Violence against metropolitan bus drivers and fare collectors in Brazil

Ada Ávila Assunção Adriane Mesquita de Medeiros About the authors

Abstracts

OBJECTIVE

To analyze the correlation between sociodemographic factors and working conditions of bus workers in a metropolitan area and violence against them.

METHODS

This cross-sectional study used a nonprobabilistic sample estimated according to the number of workers employed in bus companies located in three cities in the Belo Horizonte metropolitan region in 2012 (N = 17,470). Face-to-face interviews were conducted using a digital questionnaire. The factors associated with violence were analyzed in two stages using Poisson regression, according to each level. The magnitude of the association was evaluated using prevalence ratios with robust variance and a statistical significance of 5%, and 95% confidence intervals were obtained.

RESULTS

The study sample comprised 782 drivers and 691 fare collectors; 45.0% participants reported at least one act of violence in the workplace in the last 12 months, with passengers being predominantly responsible. The age of the bus workers was inversely associated with violence. Chronic diseases, sickness absenteeism, and working conditions were also associated with violence.

CONCLUSIONS

The findings on the correlation between violence and working conditions are essential for implementing prevention strategies by transportation service managers.

Transportation Manpower; Violence; Working Conditions; Occupational Health; Metropolitan Zones


INTRODUCTION

In the metropolitan transportation system, bus drivers, fare collectors, and passengers are exposed to noise and air pollution, traffic, pedestrian accidents, collisions with other vehicles, occupational accidents, user dissatisfaction with the quality of transportation services, and other situations that favor the development of conflicts.1111 Litman T. Transportation and public health. Annu Rev Public Health. 2013;34:217-33. DOI:10.1146/annurev-publhealth-031912-114502,1515 Organización Panamericana de la Salud. Informe sobre el estado de la seguridad vial en la Región de las Américas. Washington (DC); 2009.,2121 Waldvogel BC. A população trabalhadora paulista e os acidentes do trabalho fatais. Sao Paulo Perspec. 2003;17(2):42-53. DOI:10.1590/S0102-88392003000200006 For this reason, social reforms and sectorial policies that address the inherent dangers in the metropolitan public transportation system have been discussed. In this scenario, the activity of bus workers is affected by events that reflect different opportunities and socioeconomic conditions,2Brunoro CM, Sznelwar LI, Bolis I, Abrahão J. Contributions of ergonomics to the construction of bus drivers health and excellence in public transport and at work. Work. 2012;41(Suppl 1):30-5. DOI:10.3233/WOR-2012-0131-30 and these events in turn impact access to transportation services and the health statuses of people.8Johansson G, Evans GW, Cederström C, Rydstedt LW, Fuller-Rowell T, Ong AD. The effects of urban bus driving on blood pressure and musculoskeletal problems: a quasi-experimental study. Psychosom Med. 2012;74(1):89-92. DOI:10.1097/PSY.0b013e31823ba88f

Work-related violence constitutes any conduct considered unreasonable that results in abuse, threats, or aggression in the workplace with explicit or implied damage to the safety, well-being, and health of professionals,1414 Mayhew C, Chappell D. Workplace violence: an overview of patterns of risk and the emotional/stress consequences on targets. Int J Law Psychiatry. 2007;30(4-5):327-39. DOI:10.1016/j.ijlp.2007.06.006 i.e., any event directly or indirectly related to the labor activity of the victim. According to the work absenteeism data from Canada, 17.0% cases of victimization and violence occur in the workplace.3Campolieti M, Goldenberg J, Hyatt D. Workplace violence and the duration of workers’ compensation claims. Ind Relat. 2008;63(1):57-84. In Brazil, there is no consistent and detailed data about this phenomenon.

