*4.2. Comorbidity*

The presence of chronic health diseases/conditions in the general population is a reality for millions of people. In Brazil, according to the National Health Survey, in 2019, 52% of the population aged 18 years or older reported having been diagnosed with at least one chronic disease, with hypertension standing out with 23.9% of individuals, and

depression reaching 10.2% of the population [16]. This situation seems to be more comprehensive with the working population. The results of this study showed that most legislative staff (65.5%) reported at least one chronic disease or health problem, while the others (34.5%) reported no chronic pathology. Among the servants with chronic diseases or health problems, 44.4% reported a single occurrence, while 55.6% reported two or more comorbidities. A study conducted with more than 10,000 workers in the general population in Denmark found that 56.8% of the participants had one or more chronic diseases, which were associated with the risk of leaving for health treatment [17], corroborating the present research.

Back pain, hypertension, and depression were the pathologies with the highest frequency for all LHs, reaching 19.6, 11.0, and 8.8%, respectively, of all reported chronic diseases/problems, considering the category Other Health Problems 1, 2, and 3. Several studies corroborate the prevalence of these pathologies among workers and the general population, including civil servants. Serranheira et al., (2020) [18] investigated 735 workers from different occupational fields and reported that 69% of the respondents presented at least one episode of low back pain in 12 months, with the highest proportion of individuals presenting more than six episodes of low back pain per year among civil servants (31.8%). Research involving 4844 public service workers in Nigeria found a prevalence of 35% of cases of hypertension and 36.4% of prehypertension, with a slight predominance among male employees, while only 2% of employees diagnosed with hypertension were aware of their health condition [19]. Finally, a study evaluated the factors associated with temporary work incapacity among Brazilian university servants and found 30% of recurrent depressive disorders among 1753 cases of temporary incapacity for the 21 most prevalent diseases studied [20].
