Documents Benavides, Fernando G. 22 results

At the beginning of the 21st century, the emergence of new forms of work organization are transforming what had become standard types of work arrangements in industrialized countries. In this new labor market environment, new firms, types of workers, and risk factors are powerfully emerging. Contrary to common belief, emergent occupational health hazards should not be approached only as "technical" or "economic" value-free problems. Instead, many of the challenges faced by occupational health policy makers are predominantly related to professional values and to the political ideologies and economic interests of key stakeholders in the decision-making process. In this paper some of the key principles leading to efficient and equitable occupational health policies in the new work environment are discussed. An alternative is also proposed for dealing with the conditions and settings needed to meet the new challenges related to establishing an effective occupational health policy.

"OBJECTIVES: A case-referent study with 261 matched pairs was carried out in 8 hospitals of Comunidad Valenciana, Spain, to assess the relation between occupational exposure to pesticides and selected congenital malformations. In this paper, the results concerning paternal exposure are presented.METHODS: The parents of the case patients and the referents were interviewed to collect information about exposure to pesticides and potential confounding variables. Detailed information on direct involvement in the handling of pesticides was collected for the interviewees involved in agricultural activities during a previously defined period in relation to conception and pregnancy. Exposure data were reviewed by 2 experts who assigned ordinal scores for the probability and intensity of exposure to pesticide classes and active ingredients. RESULTS: The dichotomous analysis of exposure (absent, present) yielded some increased risks, although not statistically significant, for aliphatic hydrocarbons [adjusted odds ratio (adjusted OR) 2.05, 95% confidence interval (95% CI) 0.62-6.80], inorganic compounds (adjusted OR 2.02, 95% CI 0.53-7.72), and glufosinate (adjusted OR 2.45, 95% CI 0.78-7.70), and a significant association for pyridil derivatives (adjusted OR 2.77, 95% CI 1.19-6.44). The analysis based on the experts' scores (2 levels of exposure) showed some consistent associations for these compounds. CONCLUSIONS: This research indicates a possible risk of congenital malformations for paternal exposure to some pesticides, notably, pyridils, aliphatic hydrocarbons, inorganic compounds, and glufosinate. It did not find an increased risk for paternal exposure to pesticides in the classes of organophosphates, carbamates, organochlorines, chloroalkylthio fungicides and organosulfurs. These findings warrant further investigation."

"La salud laboral, campo que engloba no sólo la prevención de los riesgos laborales sino también la promoción de la salud a través del lugar de trabajo, está sujeta a fuerzas que van más allá de la relación inmediata entre un factor de riesgo en el ambiente de trabajo y una respuesta biológica, e incluye determinantes "macro" como son los cambios económicos globales, los altibajos del mercado laboral o las reformas legislativas que afectan a la red de protecciones sociales. Estos factores distales y proximales interactúan con las respuestas que la sociedad ha generado frente a ellos, impactando en la salud colectiva e individual de los trabajadores. Dependiendo de hacia dónde se decante la balanza, ese impacto puede afectar adversamente a la salud o promocionarla. Es en este marco conceptual donde presentamos esta cuarta edición de Salud laboral. Conceptos y técnicas para la prevención de riesgos laborales.

Con el objetivo aparentemente simplista de lograr que todo trabajador regrese a su hogar tanto o más sano de lo que salió de casa el mismo día, y procurando ir más allá del mero cumplimiento de normativas, se presentan técnicas, estrategias y acciones encaminadas a anticipar y mitigar los riesgos para la salud de los trabajadores. Todo ello desde una perspectiva global, multidisciplinar y preventiva, enfocada más a la salud colectiva que a los aspectos clínicos individuales y dirigido a todas las personas cuya vida profesional se cruza con la salud laboral, ya sea desde el ámbito académico o del ejercicio profesional. En este sentido, pensamos que el libro tiene utilidad como texto básico en la formación de futuros profesionales de la salud laboral y como fuente de consulta y reflexión para expertos en la materia, incluyendo médicos y enfermeros del trabajo, higienistas y técnicos en prevención, entre otros.