Several aspects of such violence should be considered when assessing the risk factors: nature (individual, cultural, organizational, or system-related), origin (internal or external to the institution), form (attack, abuse, aggression, slander, persecution, and harassment, among others), and type (according to the relationship between the offender and the victim).1212 Martinko MJ, Douglas SC, Harvey P. Understanding and managing workplace aggression. Organ Dyn. 2006;35(2):117-30. DOI:10.1016/j.orgdyn.2006.03.002,1414 Mayhew C, Chappell D. Workplace violence: an overview of patterns of risk and the emotional/stress consequences on targets. Int J Law Psychiatry. 2007;30(4-5):327-39. DOI:10.1016/j.ijlp.2007.06.006 The latter is divided into: type I, where the event is triggered by aggressors who are not from the workplace, such as thieves, terrorists, protesters, and individuals under the influence of drugs and other substances, resulting in theft or assault in most cases; type II, where the aggressor is the user of the service where the victim operates; and type III, where the aggressor’s acts are a consequence of disputes (grudges between former coworkers, family conflicts, marital disputes, financial debts, and others) with the target victim, who works in a certain business establishment.2222 Wassell JT. Workplace violence intervention effectiveness: a systematic literature review. Saf Sci. 2009;47(8):1049-55. DOI:10.1016/j.ssci.2008.12.001

Work-related violence is the main occupational health problem worldwide, regardless of the country’s level of development. The most vulnerable groups are public transportation workers, health care workers, security officers, military personnel, taxi drivers, judicial officers, educators, social workers, and staff in commercial establishments.1717 Piquero NL, Piquero AR, Craig JM, Clipper SJ. Assessing research on workplace violence 2000-2012. Aggression Violent Beh. 2013;18(3):383-94.,2222 Wassell JT. Workplace violence intervention effectiveness: a systematic literature review. Saf Sci. 2009;47(8):1049-55. DOI:10.1016/j.ssci.2008.12.001

As a sociological fact, scenes of urban violence can be interpreted in light of the associations between social and physical spaces.1Bourdieu P. A miséria do mundo. Petrópolis: Vozes; 2003. Efeitos de lugar; p.159-75. Municipal transportation users, including bus users, are located within the physical space and express their social status in relation to other social groups, including bus workers. Considering the dynamics of the circulation of these social groups, social inequities become evident in different organizational layouts (suburbs, ghettos, neighborhood with both lower and higher socioeconomic strata, and downtown areas) and in the access to/characteristics of the transportation system (e.g., individual or collective, motorized or not, public or private) used by the distinct social groups.1515 Organización Panamericana de la Salud. Informe sobre el estado de la seguridad vial en la Región de las Américas. Washington (DC); 2009.

The spaces (public or private) in which the social groups are integrated are related to the distribution structure of the goods or services available.1Bourdieu P. A miséria do mundo. Petrópolis: Vozes; 2003. Efeitos de lugar; p.159-75. With regard to metropolitan public transportation buses, passengers, pedestrians, and bus workers converge into the geographic space of the transportation system that connects the downtown area to the suburbs, and consequently these groups share a motorized physical environment, i.e., the bus.

The objective of this study was to analyze the correlation between sociodemographic factors and working conditions of bus workers in the metropolitan area and violence against them.

METHODS

This cross-sectional study involved drivers and fare collectors in metropolitan public transportation companies in the cities of Belo Horizonte, Betim, and Contagem, MG, Southeastern Brazil. The sample universe of the three cities investigated represented 17,470 workers, as follows: Belo Horizonte, with approximately 6,500 drivers and 6,750 fare collectors; Betim, with 696 drivers and 524 fare collectors; and Contagem, with 1,800 drivers and 1,200 fare collectors.

