001
	P02	Contemplation stage for physical activity practice	3 (73.9)	3 (58.3)	1 (32.7)	0.001
	P03	Feeling of pain	4 (93.4)	4 (67.9)	4 (79.6)	0.002
	P04	Cardiorespiratory fitness	3 (60.1)	3 (63.1)	3 (77.1)	0.001
	P05	Abdominal strength level	4 (35.6)	0 (33.5)	0 (28.1)	0.001
	P06	Flexibility level	0 (27.9)	0 (43.7)	0 (46.2)	0.001
	P07	Manual gripping force	3 (66.7)	3 (65.5)	3 (63.0)	0.003
Nursing	E02	Ergonomic risks - physical aspects	3 (81.7)	3 (68.9)	3 (63.3)	0.001
	E03	Ergonomic risks - organisational aspects	3 (94.9)	3 (94.9)	3 (91.8)	0.956
	E04	Work environment health conditions	3 (85.1)	3 (81.1)	3 (89.8)	0.259
	E05	Family relationships	3 (98.2)	3 (96.4)	3 (87.8)	0.001
	E06	Social aspects - leisure	3 (97.5)	3 (96.4)	3 (100)	0.019
	E07	Self-care level	3 (54.0)	2 (55.1)	2 (55.1)	0.001
	E08	Pests and vectors	2 (52.2)	1 (55.8)	1 (62.5)	0.031
	E09	Drinking water quality	0 (52.0)	0 (54.8)	0 (60.4)	0.733
	E10	Air quality	3 862.5)	3 (55.3)	3 (55.1)	0.147
	E11	Work accident	4 (99.6)	4 (100)	4 (100)	0.595
	E12	Work-related absenteeism	4 (48.7)	2 (32.7)	2 (32.7)	0.001
Medicine	M01	Dyslipidemia	3 (37.2)	4 (33.7)	4 (30.6)	0.082
	M02	Diabetes mellitus	4 (46.7)	2 (50.0)	2 (33.3)	0.002
	M03	Altered glycemia	4 (80.9)	4 (72.4)	4 (80.0)	0.002
	M04	Arterial hypertension	3 (84.6)	3 (74.3)	3 (37.5)	0.001
	M05	Altered blood pressure	4 (50.7)	3 (37.2)	2 (49.0)	0.001
	M06	Use of tobacco	4 (75.0)	4 (44.5)	2 (47.1)	0.001
	M07	Musculoskeletal pathology	4 (49.3)	2 (39.4)	2 (56.3)	0.001
	M08	Psychiatric pathology	4 (47.9)	4 (60.0)	3 (52.1)	0.165
	M09	Stress level and symptoms	4 (91.9)	4 (85.7)	4 (87.5)	0.021

[1] 1. Lilian Monteiro Ferrari Viterbo - PhD Student in Ecology and Environmental Health in the Faculty of Sciences and Technology of the University Fernando Pessoa (Porto, Portugal), master in Health Technologies from the Bahiana School of Medicine and Public Health (Bahia, Brazil). Graduated in Nursing in the Salvador Catholic University, Brazil. North and Northeast Health Sector Manager at Petrobras and Researcher at the UFP Energy, Environment and Health Research Unit of the University Fernando Pessoa. Salvador, Bahia, Brazil. E-mail: lilianmferrari@gmail.com

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DEVELOPMENT OF AN INNOVATIVE INDEX TO ASSESS WORKER’S HEALTH RISK: THE WHRI APPLIED TO AN OIL INDUSTRY IN BAHIA, BRAZIL

DESENVOLVIMENTO DE UM ÍNDICE INOVADOR PARA AVALIAR O RISCO EM SAÚDE DO TRABALHADOR: O WHRI APLICADO EM UMA INDÚSTRIA DE PETRÓLEO NA BAHIA, BRASIL

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