# Abstract

This paper discusses the results of a literature review carried out at the Biblioteca Virtual em Saúde (BVS) and the Scientific Electronic Library Online (SciELO) databases, covering a period of 20 years (1997-2017), about teachers’ working conditions and health. Our search returned a set of 175 eligible studies that were grouped, according to their characteristics and size samples, into the following categories: (1) Health disorders; (2) Working conditions and health; (3) Quality of life; (4) Work, career and fundamentals of teaching. Results show a growing interest on the topic in recent years, and especially regarding teachers’ quality of life as of 2006. Despite the vast number of studies on teachers’ work and health, the educational field has spared little attention to its professionals’ health, showing the need for a multidisciplinary approach on the topic.

Keywords:
Teachers; Work; Occupational Health

# Introduction

Teachers are a professional category of fundamental importance for the society and its development, as recognized by the International Labour Organization (ILO/UNESCO, 2016THE ILO/UNESCO Recommendation concerning the Status of Teachers (1966) and the UNESCO Recommendation concerning the Status of Higher-Education Teaching Personnel (1997). Geneva, ILO, 2016.). In recent years, the academic production devoted to the subject has been pointing out to a scenario of increase workload and precarious working conditions of these professionals (Assunção; Oliveira, 2009ASSUNÇÃO, A. Á.; OLIVIERA, D. A. Intensificação do trabalho e saúde dos professores. Educação e Sociedade, Campinas, v. 30, n. 107, p. 349-372, 2009. DOI: 10.1590/S0101-73302009000200003
https://doi.org/10.1590/S0101-7330200900...
; Guerreiro et al., 2016GUERREIRO, N. P.; NUNES, E. F. P. A.; GONZÁLEZ, A. D. et al. Perfil sociodemográfico, condições e cargas de trabalho de professores da rede estadual de ensino de um município da região sul do Brasil. Trabalho, Educação e Saúde, Rio de Janeiro, v. 14, n. 1, p. 197-217, 2016. DOI: 10.1590/1981-7746-sol00027
https://doi.org/10.1590/1981-7746-sol000...
), entailing negative impacts on health (Delcor et al., 2004DELCOR, N. S.; ARAÚJO, T. M.; REIS, E. J. F. B. et al. Condições de trabalho e saúde dos professores da rede particular de ensino de Vitória da Conquista, Bahia, Brasil. Cadernos de Saúde Pública, Rio de Janeiro, v. 20, n. 1, p. 187-196, 2004. DOI: 10.1590/S0102-311X2004000100035
https://doi.org/10.1590/S0102-311X200400...
; Gasparini et al., 2005GASPARINI, S. M.; BARRETO, S. M.; ASSUNÇÃO, A. Á. O professor, as condições de trabalho e os efeitos sobre sua saúde. Educação e Pesquisa, São Paulo, v. 31, n. 2, p. 189-199, 2005. DOI: 10.1590/S1517-97022005000200003
https://doi.org/10.1590/S1517-9702200500...
) and, consequently, on life (Silva; Fischer, 2020SILVA, J. P.; FISCHER, F. M. Invasão multiforme da vida pelo trabalho entre professores de educação básica e repercussões sobre a saúde. Revista de Saúde Pública, São Paulo, v. 54, n. 3, p. 1-8, 2020. DOI: 10.11606/s1518-8787.2020054001547
https://doi.org/10.11606/s1518-8787.2020...
).

In the framework of diseases typically related to the profession, mental and behavioral disorders; voice disorders; musculoskeletal disorders; and heart diseases stand out (Vedovato; Monteiro, 2008VEDOVATO, T. G.; MONTEIRO, M. I. Perfil sociodemográfico e condições de saúde e trabalho dos professores de nove escolas estaduais paulistas. Escola de Enfermagem, São Paulo, v. 42, n. 2, p. 290-297, 2008. DOI: 10.1590/S0080-62342008000200012
https://doi.org/10.1590/S0080-6234200800...
), aggravated by the high incidence reported by mental and behavioral disorders (Farber, 1984; Paparelli, 2009PAPARELLI, R. Desgaste mental do professor da rede pública de ensino: trabalho sem sentido sob a política de regularização de fluxo escolar. Tese (Doutorado em Psicologia) - Instituto de Psicologia, Universidade de São Paulo, São Paulo, 2009. Disponível em : <Disponível em : https://www.teses.usp.br/teses/disponiveis/47/47134/tde-07122009-145916/pt-br.php >. Acesso em: 20 jul. 2021.
https://www.teses.usp.br/teses/disponive...
; Cortez et al., 2017CORTEZ, P. A.; SOUZA, M. V. R.; AMARAL, L. O. et al. A saúde docente no trabalho: apontamentos a partir da literatura recente. Cadernos de Saúde Coletiva, Rio de Janeiro, v. 25, n. 1, p. 113-122, 2017. DOI: 10.1590/1414-462X201700010001
https://doi.org/10.1590/1414-462X2017000...
).

The seriousness of the problem calls into question the true conditions of the teaching practice, i.e., the conditions that teachers face to carry out their work of public and social relevance. Therefore, it is increasingly convenient to devote attention to the issue. In this sense, efforts to track and review the scientific production on the subject gain more importance, especially in view of the increase in the number of publications identified (Araújo et al., 2019ARAÚJO, T. M.; PINHO, P. S.; MASSON, M. L. V. Trabalho e saúde de professoras e professores no Brasil: reflexões sobre trajetórias das investigações, avanços e desafios. Cadernos de Saúde Pública, Rio de Janeiro, v. 35, n. 1, p. 1-14, 2019. DOI: 10.1590/0102-311x00087318
https://doi.org/10.1590/0102-311x0008731...
).