En esta cuarta edición incorporamos a una nueva editora y once nuevos autores. La estructura del texto sigue la de la edición anterior pero condensando los capítulos dedicados a explicar los fundamentos y el marco jurídico y ampliando los temas de evaluación de riesgos y la problemática de grupos específicos de trabajadores. Asimismo, continuamos la proyección hacia todos los países hispanohablantes ya iniciada en la tercera edición y que queda reflejada en la inclusión de capítulos más relevantes tanto para América Latina como para España, así como en el perfil de los autores."

"OBJECTIVES:
To estimate the association between psychosocial risk factors in the workplace and musculoskeletal disorders (MSD) in nurses and aides.
DESIGN:
Systematic review and meta-analysis.
DATA SOURCES:
An electronic search was performed using MEDLINE (Pubmed), Psychinfo, Web of Science, Tripdatabase, Cochrane Central Controlled Trials, NIOSHTIC and Joanna Briggs Institute of Systematic Reviews on Nursing and Midwifery, to identify observational studies assessing the role of psychosocial risk factors on MSD in hospital nurses and nursing aides.
REVIEW METHODS:
Two reviewers independently assessed eligibility and extracted data. Quality assessment was conducted independently by two reviewers using an adapted version of the Standardized Quality Scale. Random-effects meta-analysis was performed by subsets based on specific anatomical site and the exposure to specific psychosocial risk factors. Heterogeneity for each subset of meta-analysis was assessed and meta-regressions were conducted to examine the source of heterogeneity among studies.
RESULTS:
Twenty-four articles were included in the review, seventeen of which were selected for meta-analysis. An association was identified between high psychosocial demands-low job control with prevalent and incident low back pain (OR 1.56; 95% CI 1.22-1.99 and OR 1.52; 95% CI 1.14-2.01, respectively), prevalent shoulder pain (OR 1.89; 95% CI 1.53-2.34), prevalent knee pain (OR 2.21; 95% CI 1.07-4.54), and prevalent pain at any anatomical site (OR 1.38; 95% CI 1.09-1.75). Effort-reward imbalance was associated with prevalent MSD at any anatomical site (OR 6.13; 95% CI 5.32-7.07) and low social support with incident back pain (OR 1.82; 95% CI 1.43-2.32). Heterogeneity was generally low for most subsets of meta-analysis.
CONCLUSION:
This meta-analysis suggests that psychosocial risk factors at the workplace are associated with MSD in hospital nurses and nursing aides. Although most preventive strategies at the workplace are focused on ergonomic risk factors, improving the psychosocial work environment might have an impact on reducing MSDs."

"BACKGROUND:

Several publications have documented the effects of economic recessions on health. However, little is known about how economic recessions influence working conditions, especially among vulnerable workers.

OBJECTIVE:

To explore the effects of 2008 economic crisis on the prevalence of adverse psychosocial working conditions among Spanish and foreign national workers.

METHODS:

Data come from the 2007 and 2011 Spanish Working Conditions Surveys. Survey year, sociodemographic, and occupational information were independent variables and psychosocial factors exposures were dependent variables. Analyses were stratified by nationality (Spanish versus foreign). Prevalence and adjusted prevalence ratios (aPRs) of psychological job demands, job control, job social support, physical demands and perceived job insecurity were estimated using Poisson regression.

RESULTS:

The Spanish population had higher risk of psychological and physical job demand (aPR =?1.07, 95% CI?=?[1.04–1.10] and aPR?=?1.05, 95% CI?=?[1.01–1.09], respectively) in 2011 compared to 2007. Among both Spanish and foreign national workers, greater aPR were found for job loss in 2011 compared to 2007 (aPR?=?2.47, 95% CI?=?[2.34–2.60]; aPR?=?2.44, 95% CI?=?[2.15–2.77], respectively).

CONCLUSION:

The 2008 economic crisis was associated with a significant increase in physical demands in Spanish workers and increased job insecurity for both Spanish and foreign workers."