A quota proportional to the total number of professionals in each of the three cities was selected. Sample size was estimated considering a sampling error of 4.0%, a confidence interval of 95%, and prevalence of 50.0% as the range of outcomes of interest. On the basis of the data obtained in the workers’ trade unions from each city, the percentage of drivers and fare collectors in the three locations was estimated as follows: 72.0% and 80.0% in Belo Horizonte, 8.0% and 6.0% in Betim, and 20.0% and 14.0% in Contagem, respectively. Considering this estimate and the criteria presented, we estimated a sample represented by 1126 professionals, composed of 565 drivers and 561 fare collectors. In addition, 1,607 bus workers participated in the study, of which 853 were drivers (565 in Belo Horizonte, 164 in Betim, and 124 in Contagem) and 754 were fare collectors (549 in Belo Horizonte, 107 in Betim, and 98 in Contagem).

Data were collected between April and June 2012, during morning and afternoon shifts, using direct interviews with the aid of netbook computers. A software was created exclusively for the study, considering the objectives involving completion of a digital questionnaire (by the interviewer) and online data processing.

Data from the literature and previous interviews with union representatives and workers guided the preparation of the questions related to the urban transportation system. The questionnaire included data on the sociodemographic profile, work conditions, lifestyle and quality of life, health status, and violence/victimization. The collection procedures were tested in a pilot study involving 30 participants. Specific workshops were conducted by the study coordinators to train 22 interviewers.

The reliability of the interviews was measured by reapplication of some questions selected from the original questionnaire to the same respondents (12.0% participants).

The interviews were conducted in four of the five bus-subway stations in Belo Horizonte, and in 35 of the 244 resting stations in the three cities evaluated. On average, 80.0% passengers who use the metropolitan transportation services in Belo Horizonte pass through these four bus-subway stations. The resting stations selected were those that concentrated most of the buses, itineraries, and registered workers.

The study results were disclosed by the Radio Favela radio station in Belo Horizonte in its Saturday program for urban public transportation workers. Before the team initiated the study, posters and brochures were distributed to the companies and unions.

The response variable (event) was the history of experiencing at least one act of violence in the workplace in the last 12 months, obtained by the responses to the question: “In the last 12 months, was there any episode of aggression or threat in the workplace?” Respondents who answered with “once,” “sometimes,” or “frequently” were considered positive for the event.

The independent variables were grouped to organize a hierarchical model of analysis (Figure).

Figure
Hierarchical model of analysis. Belo Horizonte, MG, Southeastern Brazil, 2012.

Suspicion of alcohol abuse was assessed using four questions that comprise the Cut down, Annoyed by criticism, Guilty and Eye-opener (CAGE) scale, validated for Brazil.1313 Masur J, Monteiro MG. Validation of the “CAGE” alcoholism screening test in a Brazilian psychiatric inpatient hospital setting. Braz J Med Biol Res. 1983;16(3):215-8.

Analysis of the factors associated with violence was performed in two stages, using Poisson regression according to each level (Figure). The magnitude of the association was measured using prevalence ratios with robust variance intervals, and a statistical significance of 5% and 95% confidence intervals were obtained.

In the first stage, bivariate Poisson regression analysis was performed considering the explanatory variables of each level (Figure). Workers who experienced at least one act of aggression or threat were compared with workers who reported not having experienced such violence. In the second step, intermediate models were created. All variables associated with acts of violence with p ≤ 0.20 in the bivariate analysis were included in the multivariable models, considering only the variables belonging to the same level (Figure). Sequential deletion of the variables was used in the intermediate models, and only the variables associated with the experience of violence (p < 0.05) were included in the model. For the statistical analysis, SPSS 17.0 and Stata 11.0 software was used.

The study was approved by the Research Ethics Committee of the Universidade Federal de Minas Gerais (registered under CAAE ‒ 02705012.4.0000.5149). All participants signed a free and informed consent form.

RESULTS

A total of 1,473 valid questionnaires (91.0%) were obtained; 45.0% of the respondents reported having experienced at least one episode of aggression or threat in the workplace in the last 12 months. Of these, 33.0% reported that the episodes occurred more than once (frequently or sometimes). Passengers were responsible for 87.0% of the acts of violence whereas 13.0% episodes were committed by pedestrians, coworkers, or superiors.