Reviewing the scientific production on work and health of basic education teachers published over a 20-year period (1997-2017), we have identified some patterns that, thematically coded, evinced a profile. Above all, considering that surveys that reached similar results (Leite; Souza, 2011LEITE, M. P.; SOUZA, A. N. Condições de trabalho e suas repercussões na saúde de professores da educação básica no Brasil. Educação e Sociedade, Campinas, v. 32, n. 117, p. 1105-1121, 2011. DOI: 10.1590/S0101-73302011000400012
https://doi.org/10.1590/S0101-7330201100...
; Cortez et al., 2017CORTEZ, P. A.; SOUZA, M. V. R.; AMARAL, L. O. et al. A saúde docente no trabalho: apontamentos a partir da literatura recente. Cadernos de Saúde Coletiva, Rio de Janeiro, v. 25, n. 1, p. 113-122, 2017. DOI: 10.1590/1414-462X201700010001
https://doi.org/10.1590/1414-462X2017000...
) addressed different periods of analysis (1996-2007; 2003-2016, respectively), used different databases, focused on studies of different types, dealt with a relatively smaller volume of findings, and classified them under particular forms, we understand that this work provides a new contribution to understand, review, and discuss the literature concerning the subject.

# Methods

A bibliographic survey was carried out in the Biblioteca Virtual de Saúde (BVS) and Scientific Electronic Library Online (SciELO) databases. The aim was to find articles dedicated to the theme of work and health of teachers that showed identification and/or interest for the perspective of the worker’s health theoretical field (Mendes; Dias, 1991MENDES, R.; DIAS, E. C. Da medicina do trabalho à saúde do trabalhador. Revista de Saúde Pública, São Paulo, v. 25, n. 5, p. 341-349, 1991. Disponível em: < Disponível em: https://www.nescon.medicina.ufmg.br/biblioteca/imagem/2977.pdf >. Acesso em: 20 jul. 2021.
https://www.nescon.medicina.ufmg.br/bibl...
). Thus, the search strategy aimed to ensure the maximum comprehensiveness possible and employed the Portuguese terms: “professor”, “docente”, “saúde do professor e docente”, “cotidiano professor e docente” and “profissionais da educação”. In addition, we used the truncation resource, so that when we used the expression “professo$” (or “professo*”) the search would return all results derived from the truncated root, namely: professor, professora, professores, professoras. The same applies to the term “docent$”: docente, docentes.

Depending on its characteristics, each platform required specific adjustments to the strategy. In the BVS, for example, we did not use the expression “health” (teacher’s or docent’s). Since it is a health research database, doing so would be redundant. However, it allowed us to apply filters such as “workers’ health”, “working conditions”, “occupational diseases”, and others that helped restricting the search.

In SciELO, the expression “health” (of the teacher, professor, and education professionals) was used, since it is not a platform specific to the health field. At the same time, journals from other areas indexed therein (such as education and educational psychology) were considered of interest, since one of the objectives was to verify whether studies from the educational field focused on the problem of teachers’ illnesses.

For the aforementioned reasons - the intended comprehensive scope - all results that met the eligibility criteria were considered, regardless of the journal. These criteria consisted of: (1) being a research comprising elementary and secondary school teachers; (2) having been published in the last 20 years (1997-2017); and (3) being focused on the Brazilian teachers. Articles in Portuguese, Spanish, and English were included.

Articles focusing on university professors and teachers of early childhood education were excluded, as well as duplicate studies. This was a three-stage process. During the preliminary analysis, filters and delimitation resources available in the platforms (especially in the BVS) were applied to restrict the dimension of the findings to relevant articles. Among the filters, for example, “workers’ health”, “working conditions”, and “occupational diseases” were used. Among the delimiting features, “and not university and higher education professors” and “and not early childhood education” were used. Since we identified that, among the studies that focused on university professors, most investigated professors in the nursing field, we also included “and not nursing”.

After that, we performed a screening to exclude titles that did not match with the parameters defined. Altogether, 394 articles were excluded in this step. Finally, the abstracts of the resulting articles (n=232) were checked (in some cases, the content had to be consulted for clarification) in order to discharge those that did not match. The review of eligible articles (n=175) followed the thematic coding procedure (Gibbs, 2009GIBBS, G. Análise de dados qualitativos. Porto Alegre: Artmed, 2009.) supported by the Mendeley software.

In terms of the survey initial design, it was based on the literature review work by Leite and Souza (2011LEITE, M. P.; SOUZA, A. N. Condições de trabalho e suas repercussões na saúde de professores da educação básica no Brasil. Educação e Sociedade, Campinas, v. 32, n. 117, p. 1105-1121, 2011. DOI: 10.1590/S0101-73302011000400012
https://doi.org/10.1590/S0101-7330201100...
), prepared as part of the project “working conditions and their echoes on the health of Basic Education teachers in Brazil” (Ferreira, 2010FERREIRA, L. L. Relação entre o trabalho e a saúde de professores na Educação Básica no Brasil. Relatório Final do Projeto “Condições de trabalho e suas repercussões na saúde dos professores de Educação Básica no Brasil”. São Paulo: Fundacentro, 2010.), and that analyzed 65 works published from 1997 to 2006,33Although published in 2011, the aforementioned review (Leite; Souza, 2011) analyzed works published up to 2006. among theses (n=10), dissertations (n=51) and books (n=04).

