Sickness presenteeism: Are we sure about what we are studying? A research based on a literature review and an empirical illustration.

BACKGROUND: There has been an increasing interest in studying sickness presenteeism (SP). An ever-increasing amount of scientific literature is published using this term, yet there appears to be considerable heterogeneity in how it is assessed, which could result in substantial differences in the definition and interpretation of the phenomenon really being studied. We aim to discuss what really is being studied, depending on how the phenomenon is operationalized, measured, and analyzed. METHODS: A study based on a literature review and an empirical illustration using data of the third Spanish Psychosocial Risks Survey (2016). RESULTS: Differences are observed based on the population in which SP is measured, the cut-off points used to define a worker as presenteeist, the reasons for an SP episode and even an analysis of the phenomenon treated as a count or as a dichotomous. CONCLUSIONS: Without being completely exclusive, it seems that restricting the population of analysis to only those workers who consider that they should not have gone to work due to their health, and/or establishing low cut-off points to define someone as presenteeist, would more clearly delimit the study of SP to the exercise of a right to sick leave. In contrast, working with the entire population or using high cut-off points appears to relate the study of SP more with health status and less with the exercise of rights. On the other hand, taking the reasons for SP into account would probably help to improve interpretation of the phenomenon.

Prevalence, associated factors and reasons for sickness presenteeism: a cross-sectional nationally representative study of salaried workers in Spain, 2016.

OBJECTIVES: The aim of this study was to estimate the prevalence of sickness presenteeism (SP), its associated factors and the reasons given for SP episodes, among the overall salaried population and excluding the 'healthy' workers. DESIGN: Population-based cross-sectional study. SETTING: Salaried population in Spain. PARTICIPANTS: Data were obtained from the third Spanish Psychosocial Risks Survey (2016), carried out between October and December 2016, n=1615. MAIN OUTCOME MEASURES: Self-reported episodes of SP and their reasons. RESULTS: 23.0% (95% CI 19.2 to 26.8) of the workers exhibit SP, whereas among those manifesting having had some health problem in the preceding year, the figure was 53.0% (95% CI 46.9 to 59.1). The factors associated with SP when we study all workers are age, seniority, salary structure, working more than 48 hours, the contribution of worker's wage to the total household income and downsizing; factors among the 'unhealthy' workers are working more than 48 hours and not having a contract. The most common reason for SP is 'did not want to burden my colleagues', 45.7% (95% CI 37.3 to 54.4), whereas 'I could not afford it for economic reasons' ranked third, 35.9% (29.4% to 42.9%), and 27.5% (21.3% to 34.6%) of the workers report 'worried about being laid off' as a reason for going to work despite being ill. CONCLUSIONS: The estimated frequency of SP in Spain is lower than certain other countries, such as the Scandinavian countries. The factors associated vary depending on the population analysed (all workers or excluding 'healthy' workers). The reason 'I was worried about being laid off' was much more common than the estimates for Sweden or Norway.

Specific psychosocial exposures for workers' mental health: A population-based study.

BACKGROUND: In order to plan interventions it is important to obtain evidence on the relation between a health outcome and specific exposures. However, there are few studies that identify the effect of specific psychosocial work exposures on poor mental health. This is the aim of this study. METHODS: Population-based cross-sectional study in Catalonia. We estimated prevalence ratios (PR) of minor psychiatric disorder associated with several psychosocial work exposures. RESULTS: The items with highest PR were "Are there times when you need to be at work and at home at the same time?" (PR = 1.81), "Are you worried about a variation in your salary?" (PR = 1.77), "Is your work emotionally demanding?" (PR = 1.65) and "Are you worried about it being difficult for you to find another job if you became unemployed?" (PR = 1.51). CONCLUSIONS: This study could be useful in order to begin planning interventions on specific psychosocial exposures to protect mental health in the workplace.

[Estimating non work-related sickness leave absences related to a previous occupational injury in Catalonia (Spain)]. / Estimación de episodios de incapacidad temporal por contingencia común relacionados con un accidente de trabajo previo en Cataluña / Estimació d'episodis d'incapacitat temporal per contingències comunes relacionats amb un accident de treball previ a Catalunya.