The study sample consisted primarily of men (87.0%) with a mean age of 36 years (18-75 years), and 67.0% were aged ≤ 40 years. Most workers (73.0%) were self-declared as being of mixed or black ethnicity; 82.0% had ≥ 8 years of schooling, 60.0% were married, and 84.0% had a family income > 2 minimum wages.

Of the respondents, 52.0% did not practice any physical activity on a weekly basis, 14.0% probably used alcohol in an abusive manner. Furthermore, 70.0% had a medical diagnosis of one or more diseases, 35.0% were on sick leave in the last 12 months for health reasons, and 80.0% rated their health as very good or good.

Most workers (53.0%) were drivers or driver/conductors and reported having a formal employment contract (84.0%) and < 5 years in their current position (56.0%). Approximately 70.0% professionals worked overtime (28.0% sometimes and 45.0% always or usually) and did not take breaks during the working period (40.0% sometimes and 30.0% always or almost always). In addition, 48.0% of the respondents never or rarely worked on the same bus.

The majority of respondents reported that they perceived the traffic as bad or very bad (85.0%) and considered the conditions inside the bus as adequate: tolerable or slightly uncomfortable temperature (55.0%), good lighting (67.0%), no exposure to whole-body vibration (40.0%), good equipment and technical resources (43.0%), negligible or moderate noise level inside (49.0%) and outside the bus (62.0%).

Among the sociodemographic characteristics related to lifestyle and health, age > 40 years and performance of physical activity on a weekly basis were negatively correlated with the event in the bivariate analysis (p < 0.05). The proportions of cases of violence in the workplace were positively associated (p < 0.05) with alcohol abuse, sickness absenteeism, worse self-assessed health (fair, poor, and very poor), and at least one chronic disease diagnosed by a physician (Table 1).

Table 1
Descriptive analysis of the event and bivariate association between experiencing acts of violence in the workplace and sociodemographic characteristics, lifestyle, and health status among urban public transportation drivers and fare collectors in Belo Horizonte, Betim, and Contagem, MG, Southeastern Brazil, 2012.

The work-related variables which were significantly correlated with the event in the bivariate analysis were as follows: 2-5 years in the current position, rarely or never working on the same bus, frequent deprivation of breaks during the working period, and assessment of workplace conditions as inadequate (traffic, body vibration, temperature, lighting, technical resources, equipment, and noise level inside the bus) (Table 2).

Table 2
Descriptive analysis of the event and bivariate association between experiencing acts of violence in the workplace and aspects of functional activity and working conditions among urban public transportation drivers and fare collectors in Belo Horizonte, Betim, and Contagem, MG, Southeastern Brazil, 2012.

Table 3 presents the variables according to their degree of statistically significant correlation with the event in the multivariate analysis (intermediate models) and in the final model.

Table 3
Prevalence ratios* for violence/victimization according to sociodemographic characteristics, lifestyle and health status, functional activity, and working conditions of urban public transportation drivers and fare collectors in Belo Horizonte, Betim, and Contagem, MG, Southeastern Brazil, in 2012.

In the final model, the prevalence of acts of violence in the workplace was inversely correlated with age > 40 years. The variables that were positively correlated with acts of violence in the workplace were: being on sick leave, at least one chronic disease diagnosed by a physician, poor or very poor traffic conditions, frequent exposure to whole-body vibration, very uncomfortable or intolerable temperature inside the bus, and inadequate lighting (fair, poor, or very poor). The other variables, i.e., alcohol abuse, working on the same bus, lack of breaks during the working period, insufficient technical resources and equipment, and noise level inside the bus, lost their effect after adjustment of the hierarchical model (Table 3).

DISCUSSION

We observed that 45.0% participants reported having experienced acts of violence in the Belo Horizonte metropolitan area (BHMA) in the 12 months prior to the study, and these experiences were correlated with age, health status, sickness absenteeism, working conditions, and traffic conditions.