In our survey, we gave priority to articles and updated the analysis period, extending it up to 2017 (1997-2017). In order to avoid duplicity or overlapping, we made sure that no results previously covered by the aforementioned review (Leite; Souza, 2011LEITE, M. P.; SOUZA, A. N. Condições de trabalho e suas repercussões na saúde de professores da educação básica no Brasil. Educação e Sociedade, Campinas, v. 32, n. 117, p. 1105-1121, 2011. DOI: 10.1590/S0101-73302011000400012
https://doi.org/10.1590/S0101-7330201100...
) were incorporated. This task was made easier by the fact that we reviewed different productions. We also strove to identify articles resulting from theses and dissertations part of the 65 works of the study in question, and we reached 9 matchings. We kept these articles among our results because these were publications of different types.

The research conducted for this review was approved by the Research Ethics Committee of the Faculdade de Saúde Pública of Universidade de São Paulo, no. 1,553,835, CAAE 54839516.1.0000.5421.

# Results

After applying filters, delimiting features and exclusions, the results showed a total of 175 eligible studies: BVS (n=101) and SciELO (n=74). The material review led to four main categories of studies. Graph 1 presents these categories44The categories are represented in the order they were formed based on the findings and, as such, they firstly reflect the survey conducted in the BVS. Category #4 was established only after the survey in the SciELO database. and the distribution of findings in percentage. Table 1, in turn, shows the structure of the four main categories - their subcategories - in absolute numbers and percentages.

Graph 1
Main categories of publications\

Table 1
Composition of publications - categories and subcategories

## Category 1. Studies on health disorders

In its subcategories, the first category comprised the studies aimed to approach specific health conditions (such as those related to voice disorders and mental and behavioral disorders, for example, according to Table 1) that affect teachers. In general, both types of studies are linked to the fields of speech therapy and mental health, respectively.

Although research on the other components of this category (musculoskeletal disorders, cardiovascular health, and eye health) were not found in significant numbers, this category, like the others, has room to frame and group (among subcategories) new investigations to be conducted on health conditions found specifically among teachers.

As a core methodological characteristic, the articles in this section were defined by the predominantly quantitative analyses, except for some studies in the field of psychology devoted to teachers’ mental health that used qualitative methods.

## Category 2. Studies on teachers’ working conditions and health

The second category included a group that was more complex to be classified, given the diversity of studies associated with the theme. Even having a common core, they showed to share a link of a nature not always easy to identify, since such a link sometimes presented was not very clear at first sight. The analysis of their main characteristics, however, revealed that the studies were focused on phenomena whose manifestations directly refer to working conditions in their relationship with health, as shown in Table 1.

Despite the variety presented in studies associated with this category, they showed consistent correspondence with the central theme in question. Thus, researches dedicated to investigating teachers’ working conditions and health per se (or working conditions and health in general), accounted for most of the findings.

Besides the works that bear in their titles and/or abstracts the characterization of teachers’ working conditions and health as a central subject (for example, the study by Gasparini et al., 2005GASPARINI, S. M.; BARRETO, S. M.; ASSUNÇÃO, A. Á. O professor, as condições de trabalho e os efeitos sobre sua saúde. Educação e Pesquisa, São Paulo, v. 31, n. 2, p. 189-199, 2005. DOI: 10.1590/S1517-97022005000200003
https://doi.org/10.1590/S1517-9702200500...
), we found works that, although investigating different subjects, proved to be focused on specific elements of the teachers’ working context, whose manifestation is linked to and/or directly explained by general working conditions. Such studies addressed, for example, moral harassment at work (Campos et al., 2012CAMPOS, I. C. M., SERAFIM, A. C., CUSTÓDIO, K. V. et al. Moral harassment of public schools teachers. Work, Amsterdam, v. 41, n. 1, p. 2001-2007, 2012. DOI: 10.3233/WOR-2012-0422-2001
https://doi.org/10.3233/WOR-2012-0422-20...
); relationship between unionism and working conditions configuration (Souza; Brito, 2012SOUZA, K. R.; BRITO, J. C. Sindicalismo, condições de trabalho e saúde: a perspectiva dos profissionais da educação do Rio de Janeiro. Ciência e saúde coletiva, Rio de Janeiro, v. 17, n. 2, p. 379-388, 2012. DOI: 10.1590/S1413-81232012000200012
https://doi.org/10.1590/S1413-8123201200...
); and relationship between the implementation of innovations and health (Friedman et al., 2013FRIEDMAN, S. R.; LOH, L. C.; BURDICK, W. P. Educator perceptions of the relationship between education innovations and improved health. Medical Teacher, London, v. 35, n. 4, p. 1060-1067, 2013. DOI: 10.3109/0142159X.2012.733450
https://doi.org/10.3109/0142159X.2012.73...
). Together, these studies made up the first subcategory “working conditions and health in general”.

In the same vein, studies on the “teachers’ morbidity profile” were also linked to the category in question. It is certain that those studies entail typical illnesses as the main result. For that reason, we initially considered that they should be listed in the first category (according to Table 1), that of “health disorders”. However, upon analysis, we found that they do not focus on the study of a particular disease or typical health condition, as is the case of the papers in question.

When we talk about working conditions and health of a given professional group, the subject naturally invokes the need to know the health status of that group, as the studies on morbidity profile indicate. These studies of quantitative and epidemiological nature provide an important contribution to the understanding of the health status of the population studied.

Devoted to the perspective of occupational health, however, publications do more than simply trace the morbidity profile of professional groups. The working conditions faced by such groups are brought into focus, i.e., the circumstances that directly or indirectly led to the health condition they describe. Therefore, as a way of explaining their results, morbidity profile studies usually discuss the panorama of working conditions that gave rise to the occupational diseases they identify, as well as the distribution of those diseases among the population studied.

Therefore, these studies not only suggest the incidence and prevalence of diseases among a population of workers, but also aim to present the context in which the illnesses occurred, considering the existing working conditions. It is our view that within the proposed categorization, the fundamental characteristics of these studies on morbidity profile correspond to the category of studies on “working conditions and health”.

