Risco de dor muscular mastigatória entre teleatendentes na cidade de Salvador, Bahia: um estudo de coorte prospectiva

Abstract

Background: The term temporomandibular disorder refers to pain in the masticatory muscles, the temporomandibular joint (TMJ), or both, with masticatory muscle pain (MMP) being the most prevalent manifestation. MMP is frequently observed among call center telemarketers, whose work involves repetitive TMJ movements for long periods, often without adequate breaks and under continuous exposure to stressors. Although the multifactorial nature of these conditions is well recognized, the specific investigation of MMP in this population remains an important gap in the scientific field. Objectives: To estimate the risk of MMP, the prevalence of TMD, and the factors associated with its occurrence—particularly those related to occupational exposure—and to describe psychosocial aspects among telemarketers in the city of Salvador, Bahia. Materials and Methods: A cross-sectional epidemiological study nested within a 12-month prospective cohort was conducted among call center telemarketers and technical-administrative employees from another company. A structured questionnaire was applied, comprising five sections addressing sociodemographic, clinical, occupational, and psychosocial characteristics (JCQ); minor psychiatric disorders (SRQ-20); psychological stress (GHQ-12); and TMD/MMP diagnosis using the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), Axis I. Variables with p ≤ 0.20 in the bivariate analysis were included in the multivariable logistic regression model, with estimation of odds ratios (OR) and 95% confidence intervals (95% CI). The final model was adjusted using the backward stepwise method, adopting p < 0.05 as the level of statistical significance. Model fit was assessed using the Hosmer–Lemeshow test, and discriminatory performance using the ROC curve. The study was approved by the Research Ethics Committees of the Institute of Collective Health at the Federal University of Bahia (ISC-UFBA) and the State University of Bahia (UNEB). Results: The prevalence of TMD among telemarketers was 40.50%, with predominantly mild cases according to the Temporomandibular Index (TMI = 0.08 ± 0.02). Multivariable analysis showed statistically significant associations between TMD and time in the job longer than seven months (adjusted OR = 2.0; 95% CI: 1.1–4.0), more than 82 calls per day (adjusted OR = 2.1; 95% CI: 1.1–3.9), and high levels of occupational stress (adjusted OR = 2.1; 95% CI: 1.1–4.4). The occupational activity was considered stressful by 68.0% of participants, while 60.0% did not perceive a relationship between their symptoms and their work. The occupation was characterized as high demand (46.5%) and low control (47.5%). Although 22% of telemarketers exhibited high stress levels and 25.5% screened positive for minor mental disorders, psychological signs were identified in only 2% of participants. The risk of MMP was higher among telemarketers (OR = 5.09; 95% CI: 2.37–10.94), those reporting pain in the previous month (OR = 1.94; 95% CI: 1.10–3.41), those perceiving their job as stressful (OR = 2.31; 95% CI: 1.29–4.12), and individuals with greater severity (OR = 9.08; 95% CI: 5.68–14.53), adjusted for sex and age. Conclusion: Masticatory Muscle Pain (MMP) is highly prevalent among telemarketers and shows a strong association with the occupational activity performed. Telemarketing work emerged as an independent risk factor for the onset and worsening of pain, influenced by occupational stress, prior pain, and clinical severity. The methodological robustness of the study, including multivariable analyses and ROC curve validation, reinforces the reliability of the findings. It is essential to implement evidence-based preventive strategies—such as ergonomic interventions, functional education, longitudinal monitoring, and psychosocial support—to reduce symptom progression and promote healthier and more sustainable work environments.