Although worrying, the percentage of reports of acts of violence identified in this study was lower than that found in a similar study conducted in Maputo, Mozambique4Couto MT, Lawoko S, Svanstrom L. Violence against drivers and conductors in the road passenger transport sector in Maputo, Mozambique.Afr Saf Promot J. 2009;7(2):17-36. (70.8%), particularly with regard to type II violence (passenger-related). Despite the absence of a national panorama, a study conducted in Salvador, Bahia, Brazil, showed the vulnerabilities of bus workers: 20,572 assaults on buses, with an estimate that each bus worker experienced one or two assault incidents in the workplace between 1990 and 1998.1616 Paes-Machado E, Levenstein C. Assaltantes a bordo: violência, insegurança e saúde no trabalho em transporte coletivo de Salvador, Bahia, Brasil. Cad Saude Publica. 2002;18(5):1215-27. DOI:10.1590/S0102-311X2002000500014

The negative association between acts of violence and age may be a result of skills developed during the professional career, and these skills help more experienced workers face stressful situations and events.2020 Volkoff S, Buisset C, Mardon C. Does intense time pressure at work make older employees more vulnerable? A statistical analysis based on a French survey “SVP50”. Appl Ergon. 2010;41(6):754-62. DOI:10.1016/j.apergo.2009.12.014

With regard to the respondent’s health status, a positive correlation was found between the event, sickness absenteeism, and the number of chronic diseases diagnosed by a physician. Considering the entirety of the situation (environment, labor relations, and security), this result was expected, considering that exposure contributes to worsened health status, which in turn affects the personal willingness to confront situations or occupational stressors that culminate in violent acts.8Johansson G, Evans GW, Cederström C, Rydstedt LW, Fuller-Rowell T, Ong AD. The effects of urban bus driving on blood pressure and musculoskeletal problems: a quasi-experimental study. Psychosom Med. 2012;74(1):89-92. DOI:10.1097/PSY.0b013e31823ba88f,2323 Wieclaw J, Agerbo E, Mortensen PB, Burr H, Tüchsen F, Bonde JP. Work related violence and threats and the risk of depression and stress disorders.J Epidemiol Community Health. 2006;60(9):771-5. DOI:10.1136/jech.2005.042986 In Canada, the duration of work absenteeism after acts of violence was 50.0%, which was 68.0% longer compared with the duration of absenteeism from other causes.3Campolieti M, Goldenberg J, Hyatt D. Workplace violence and the duration of workers’ compensation claims. Ind Relat. 2008;63(1):57-84.

With regard to the correlation between the event and chronic diseases diagnosed by a physician, previous studies have shown that intimidation suffered by workers while performing their duties is associated with increased fatigue and stress, depression, suicidal tendencies, anxiety, and psychosomatic complaints.6Hansen AM, Hogh A, Persson R, Karlson B, Garde AH, Ørbaek P. Bullying at work, health outcomes, and physiological stress response. J Psychosom Res. 2006;60(1):63-72. DOI:10.1016/j.jpsychores.2005.06.078,7Hogh A, Borg V, Mikkelsen KL. Work-related violence as a predictor of fatigue: a 5-year follow-up of the Danish Work Environment Cohort Study.Work Stress. 2003;17(2):182-94. DOI:10.1080/0267837031000156876 In Denmark, men involved in occupations susceptible to exposure to violence were at 50.0% higher risk of developing stress-related diseases.2323 Wieclaw J, Agerbo E, Mortensen PB, Burr H, Tüchsen F, Bonde JP. Work related violence and threats and the risk of depression and stress disorders.J Epidemiol Community Health. 2006;60(9):771-5. DOI:10.1136/jech.2005.042986 In Sweden, workload (in hours) was associated with arterial hypertension and musculoskeletal disorders in metropolitan bus drivers.8Johansson G, Evans GW, Cederström C, Rydstedt LW, Fuller-Rowell T, Ong AD. The effects of urban bus driving on blood pressure and musculoskeletal problems: a quasi-experimental study. Psychosom Med. 2012;74(1):89-92. DOI:10.1097/PSY.0b013e31823ba88f In addition, organizational aspects (long work periods, restricted breaks, poor social support) and uncomfortable eating conditions were associated with harmful habits (e.g., unbalanced diet), which in turn were correlated with the development of chronic diseases.8Johansson G, Evans GW, Cederström C, Rydstedt LW, Fuller-Rowell T, Ong AD. The effects of urban bus driving on blood pressure and musculoskeletal problems: a quasi-experimental study. Psychosom Med. 2012;74(1):89-92. DOI:10.1097/PSY.0b013e31823ba88f