We know that, in general, all the health conditions of teachers (at least the work-related ones), reviewed in the light of workers’ health, identify this interdependence between working conditions and health. However, in the second subcategory (morbidity profile) we refer to studies whose central phenomenon addressed (falling sick) is expressed so closely linked to teachers’ general working conditions that the characteristics and components of those conditions became the core explanatory elements.

In addition to the two above-mentioned subcategories, we have identified other subcategories aimed at specific subjects, but equally focused on events related to working conditions and health. This was the case of the studies on “strategies of resistance and health promotion”, “gender relations and work”, “research-intervention”, and “environmental risk conditions and agents”, shown in Table 1. All of these studies, in one way or another, have shown to have taken working conditions and health as their starting point and/or core parameter.

Recognizing the profusion of subjects pooled under the category “working conditions and health”, as well as the differences between them, we consider the effort to be complex, yet fruitful. Understanding that some works were ranked within very tenuous limits, we inserted the criteria used for synthesizing, in an attempt to ensure that the identity specificities of each study were maintained. This could be expressed from the very titles of the subcategories.

In the methodological light, except for the articles on morbidity profile and the few studies on environmental analysis of risk agents (identified with the area of occupational hygiene), most of the section’s findings employed a qualitative method, based on interviews or on the observation of the work activity. Psychodynamics of work and ergonomics were the main theoretical references, besides the Clinic of Activity and Ergology, to a lesser extent.

## Category 3. Studies on teachers’ quality of life and work

The analysis of the academic production on teachers’ work and health also unveiled an expressive set of studies on teachers’ quality of life. Interestingly, such studies emerged only from the year 2006, being constant since then and pointing to growing interest in the subject, as shown in Graph 2.

Graph 2
Set of results according to year of publication

Among the findings in this category, two main groups stand out. The first deals with the teachers’ quality of life in the strict sense of the work, and is characterized by studies on quality of life at work (QLW). The other was made up of publications aimed at studying the quality of life of teachers in a specific sense, i.e., related to some health condition such as voice disorder or burnout, for example.

The main goal of the set of studies on quality of life was to identify (measure, more precisely) the status of teachers’ quality of life, either in a broad sense or related to some specific pathology. The typically quantitative approach and the use of predominantly standardized instruments are among the main characteristics of these studies.

Regarding instruments, the findings pointed to the existence of two types: generic and specific instruments. According to Dantas et al. (2003DANTAS, R. A. S.; SAWADA, N. O.; MALERBO, M. B. Pesquisas sobre qualidade de vida: revisão da produção científica das universidades públicas do estado de São Paulo. Latino-americana Enfermagem, Ribeirão Preto, v. 11, n. 4, p. 532-538, 2003. DOI: 10.1590/S0104-11692003000400017
https://doi.org/10.1590/S0104-1169200300...
), the generic instruments may be used to study individuals belonging to the general population or specific groups (such as teachers). It has the advantage of allowing the comparison of quality of life between healthy and sick individuals, or individuals with the same disease. As a disadvantage, they are not sensitive to detect particular and specific aspects of the quality of life of individuals with a given disease. According to the authors, the specific instruments, on the other hand, would have the advantage of being able to detect particularities of quality of life in certain situations, despite their difficulties in understanding the phenomenon and validating the psychometric characteristics of the instrument. Because they provide different (and therefore complementary) information, these instruments can be used concomitantly, according to the authors.

Among the generic instruments most used in studies on teachers’ quality of life, two stand out. The first was the Medical Outcomes Studies 36-item Short-Form (MOS SF-36), which basically analyzes eight domains: functional capacity; limitations by physical aspects; pain; general health status; vitality; social aspects; limitation by emotional aspects and mental health, as used, for example, in the study by Rocha and Fernandes (2008ROCHA, V. M.; FERNANDES, M. H. Qualidade de vida de professores do ensino fundamental: uma perspectiva para a promoção da saúde do trabalhador. Jornal Brasileiro de Psiquiatria, Rio de Janeiro, v. 57, n. 1, p. 23-27, 2008. DOI: 10.1590/S0047-20852008000100005
https://doi.org/10.1590/S0047-2085200800...
). The other is the World Health Organization Quality of Life/Bref (WHOQOL-bref), an instrument validated by the World Health Organization (WHO). This instrument (questionnaire) aims to measure quality of life based on four domains: physical, psychological, social relations, and environment. In addition to these four domains, it includes two questions about the general perception of quality of life and health of the individual, as used, for example, in the study by Pereira et al. (2013PEREIRA, É. F.; TEIXEIRA, C. S.; LOPES, A. S. Qualidade de vida de professores de educação básica do município de Florianópolis, SC, Brasil. Ciência e Saúde Coletiva, Rio de Janeiro, v. 18, n. 7, p. 1963-1970, 2013. DOI: 10.1590/S1413-81232013000700011
https://doi.org/10.1590/S1413-8123201300...
).

In the light of the studies using specific instruments, the wide range of pathologies covered by them led to another type of dynamic marked by the use of several distinct tools. Usually resorting to some generic instrument on a complementary basis, the analysis resources used by these studies proved to be as varied as the specific pathology or health condition they seek to investigate. This is the case, for example, of the Voice-Related Quality of Life (V-RQOL) instrument, identified by Ribas et al. (2014RIBAS, T. M.; PENTEADO, R. Z.; GARCÍA-ZAPATA, M. T. A. Qualidade de vida relacionada à voz de professores: uma revisão sistemática exploratória da literatura. CEFAC, Campinas, v. 16, n. 1, p. 294-306, 2014. DOI: 10.1590/1982-021620144812
https://doi.org/10.1590/1982-02162014481...
), as the most used tool, as well as the Maslach Burnout Inventory (MBI), used by Tabeleão et al. (2011TABELEÃO, V. P.; TOMASI, E.; NEVES, S. F. Qualidade de vida e esgotamento profissional entre docentes da rede pública de Ensino Médio e Fundamental no Sul do Brasil. Cadernos de Saúde Pública, Rio de Janeiro, v. 27, n. 12, p. 2401-2408, 2011. DOI: 10.1590/S0102-311X2011001200011
https://doi.org/10.1590/S0102-311X201100...
) in their study on teachers’ quality of life and Burnout.