"Objective This study aims to investigate whether associations of psychological risk factors with the incidence and persistence of disabling musculoskeletal pain differ from those for non-disabling musculoskeletal pain. Methods As part of the international Cultural and Psychosocial Influences in Disability (CUPID) study, 1105 Spanish nurses and office workers were asked at baseline about health beliefs concerning pain, mental health, and somatizing tendency. Musculoskeletal pain in the past months at ten anatomical sites (back, neck, and left and right shoulder, elbow, wrist/hand, and knee) was ascertained at baseline and one year later. Pain was classed as disabling if it made ?1 specified everyday activities difficult or impossible. Multilevel multinomial logistic regression modeling was used to explore associations of baseline risk factors with pain outcomes at follow-up, conditioned on pain status at baseline. Results A total of 971 participants (87.9%) completed follow-up. Among anatomical sites that were pain-free at baseline, the development of disabling musculoskeletal pain was predicted by pessimistic beliefs about pain prognosis [odds ratio (OR) 1.5, 95% confidence interval (95% CI) 1.0–2.1], poor mental health (OR 2.0, 95% CI 1.3–3.0), and somatizing tendency (OR 4.0, 95% CI 2.5–6.4). Adverse beliefs about prognosis were also associated with the transition from non-disabling to disabling musculoskeletal pain (OR 3.7, 95% CI 1.1–12.5) and the persistence of disabling musculoskeletal pain (OR 2.5, 95% CI 1.2–5.5), which was already present at baseline. Associations with non-disabling musculoskeletal pain were weaker and less consistent.Conclusion Our findings suggest that established psychological risk factors relate principally to the disability that arises from musculoskeletal pain."

"Background: Gender inequalities in the exposure to work-related psychosocial hazards are well established. However, little is known about how welfare state regimes influence these inequalities.Objectives: To examine the relationship between welfare state regimes and gender inequalities in the exposure to work-related psychosocial hazards in Europe, considering occupational social class.Methods: We used a sample of 27,?465 workers from 28 European countries. Dependent variables were high strain, iso-strain, and effort-reward imbalance, and the independent was gender. We calculated the prevalence and prevalence ratio separately for each welfare state regime and occupational social class, using multivariate logistic regression models.Results: More female than male managers/professionals were exposed to: high strain, iso-strain, and effort?reward imbalance in Scandinavian and Continental regimes, Southern, and Eastern regimes.Conclusion: Gender inequalities in the exposure to work-related psychosocial hazards were not lower in those welfare state regimes with higher levels of universal social protection policies"

"Objective: To determine whether observed higher risks of occupational injury among temporary workers are due to exposure to hazardous working conditions and/or to lack of job experience level.

Methods: Data systematically recorded for 2000 and 2001 by the Spanish Ministry of Labour and Social Affairs on fatal and non-fatal traumatic occupational injuries were examined by type of employment and type of accident, while adjusting for gender, age, occupation, and length of employment in the company. In the study period there were 1500 fatal and 1 806 532 non-fatal traumatic occupational injuries that occurred at the workplace. Incidence rates and rate ratios (RR) were estimated using Poisson regression models.

Results: Temporary workers showed a rate ratio of 2.94 for non-fatal occupational injuries (95% CI 2.40 to 3.61) and 2.54 for fatal occupational injuries (95% CI 1.88 to 3.42). When these associations were adjusted by gender, age, occupation, and especially length of employment, they loose statistic significance: 1.05 (95% CI 0.97 to 1.12) for non-fatal and 1.07 (95% CI 0.91 to 1.26) for fatal.

Conclusions: Lower job experience and knowledge of workplace hazards, measured by length of employment, is a possible mechanism to explain the consistent association between temporary workers and occupational injury. The role of working conditions associated with temporary jobs should be assessed more specifically."

"Objetivo: Evaluar la calidad del Sistema de Información sobre Lesiones por Accidente de Trabajo en España (SILAT).
Métodos: Los parámetros de calidad evaluados han sido la simplicidad, flexibilidad, aceptabilidad, exhaustividad,previsibilidad, representatividad y puntualidad. De acuerdo con las características del SILAT y la informacióndisponible a partir de estudios publicados, se han valorado cada uno de estos parámetros en los grados de bajo, medio yalto.
Resultados: La calidad del SILAT fue baja respecto a los parámetros de simplicidad y flexibilidad, lo que tiene que verfundamentalmente con su diseño y la definición de algunas variables. Respecto a la aceptabilidad, exhaustividad,previsibilidad y representatividad su valoración fue moderada. La puntualidad fue valorada como alta.
Conclusiones: La calidad del SILAT podría mejorarse si, tal y como prevé el nuevo parte de accidente, se recogierainformación estructurada sobre las condiciones de trabajo, se simplificara el circuito que siguen los documentos y seincrementara el grado de información aportada en los impresos y exactitud de variables como el tamaño de la empresa yla gravedad."