The relationship between fleet/available bus lines and number of passengers as well as the fleet’s state of conservation can affect not only drivers and fare collectors but also the passengers who suffer the effects of such conditions. Moreover, lack of transportation coverage in certain metropolitan areas, delays, overcrowded buses, long lines, and discomfort during the trip are common.2Brunoro CM, Sznelwar LI, Bolis I, Abrahão J. Contributions of ergonomics to the construction of bus drivers health and excellence in public transport and at work. Work. 2012;41(Suppl 1):30-5. DOI:10.3233/WOR-2012-0131-30 In short, the many risks8Johansson G, Evans GW, Cederström C, Rydstedt LW, Fuller-Rowell T, Ong AD. The effects of urban bus driving on blood pressure and musculoskeletal problems: a quasi-experimental study. Psychosom Med. 2012;74(1):89-92. DOI:10.1097/PSY.0b013e31823ba88f that drivers and fare collectors encounter are associated with increased susceptibility to illnesses among these professionals and the decline in the quality of services provided. The experience of poor and very poor traffic conditions and exposure to whole-body vibration and temperature and inadequate lighting conditions inside the bus were statistically correlated with violence in the workplace. These results are unprecedented and reinforce the occurrence of various physical and psychosocial risks to which these professionals are exposed.8Johansson G, Evans GW, Cederström C, Rydstedt LW, Fuller-Rowell T, Ong AD. The effects of urban bus driving on blood pressure and musculoskeletal problems: a quasi-experimental study. Psychosom Med. 2012;74(1):89-92. DOI:10.1097/PSY.0b013e31823ba88f Considering the complexity of this environment, Zannin2424 Zannin PHT. Occupational noise in urban buses. Int Journal Ind Ergonom. 2006;36(10):901-5. DOI 10.1016/j.ergon.2006.06.010 suggested a decrease in the workload to help reduce exposure to noise. Similarly, the author highlights the importance of wage increases to prevent the use of overtime, which results in more exposure and less recovery time.

Violent acts are more common in areas with a high social vulnerability index, where the transportation network and bus fleet are commonly in poor condition. Vehicles circulating in degraded transportation routes suffer damages (e.g., vehicle misalignments) that can affect the professionals (e.g., whole-body vibration).1616 Paes-Machado E, Levenstein C. Assaltantes a bordo: violência, insegurança e saúde no trabalho em transporte coletivo de Salvador, Bahia, Brasil. Cad Saude Publica. 2002;18(5):1215-27. DOI:10.1590/S0102-311X2002000500014 The poor state of conservation of the transportation grid is one of the factors responsible for high mortality in traffic, primarily affecting drivers and fare collectors.2121 Waldvogel BC. A população trabalhadora paulista e os acidentes do trabalho fatais. Sao Paulo Perspec. 2003;17(2):42-53. DOI:10.1590/S0102-88392003000200006