In general, the findings of the category “quality of life and work” also involved studies on teacher well-being and satisfaction and lifestyle, although to a lesser extent.

Taken together, the results curiously indicated relatively high levels of satisfaction with quality of life among teachers while, conversely, high levels of dissatisfaction with work (Moreira et al., 2010MOREIRA, H. R.; NASCIMENTO, J. V.; SONOO, C. N. et al. Qualidade de vida do trabalhador docente e os ciclos vitais de professores de educação física do estado do Paraná, Brasil. Revista brasileira de ciência e movimento, Brasília, DF, v. 18, n. 3, p. 12-20, 2010. DOI: 10.18511/rbcm.v18i3.1650
https://doi.org/10.18511/rbcm.v18i3.1650...
; Penteado; Pereira, 2007PENTEADO, R. Z.; PEREIRA, I. M. T. B. Qualidade de vida e saúde vocal de professores. Revista de Saúde Pública, São Paulo, v. 41, n. 2, p. 236-243, 2007. DOI: 10.1590/S0034-89102007000200010
https://doi.org/10.1590/S0034-8910200700...
; Oliveira et al., 2016OLIVEIRA, T. F.; LINS, V. L.; SILVA, R. M. et al. Qualidade de vida no trabalho: um estudo comparativo entre professores de escola pública e privada. Psicologia Argumento, Curitiba, v. 34, n. 85, p. 104-119, 2016. DOI: 10.7213/psicol.argum.34.085.AO02
https://doi.org/10.7213/psicol.argum.34....
).

## Category 4. Studies on work, career and fundamentals of teaching action

The results linked to this section have a remarkable peculiarity: they appeared only in the SciELO search. This is explained both by the origin of these studies, and by the different nature of the two databases consulted. While the BVS is specifically devoted to the health field, SciELO has a broader indexing spectrum, including journals from various fields of knowledge.

Mainly originating from the field of education (pedagogy and educational psychology, in addition to studies in the field of economics, addressing teachers’ salary and careers), and marked by an almost exclusively qualitative approach, the findings fit into this category were the most complex to typify, since their titles, subjects, and forms of presentation showed a wide diversity, as shown in Table 1. Resorting to a freer and sometimes even poetic style, as is usual in some fields such as education, such studies often used titles and presentations that did not always exactly match their actual research subjects. After a deep analysis of the material, it was found that some titles, apparently very different from each other, addressed the same subject.

In general, the set of findings reflected two major lines of research: teacher training and educational public policies. It was observed that, among the 35 papers reviewed in this category, none dealt exactly with the issues of teachers’ health. This preliminarily indicates that studies in the field of education have not been concerned with researching the health of its professionals, neither from the perspective of teacher training nor in the light of educational public policies. Even when the topic “teaching work” was evoked, focus was on pedagogical and/or career issues, aiming to discuss how the teaching work can be improved in terms of pedagogical rather than health results.

# Distribution of results according to year of publication

The review of studies based on the year of publication revealed that, despite some fluctuations, interest in the theme has increased, especially as of 2006. There were 38 studies between 1997 and 2006 (average of 3.8 publications), the period covered by the reference study (Leite; Souza, 2011LEITE, M. P.; SOUZA, A. N. Condições de trabalho e suas repercussões na saúde de professores da educação básica no Brasil. Educação e Sociedade, Campinas, v. 32, n. 117, p. 1105-1121, 2011. DOI: 10.1590/S0101-73302011000400012
https://doi.org/10.1590/S0101-7330201100...
), and 137 new studies since then, i.e., between 2007 and 2017 (average of 12.4). Graph 2 presents the results.

Considering the study by Leite and Souza (2011LEITE, M. P.; SOUZA, A. N. Condições de trabalho e suas repercussões na saúde de professores da educação básica no Brasil. Educação e Sociedade, Campinas, v. 32, n. 117, p. 1105-1121, 2011. DOI: 10.1590/S0101-73302011000400012
https://doi.org/10.1590/S0101-7330201100...
), it should be clarified that the 38 results we identified in the same period (1997-2006) are not confounded with the 65 works described in that work, since we identified only nine articles as directly stemming from the theses or dissertations analyzed by that work. Thus, we are referring to a set of at least 240 publications (this survey n=175, aforementioned study n=65).

# Discussion

In addition to presenting the profile of the publications, which is the initial objective of our work, we found results similar to those of the review on which we grounded our work (Leite; Souza, 2011LEITE, M. P.; SOUZA, A. N. Condições de trabalho e suas repercussões na saúde de professores da educação básica no Brasil. Educação e Sociedade, Campinas, v. 32, n. 117, p. 1105-1121, 2011. DOI: 10.1590/S0101-73302011000400012
https://doi.org/10.1590/S0101-7330201100...
). That confirmed the endurance of a context of intensification of precariousness at work and diseasing among teachers.

