The Working Environment in Primary Healthcare Outpatient Facilities: Assessment of Physical Factors and Health Professionals' Perceptions of Working Environment Conditions

Abstract

The objectives of this study were to assess the adequacy of physical parameters/factors (temperature, relative humidity, noise, and illuminance levels) of the work environment in PHC facilities, to evaluate the association between the adequacy of these measured physical parameters and the physical characteristics of the PHC facilities and their surroundings and to assess the association between health professionals' perceptions about exposure to physical risks in the PHC work environment and the adequacy of physical parameters measured in the same facilities. The study monitored 23 PHC facilities in southern Brazil and interviewed 210 health professionals. Data analysis involved Pearson's chi-square, Fisher's exact test, Spearman's correlation, and multivariate linear regression analysis was used to control for confounding factors. The significance level was set at 5% (p ≤ 0.05). The combination of temperature and relative humidity presented thermal comfort levels outside the adopted criteria for adequacy in consultation (outdoor relative humidity, p = 0.013) and procedure rooms (front door open, p = 0.034). Inadequate sound comfort (noise) levels in the morning shift were found in the vaccination (front door open, p = 0.021) and consultation rooms (movement of people, p = 0.016). In PHC facilities where reception rooms had insufficient lighting, internal curtains were opened less frequently (p = 0.047). The analysis of health professionals' perceptions of physical factors demonstrated that physicians more frequently perceive the physical risk of temperature and humidity (p = 0.044). The higher the number of nurses (p = 0.004) and oral health technicians in the PHC facilities (p = 0.031), the greater the general percentage of adequacy of monitored physical parameters. It was also confirmed that the higher the perception of moderate or severe physical risk among health professionals, the lower the general percentage of the adequacy of the physical parameters of the work environment of the PHC facilities evaluated (r_s = -0.450, p = 0.031). This study's evidence contributes to a better understanding of physical conditions and future occupational interventions to ensure the comfort, safety, and well-being of PHC workers.

Keywords: air humidity; illuminance; noise; occupational health; physical factors; primary healthcare; risk perception; security and healthy environmental; temperature.

Figure 1

Temperature and relative humidity in PHC facilities.

Figure 2

Average noise levels were measured in each PHC facility (from line 1 to line 23), with eight records in each of four rooms and across two shifts.

Figure 3

Percentage of adequacy levels (individual and total) obtained in 23 PHC facilities. The vertical line in the box plot represents the median, and the lower and upper limits represent the first and third quartiles. Circles (°) and asterisks (*) represent extreme values in the sample. Circles exceeded 1.5 times the interquartile range and asterisks exceeded 3 times this value.

Figure 4

Percentage of PHC facilities with adequacy levels equal to or above 70% in three parameters.

Figure 5

Association between the general percentage of environmental adequacy and the perception of moderate or severe physical risk by the health professional.

Figure 6

Association between the general percentage of environmental adequacy and the percentage of nurses working in the PHC facilities.