[Influence of Ergonomic Preventive Resources in Development of Sequels Due to Non-Traumatic Diseases of the Shoulder]. / Influencia de las medidas preventivas ergonómicas en el desarrollo de secuelas por patología no traumática del hombro.

OBJECTIVE: To describe the sequelae referred to the cases attended by non-traumatic diseases of the shoulder. To know how sociodemographic characteristics, preventive knowledge about the workplace and ergonomic requirements are associated with the presence of sequelae. METHODS: Cross-sectional observational study in a population of 345 patients attended for a year in the consultations of a primary health care center in Alicante. Through the Chi-square test, the associations between the sequels and the rest of the variables were studied. RESULSTS: 53.9% (n=186) of the participants reported having sequelae derived, especially occasional pain associated or not with limitation of joint mobility. They are risk factors: a low level of studies, cleaning activities and industrial sector, raising the arm over the shoulder and the monotony in the workplace. However, they are protective factors: male sex, having information on occupational risks, Personal Protective Equipment, the existence of a Labor Risk Prevention Service, Risk Assessment, Prevention Plan and periodic medical examinations. Knowing the risks of the position was shown as an independent protection factor against the development of secondary sequelae in the shoulder (ORa=0,2; IC95%=0,1-0,4). However, to raise the arm above the shoulder, behaving as an independent risk factor for the development of sequelae due to shoulder pathology (ORa=2,1; IC95%=1,0-4,3). CONCLUSIONS: The combination of ergonomic and training strategies seems useful in the prevention of the development of shoulder-level sequelae.

OBJETIVO: Describir las secuelas referidas en los casos atendidos por patología no traumática del hombro. Y conocer cómo se asocian con la presencia de secuelas las características sociodemográficas, disponer de conocimientos en prevención de riesgos laborales y los requerimientos ergonómicos del puesto de trabajo. MÉTODOS: Estudio observacional transversal en una población de 345 pacientes atendidos durante un año en las consultas de un centro de atención primaria de salud en Alicante. Mediante la prueba de la Ji-cuadrado se estudiaron las asociaciones entre las secuelas y el resto de variables. RESULTADOS: El 53,9% (n=186) de los participantes refirieron presentar secuelas derivadas, sobre todo dolor ocasional asociado o no a limitación de la movilidad. Son factores de riesgo: un bajo nivel de estudios, actividades de limpieza y sector industrial, alzar los brazos por encima del hombro y la monotonía en las tareas. Sin embargo, son factores protectores: el sexo masculino, disponer de información sobre los riesgos laborales, equipos de protección individual, existencia de Servicio de Prevención de Riesgos Laborales, evaluación de riesgos, plan de prevención y los reconocimientos médicos periódicos. Conocer los riesgos del puesto se mostró como factor de protección independiente frente al desarrollo de secuelas (ORa=0,2; IC95%=0,1-0,4). Sin embargo, alzar el brazo por encima del hombro, se comporta como factor de riesgo independiente para el desarrollo de secuelas por patología del hombro (ORa=2,1; IC95%=1,0-4,3). CONCLUSIONES: La combinación de estrategias ergonómicas y formativas parecen útiles para la prevención del desarrollo de secuelas a nivel del hombro.

A new risk score to assess atrial fibrillation risk in hypertensive patients (ESCARVAL-RISK Project.

This study aimed to assess atrial fibrillation (AF) incidence and predictive factors in hypertensive patients and to formulate an AF risk assessment score that can be used to identify the patients most likely to develop AF. This was a cohort study of patients recruited in primary healthcare centers. Patients aged 40 years or older with hypertension, free of AF and with no previous cardiovascular events were included. Patients attended annual visits according to clinical practice until the end of study or onset of AF. The association between AF incidence and explanatory variables (age, sex, body mass index, medical history and other) was analyzed. Finally, 12,206 patients were included (52.6% men, and mean age was 64.9 years); the mean follow-up was 36.7 months, and 394 (3.2%) patients were diagnosed with AF. The incidence of AF was 10.5/1000 person-years. Age (hazard ratio [HR] 1.06 per year; 95% confidence interval [CI] 1.05-1.08), male sex (HR 1.88; 95% CI 1.53-2.31), obesity (HR 2.57; 95% CI 1.70-3.90), and heart failure (HR 2.44; 95% CI 1.45-4.11) were independent predictors (p < 0.001). We propose a risk score based on significant predictors, which enables the identification of people with hypertension who are at the greatest risk of AF.

The influence of information on the prevention of occupational risks and ergonomic requirements in the development of non-traumatic osteomuscular diseases of the shoulder - a pilot study.

OBJECTIVES: Shoulder pain associated with upper limb musculoskeletal disorders is an important health problem in clinical practice due to its high prevalence, frequent consultations in primary healthcare and occupational health. Preventive strategies, including information disseminated among workers, can be useful. The aim of this study is to analyze the associations between non-traumatic osteomuscular diseases of the shoulder and the workers' knowledge of the risks at the workplace and preventive measures developed there, as well as the association with ergonomic requirements. MATERIAL AND METHODS: An observational case-control study was carried out on an occupationally active population assisted during 1 year in 1 healthcare center, involving 690 participants. Data were collected through a questionnaire including sociodemographic variables, the workplace, the knowledge of prevention and ergonomic requirements. The independent effect of the variables associated with non-traumatic shoulder pathology was explored through logistic regression. RESULTS: In total, 66.7% of the participants stated that they had been informed of the occupational hazards related to their jobs. The following variables were associated with a lower probability of shoulder injuries: male gender, working hours > 9 h/day or > 40 h/week, as well as having information on the risks associated with the workplace, using personal protective equipment, the existence of an occupational risks prevention service and/or risk assessment, the knowledge of the prevention plan, periodic medical examinations, and using one arm or physical force at work. A multivariate analysis revealed that the risk increased with age and lower educational levels, forced postures, repeated gestures, monotony and temporary absences from work. Furthermore, being informed of workplace risks, and using a single arm as well as physical force were shown as independent protective factors. CONCLUSIONS: Information on both the ergonomic requirements and how to prevent occupational risks is a useful tool for the prevention of non-traumatic shoulder diseases. Preventive policies including health education interventions in the workplace could benefit other developed preventive activities. Int J Occup Med Environ Health. 2019;32(6):825-40.