In this sense, the authors observed the prevalence of research on mental and vocal disorders among teachers, stating that: “the main morbid situations affecting teachers have been vocal dysfunction, stress, depression, among others” (Leite; Souza, 2011LEITE, M. P.; SOUZA, A. N. Condições de trabalho e suas repercussões na saúde de professores da educação básica no Brasil. Educação e Sociedade, Campinas, v. 32, n. 117, p. 1105-1121, 2011. DOI: 10.1590/S0101-73302011000400012
https://doi.org/10.1590/S0101-7330201100...
, p. 1110, free translation). In terms of the most prevalent morbidities showed by the published studies it confirms the results found in previous research works. In terms of the publications’ profile, studies on specific health disorders remain the majority, constituting 42% of our findings.

Regarding the new elements identified, in addition to the increase in the volume of publications, the emergence of studies on teachers’ work-related quality of life as of 2006 is worth of notice. Additionally, and as we tried to incorporate, the broadening of the viewpoint of studies on teachers’ work performed in the field of education also deserves to be mentioned something that constituted a specific category in our profile, although the ranking has not been defined by area of knowledge, but by subject of study.

The literature review have the potential to assist researchers and other stakeholders to adopt a position facing similar research problems and contexts. Different search criteria and findings classification may be used, since they all assume a given level of arbitrariness, as Paparelli (2009PAPARELLI, R. Desgaste mental do professor da rede pública de ensino: trabalho sem sentido sob a política de regularização de fluxo escolar. Tese (Doutorado em Psicologia) - Instituto de Psicologia, Universidade de São Paulo, São Paulo, 2009. Disponível em : <Disponível em : https://www.teses.usp.br/teses/disponiveis/47/47134/tde-07122009-145916/pt-br.php >. Acesso em: 20 jul. 2021.
https://www.teses.usp.br/teses/disponive...
) reminds us, impacting on choices and variations. Still, whatever the criterion adopted, those studies are relevant especially when dealing with subjects whose accumulation of works reaches a significant volume and demands some kind of synthesis, as is the case of the theme studied in this paper. In doing so, researchers reorganize the subject’s state-of-the-art and provide a feasible starting point.

The study by Cunha (2009CUNHA, K. W. V. A produção científica no Brasil nos anos de 2003 a 2008 sobre síndrome de Burnout e docência. 2009. Tese (Mestrado em Saúde Pública) - Escola Nacional de Saúde Pública Sergio Arouca, Fiocruz, Rio de Janeiro, 2009. Disponível em: <Disponível em: https://www.arca.fiocruz.br/handle/icict/2352 >. Acesso em: 20 jul. 2021.
https://www.arca.fiocruz.br/handle/icict...
), for example, analyzed the scientific production in Brazil on Burnout syndrome and teaching, from 2003 to 2008. The author identified several works and, focusing on the specific issue of Burnout, proposed a categorization based on the following criteria: (1) Breakdown by journals, areas of concentration, and year of publication; (2) Methodologies used in the studies; (3) Distribution of works according to region of publication.

As it was specific about Burnout, the set of works approached by the study was numerically restricted (n=10), but it drew attention to the perception that categorizing these works (according to the objectives of the study) would be advisable.

The study by Cortez et al. (2017CORTEZ, P. A.; SOUZA, M. V. R.; AMARAL, L. O. et al. A saúde docente no trabalho: apontamentos a partir da literatura recente. Cadernos de Saúde Coletiva, Rio de Janeiro, v. 25, n. 1, p. 113-122, 2017. DOI: 10.1590/1414-462X201700010001
https://doi.org/10.1590/1414-462X2017000...
) included a similar proposal. The authors aimed to analyze publications from the Biblioteca Virtual de Saúde em Psicologia (BVS-Psi) related to health in the teaching work, covering a 14-year period (2003-2016). Although they said that it was a survey specifically focused on the area of psychology, the results presented were not limited to it, and comprised studies from several areas, such as: speech therapy, pedagogy, medicine, administration, and nursing, among others. They also included teachers from the most varied grades (from nursery school to college), disregarding the specificities of each of them. We believe this requires some caution, at least when it comes to reviewing the data together, as was done in the study in question.

In terms of volume of publications, the results they found (n=69) were close to those also found in the BVS (n=101), indicating that despite the authors’ statement, their search seems to have returned results not only from the field of psychology (BVS-Psi). Thus, the difference was mainly due to the time cut-off adopted (2003-2016). The main fact to highlight, however, is that the aforementioned work presented the same concern when proposing a categorization of the works. Being a typical review study, its classification criteria were diverse, encompassing: area; theoretical reference; theme; participants; method; instruments; axes of analysis, and predominant theme pooling.

As they also presented their own way of categorizing their findings, it is worth summarizing the dialogue with the work of Leite and Souza (2011LEITE, M. P.; SOUZA, A. N. Condições de trabalho e suas repercussões na saúde de professores da educação básica no Brasil. Educação e Sociedade, Campinas, v. 32, n. 117, p. 1105-1121, 2011. DOI: 10.1590/S0101-73302011000400012
https://doi.org/10.1590/S0101-7330201100...
), aimed to analyze the works identified “based on the research on teaching malaise, emotional stress and Burnout syndrome” (Leite; Souza, 2011LEITE, M. P.; SOUZA, A. N. Condições de trabalho e suas repercussões na saúde de professores da educação básica no Brasil. Educação e Sociedade, Campinas, v. 32, n. 117, p. 1105-1121, 2011. DOI: 10.1590/S0101-73302011000400012
https://doi.org/10.1590/S0101-7330201100...
, p. 1110, free translation). In the electronic document “Estado da arte” (Leite; Souza, 2007LEITE, M. P.; SOUZA, A. N. (Coord.). Condições de trabalho e suas repercussões na saúde de professores da educação básica no Brasil: estado da arte. Campinas: Unicamp, 2007.), the results were presented and discussed from the categories: “1. The teaching work in figures; 2. Organization of the teaching work: working conditions and health; 3. Teacher malaise; 4. Studies on the voice: voice disorders; 5. Emotional Stress and Burnout Syndrome” (Leite; Souza, 2007LEITE, M. P.; SOUZA, A. N. (Coord.). Condições de trabalho e suas repercussões na saúde de professores da educação básica no Brasil: estado da arte. Campinas: Unicamp, 2007., p. 19, free translation). It is noticeable that the authors followed a trend towards classifying works according to the subject of investigation of each study (Burnout, malaise, dysphonia, etc.), as we also did.