Governmental regulation of the services provided by private companies creates tensions between the profit objectives of these companies and decreased transportation fare prices that passengers demand.2Brunoro CM, Sznelwar LI, Bolis I, Abrahão J. Contributions of ergonomics to the construction of bus drivers health and excellence in public transport and at work. Work. 2012;41(Suppl 1):30-5. DOI:10.3233/WOR-2012-0131-30 In this situation, wages and working conditions are sacrificed, and both of these factors can negatively affect the quality of services provided1919 Assunção AA, Silva LS. Condições de trabalho nos ônibus e os transtornos mentais comuns em motoristas e cobradores: Região Metropolitana de Belo Horizonte, Minas Gerais, Brasil, 2012. Cad Saude Publica. 2013;29(12):2473-86. DOI:10.1590/0102-311X00181412 and the health of workers.8Johansson G, Evans GW, Cederström C, Rydstedt LW, Fuller-Rowell T, Ong AD. The effects of urban bus driving on blood pressure and musculoskeletal problems: a quasi-experimental study. Psychosom Med. 2012;74(1):89-92. DOI:10.1097/PSY.0b013e31823ba88f

Additional studies addressing labor relations in the context of the creation of public-private services are needed, as in the case of urban transport in the BHMA. With limited profit margins due to governmental regulations that control the fare prices, the companies strive to control costs related to workers’ pay, the scale of supply, and the rate of fleet renovation, all of which impact fleet conditions. A previous study found that, in parallel with wage stability, the prices for the other inputs needed to maintain the bus fleet increased above inflation levels.1919 Assunção AA, Silva LS. Condições de trabalho nos ônibus e os transtornos mentais comuns em motoristas e cobradores: Região Metropolitana de Belo Horizonte, Minas Gerais, Brasil, 2012. Cad Saude Publica. 2013;29(12):2473-86. DOI:10.1590/0102-311X00181412

This same study is one of the few that addresses the violence experienced by public bus workers in the BHMA. It reported a high mortality rate due to violence (17.3 deaths per 100,000 inhabitants)1818 Souza ER, Lima MLC. Panorama da violência urbana no Brasil e suas capitais. Cienc Saude Coletiva. 2007;11(Supl):1211-22. DOI:10.1590/S1413-81232006000500011and a positive correlation with working conditions, a dimension which has not been analyzed in most studies. The technical and organizational environment and context of urban transport services were examined and indicated that acts of violence in the workplace were hidden and had no social visibility, a situation also observed in other occupational categories.1010 Lancman S, Sznelwar LI, Uchida S, Tuacek TA. O trabalho na rua e a exposição à violência no trabalho: um estudo com agentes de trânsito.Interface Comun Saude Educ. 2007;11(21):79-92. DOI:10.1590/S1414-32832007000100008Therefore, it is plausible to hypothesize that the consequences of violence in the workplace decrease the efficiency and effectiveness of the services.2Brunoro CM, Sznelwar LI, Bolis I, Abrahão J. Contributions of ergonomics to the construction of bus drivers health and excellence in public transport and at work. Work. 2012;41(Suppl 1):30-5. DOI:10.3233/WOR-2012-0131-30

In short, traversing the urban transportation network can lead to exposure to multiple harmful factors because, in addition to the effects of the working conditions, this exposure overlaps with the exposure to general conditions of the roads and the external environment,1111 Litman T. Transportation and public health. Annu Rev Public Health. 2013;34:217-33. DOI:10.1146/annurev-publhealth-031912-114502,1515 Organización Panamericana de la Salud. Informe sobre el estado de la seguridad vial en la Región de las Américas. Washington (DC); 2009.,2121 Waldvogel BC. A população trabalhadora paulista e os acidentes do trabalho fatais. Sao Paulo Perspec. 2003;17(2):42-53. DOI:10.1590/S0102-88392003000200006 increasing dissatisfaction among professionals and users, and the latter group may express discontent with the former through aggressive behavior.