Considering the Estado da arte (Leite; Souza, 2011LEITE, M. P.; SOUZA, A. N. Condições de trabalho e suas repercussões na saúde de professores da educação básica no Brasil. Educação e Sociedade, Campinas, v. 32, n. 117, p. 1105-1121, 2011. DOI: 10.1590/S0101-73302011000400012
https://doi.org/10.1590/S0101-7330201100...
) as an important contribution to the area and based on it, Paparelli (2009PAPARELLI, R. Desgaste mental do professor da rede pública de ensino: trabalho sem sentido sob a política de regularização de fluxo escolar. Tese (Doutorado em Psicologia) - Instituto de Psicologia, Universidade de São Paulo, São Paulo, 2009. Disponível em : <Disponível em : https://www.teses.usp.br/teses/disponiveis/47/47134/tde-07122009-145916/pt-br.php >. Acesso em: 20 jul. 2021.
https://www.teses.usp.br/teses/disponive...
) also proposed a reclassification for the findings, as follows: (1) Research in the field of Speech Therapy; (2) Epidemiological profile of teachers’ morbidity; (3) Research that approach mental suffering, such as Burnout or stress; (4) Research that approach mental suffering in general; (5) Research on ergonomics of activity and psychodynamics of work; and (6) Miscellaneous themes or group of papers that did not fit into any of the constructed categories. As can be observed, the criteria adopted were hybrid, comprising both research subjects (for example: “Research that approach mental suffering”) and fields of study (“Research in the field of speech therapy”, “Research in ergonomics of activity”).

As we noticed some patterns in the works surveyed, it is our view that, as in other works consulted, it would be advisable to propose pooling them by categories. The fact that we have found an expressive number of publications also confirmed the viability of the intent, since when working with a given volume of publications, the search for some strategy capable of organizing and consolidating the data seems to be crucial.

Finally, as the publications mentioned in this discussion make clear, some works reported traits of review studies, following two main trends. The first was that of a broader perspective, i.e., a general review on the subject of the teachers’ work and health. The studies by Leite and Souza (2011LEITE, M. P.; SOUZA, A. N. Condições de trabalho e suas repercussões na saúde de professores da educação básica no Brasil. Educação e Sociedade, Campinas, v. 32, n. 117, p. 1105-1121, 2011. DOI: 10.1590/S0101-73302011000400012
https://doi.org/10.1590/S0101-7330201100...
) and Cortez et al. (2017CORTEZ, P. A.; SOUZA, M. V. R.; AMARAL, L. O. et al. A saúde docente no trabalho: apontamentos a partir da literatura recente. Cadernos de Saúde Coletiva, Rio de Janeiro, v. 25, n. 1, p. 113-122, 2017. DOI: 10.1590/1414-462X201700010001
https://doi.org/10.1590/1414-462X2017000...
) represented this trend

The second trend was that of reviews focused on specific subjects, such as Burnout (Cunha, 2009CUNHA, K. W. V. A produção científica no Brasil nos anos de 2003 a 2008 sobre síndrome de Burnout e docência. 2009. Tese (Mestrado em Saúde Pública) - Escola Nacional de Saúde Pública Sergio Arouca, Fiocruz, Rio de Janeiro, 2009. Disponível em: <Disponível em: https://www.arca.fiocruz.br/handle/icict/2352 >. Acesso em: 20 jul. 2021.
https://www.arca.fiocruz.br/handle/icict...
; Carlotto; Câmara, 2008CARLOTTO, M. S.; CÂMARA, S. G. Análise da produção científica sobre a Síndrome de Burnout no Brasil. Psico, Porto Alegre, v. 39, n. 2, p. 152-158, 2008. Disponível em: <Disponível em: https://revistaseletronicas.pucrs.br/ojs/index.php/revistapsico/article/view/1461/3035 >. Acesso em: 20 jul. 2021.
https://revistaseletronicas.pucrs.br/ojs...
), quality of life (Dantas et al., 2003DANTAS, R. A. S.; SAWADA, N. O.; MALERBO, M. B. Pesquisas sobre qualidade de vida: revisão da produção científica das universidades públicas do estado de São Paulo. Latino-americana Enfermagem, Ribeirão Preto, v. 11, n. 4, p. 532-538, 2003. DOI: 10.1590/S0104-11692003000400017
https://doi.org/10.1590/S0104-1169200300...
; Pereira et al., 2009PEREIRA, É. F.; TEIXEIRA, C. S.; SANTOS, A. et al. Qualidade de vida e saúde dos professores de educação básica: discussão do tema e revisão de investigações. Revista Brasileira de Ciência e Movimento, Brasília, DF, v. 17, n. 2, p. 100-107, 2009. DOI: 10.18511/rbcm.v17i2.1035
https://doi.org/10.18511/rbcm.v17i2.1035...
), and teachers’ voice-related quality of life (Ribas et al., 2014RIBAS, T. M.; PENTEADO, R. Z.; GARCÍA-ZAPATA, M. T. A. Qualidade de vida relacionada à voz de professores: uma revisão sistemática exploratória da literatura. CEFAC, Campinas, v. 16, n. 1, p. 294-306, 2014. DOI: 10.1590/1982-021620144812
https://doi.org/10.1590/1982-02162014481...
).

According to the criteria adopted to track and organize our findings (focused on the objects of the research), the first type of study mentioned (general review) was categorized under “working conditions and health”, while the works of the second type were framed in the categories/subcategories more related with the specific subject of each review. For example, review studies on Burnout were categorized under the category “health disorders”, subcategory “mental health”.

In this regard, it should be explained that, in terms of theoretical background, the studies found on teachers’ mental health are predominantly anchored in what Paparelli (2009PAPARELLI, R. Desgaste mental do professor da rede pública de ensino: trabalho sem sentido sob a política de regularização de fluxo escolar. Tese (Doutorado em Psicologia) - Instituto de Psicologia, Universidade de São Paulo, São Paulo, 2009. Disponível em : <Disponível em : https://www.teses.usp.br/teses/disponiveis/47/47134/tde-07122009-145916/pt-br.php >. Acesso em: 20 jul. 2021.
https://www.teses.usp.br/teses/disponive...
, p. 38-39) called “stress theory”. This perspective includes the Burnout syndrome, which is the main subject among the findings of the subcategory in question. Although the author does not deny the existence of the problem nor the importance of recognizing it as a work-related disease, she emphasizes that the way of explaining the diseasing process in the Burnout theory incurs in events of reductionism, namely: non-incorporation of advances brought by the worker’s health perspective; conception of occupational illness based on a guilt matrix, which naturalizes the stressing agents and blames the individual for not being able to cope with them; and the adaptationist verve, understanding that workers must have the personal resources required to face and overcome the work’s harmfulness. Thus, she proposes the concept of mind damage .

Likewise, the studies identified under the category “quality of life” also call for thinking about the weaknesses of such a conception for understanding the health-work relationship. That is mainly because the individualizing assumption underlying such an approach that is marked, among others, by personal actions such as cognitive and behavioral changes, does not reach the sphere of work organization, a fundamental category of analysis to explain the health conditions of workers (Paparelli, 2009PAPARELLI, R. Desgaste mental do professor da rede pública de ensino: trabalho sem sentido sob a política de regularização de fluxo escolar. Tese (Doutorado em Psicologia) - Instituto de Psicologia, Universidade de São Paulo, São Paulo, 2009. Disponível em : <Disponível em : https://www.teses.usp.br/teses/disponiveis/47/47134/tde-07122009-145916/pt-br.php >. Acesso em: 20 jul. 2021.
https://www.teses.usp.br/teses/disponive...
).

# Final considerations

More than describing the findings of our research, the profile of publications presented is a proposal to support the mapping, analysis and discussion of studies on teachers’ working conditions and health. Therefore, it does not aim at a mere description, but at the proposition of a parameter that could be incorporated to the recognition and analysis of the literature on the subject.

Even considering their limitations, such as the fact that we have essentially contemplated studies approaching Brazilian teachers, the categories and subcategories presented (and the publications that compose them) have the potential to be both organizing and expansive. As organizing structures, each category and subcategory may be thought of as an anchorage for the accommodation and discussion of both current and further studies.

As one among so many organizing possibilities, surveys allow for resizing, as they are not indisputable. Above all, they provide a mapping, indicating what has been published and what, due to absence or demonstrated fragility, requires further study. In doing so, they offer clues about new structures or work categories that may eventually prove to be relevant to expand or reconfigure this profile.

If, for example, the search for articles were to include the current moment, the profile of publications would certainly have to include a new study theme: that of the relationship between teachers’ work and health during the Covid-19 pandemic. It is yet to be discussed in which of these categories/subcategories it would be inserted or whether it would launch a new one.

In terms of the main results, it was found that the number of publications has been increasing since the last major literature review on the subject, and that interest in the topic “teachers’ quality of life” has emerged as of 2006. It also concluded that studies in the field of education have not included the concern about teachers’ health, even when the intent is to study teachers’ work, teacher’s training, and educational public policies. Bringing to the field those mentioned themes is crucial, as well as the adoption of intervention actions since, despite the significant number of studies published, little has been done in terms of practical actions anchored in the results of those studies to improve teachers’ working conditions and health.

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» https://doi.org/10.1590/S0102-311X2011001200011
• THE ILO/UNESCO Recommendation concerning the Status of Teachers (1966) and the UNESCO Recommendation concerning the Status of Higher-Education Teaching Personnel (1997). Geneva, ILO, 2016.
• VEDOVATO, T. G.; MONTEIRO, M. I. Perfil sociodemográfico e condições de saúde e trabalho dos professores de nove escolas estaduais paulistas. Escola de Enfermagem, São Paulo, v. 42, n. 2, p. 290-297, 2008. DOI: 10.1590/S0080-62342008000200012
» https://doi.org/10.1590/S0080-62342008000200012
• 3
Although published in 2011, the aforementioned review (Leite; Souza, 2011LEITE, M. P.; SOUZA, A. N. Condições de trabalho e suas repercussões na saúde de professores da educação básica no Brasil. Educação e Sociedade, Campinas, v. 32, n. 117, p. 1105-1121, 2011. DOI: 10.1590/S0101-73302011000400012
https://doi.org/10.1590/S0101-7330201100...
) analyzed works published up to 2006.
• 4
The categories are represented in the order they were formed based on the findings and, as such, they firstly reflect the survey conducted in the BVS. Category #4 was established only after the survey in the SciELO database.
• Contribution by the authors
Silva was responsible for the conception, planning, design and execution of the study, data collection, data analysis and discussion, and drafting of the manuscript. Fischer was responsible for the planning and design of the study, suggestions for the analyses, data discussion, critical review of the many versions of the article, and approval of the final version.

# Publication Dates

• Publication in this collection
15 Sept 2021
• Date of issue
2021