Among the limitations of this study, the non-probabilistic nature of the sample and the volunteer effect7Hogh A, Borg V, Mikkelsen KL. Work-related violence as a predictor of fatigue: a 5-year follow-up of the Danish Work Environment Cohort Study.Work Stress. 2003;17(2):182-94. DOI:10.1080/0267837031000156876 are potential selection biases. The sample did not include subjects who were on leave from work or those who, because of deteriorating health conditions, were unable to remain active (healthy worker effect).5Froom P, Melamed S, Kristal-Boneh E, Benbassat J, Ribak J. Healthy volunteer effect in industrial workers. J Clin Epidemiol.1999;52(8):731-5. DOI:10.1016/S0895-4356(99)00070-0,9Ki M, Sacker A, Kelly Y, Nazroo J. Health selection operating between classes and across employment statuses. J Epidemiol Community Health. 2011;65(12):1132-9. DOI:10.1136/jech.2009.107995 The response variable depended on the respondent’s recollection of the acts of violence during the 12-month period, causing a potential information bias. In addition, self-reporting can lead to overestimation or underestimation of exposure. In cross-sectional designs, overcoming such biases is unlikely. However, less healthy individuals and those who are more vulnerable to unhealthy life styles were probably inclined to respond to the questionnaire and report their assessment of health status and work conditions; however, their perception would tend to be more positive than that of the excluded participants. On the other hand, this situation would counterbalance the over-representation of healthy individuals, leading to greater proximity of the study group to the sample universe.

Notwithstanding these limitations, the findings on the correlation between violence and working conditions are essential for implementing prevention strategies, which in turn can help formulate urban public transportation policies, such as the creation of a budget to improve fleet conditions and rebalance the wages that currently correspond to the lowest percentage of the production costs, identification of the itineraries with the highest risk of assaults and other acts of violence by expanding the dialogue between transportation companies and bus workers, installation of security devices inside and outside the vehicles (e.g., at bus stops), and development of strategies to address the grievances of bus workers who may potentially become victims of violence in the workplace.

REFERENCES

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    Bourdieu P. A miséria do mundo. Petrópolis: Vozes; 2003. Efeitos de lugar; p.159-75.
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    Brunoro CM, Sznelwar LI, Bolis I, Abrahão J. Contributions of ergonomics to the construction of bus drivers health and excellence in public transport and at work. Work 2012;41(Suppl 1):30-5. DOI:10.3233/WOR-2012-0131-30
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    Campolieti M, Goldenberg J, Hyatt D. Workplace violence and the duration of workers’ compensation claims. Ind Relat 2008;63(1):57-84.
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    Couto MT, Lawoko S, Svanstrom L. Violence against drivers and conductors in the road passenger transport sector in Maputo, Mozambique.Afr Saf Promot J 2009;7(2):17-36.
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    Froom P, Melamed S, Kristal-Boneh E, Benbassat J, Ribak J. Healthy volunteer effect in industrial workers. J Clin Epidemiol1999;52(8):731-5. DOI:10.1016/S0895-4356(99)00070-0
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    Hansen AM, Hogh A, Persson R, Karlson B, Garde AH, Ørbaek P. Bullying at work, health outcomes, and physiological stress response. J Psychosom Res 2006;60(1):63-72. DOI:10.1016/j.jpsychores.2005.06.078
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    Hogh A, Borg V, Mikkelsen KL. Work-related violence as a predictor of fatigue: a 5-year follow-up of the Danish Work Environment Cohort Study.Work Stress 2003;17(2):182-94. DOI:10.1080/0267837031000156876
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    Johansson G, Evans GW, Cederström C, Rydstedt LW, Fuller-Rowell T, Ong AD. The effects of urban bus driving on blood pressure and musculoskeletal problems: a quasi-experimental study. Psychosom Med 2012;74(1):89-92. DOI:10.1097/PSY.0b013e31823ba88f
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  • This study was supported by the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq – Process 458922/2014-5).

History

  • Received
    12 Feb 2014
  • Accepted
    3 Sept 2014
  • Online publication
    27 Feb 2015
Faculdade de Saúde Pública da Universidade de São Paulo São Paulo - SP - Brazil
E-mail: revsp@org.usp.br