OBJECTIVES: To estimate the frequency of non-work sickness absence (ITcc) related to previous occupational injuries with (ATB) or without (ATSB) sick leave. METHODS: Prospective longitudinal study. Workers with ATB or ATSB notified to the Occupational Accident Registry of Catalonia were selected in the last term of 2009. They were followed-up for six months after returning to work (ATB) or after the accident (ATSB), by sex and occupation. Official labor and health authority registries were used as information sources. An "injury-associated ITcc" was defined when the sick leave occurred in the following six months and within the same diagnosis group. The absolute and relative frequency were calculated according to time elapsed and its duration (cumulated days, measures of central trend and dispersion), by diagnosis group or affected body area, as compared to all of Catalonia. RESULTS: 2,9%of ATB (n=627) had an injury-associated ITcc, with differences by diagnosis, sex and occupation; this was also the case for 2,1% of ATSB (n=496).With the same diagnosis, duration of ITcc was longer among those who had an associated injury, and with respect to all of Catalonia. CONCLUSIONS: Some of the under-reporting of occupational pathology corresponds to episodes initially recognized as being work-related. Duration of sickness absence depends not only on diagnosis and clinical course, but also on criteria established by the entities managing the case. This could imply that more complicated injuries are referred to the national health system, resulting in personal, legal, healthcare and economic cost consequences for all involved stakeholders.

Occupational exposure assessment of highway toll station workers to vehicle engine exhaust.

Toll station workers are occupationally exposed to vehicle engine exhaust, a complex mixture of different chemical substances, including carcinogenic compounds. Therefore, a study was carried out on attendants of two highway toll stations to describe their occupational exposure to vehicle engine exhaust, based on a worst-case scenario approach. Personal sampling was conducted during the day shift for all attendants, testing for three groups of chemical substances: polycyclic aromatic hydrocarbons (PAHs), volatile organic compounds (VOCs) and aldehydes (formaldehyde and acrolein). Concentrations of total PAH, BTEX (benzene, toluene, ethylbenzene, and xylenes) and formaldehyde content varied between 97.60-336.08 ng/m3, 5.01-40.52 µg/m3, and 0.06-19.13 µg/m3, respectively. No clear relationships could be established between exposure levels and the number of vehicles. Furthermore, no differences were found between truck versus car lanes, or inside versus outside the tollbooth. Not all the detected VOCs were related to vehicle exhaust; some were consistent with the use of cleaning products. The measured concentrations were far below the established occupational exposure limits, but tended to be higher than values reported for outdoor urban environments. There are very few international studies assessing occupational exposures among toll station workers, and this is the first such study to be conducted in Spain. The results suggest that further, more detailed studies are necessary to characterize exposure properly, and ones which include other airborne pollutants, such as ultrafine particles. The comparison of the results to other similar studies was difficult, since no data related to some important exposure determinants have been provided. Therefore, it is recommended that these determinants be considered in future studies.

[Occupational exposure to carcinogens: analysis of the application of the CAREX information system to Catalonia]. / Exposición laboral a cancerígenos: análisis del sistema de información CAREX para su uso en Cataluña.

OBJECTIVE: The objective of this study is to estimate occupational exposures to human carcinogens in Catalonia in 2009, taking as a reference the CAREX ESP 2007 information system, and to evaluate the suitability of extrapolating these data to Catalonia. METHODS: The reference population is the number of people registered with the Social Security system in Catalonia in 2009. Carcinogens considered are those which the International Agency for Research on Cancer (IARC) classified into groups 1 and 2A and are related to occupational exposures. The exposure prevalences from the CAREX ESP 2007, adapted to the Catalonian Industrial Classification (CCAE 09), were used. Technical survey reports from the Occupational Safety and Health Centers of the Catalonian local government, and related databases were consulted. RESULTS: The most frequent occupational exposures to human carcinogens were solar radiation, crystalline silica, diesel exhaust, radon and wood dust, although based mainly on data not considered adequate for extrapolation to Catalonia. Around 217 exposure situations for 25 carcinogens, not previously considered in CAREX ESP 2007, were identified. CONCLUSIONS: The estimated number of workers exposed to human carcinogens in Catalonia in 2009 based on the CAREX ESP 2007 system could differ from the real situation. Development of a CAREX CAT system that incorporates exposure data from Catalonia is recommended.

OBJETIVO: El objetivo de este estudio es estimar la exposición laboral a cancerígenos en Cataluña para el año 2009 utilizando el sistema de información CAREX ESP 2007 como referencia, y valorar la adecuación o no de extrapolar estos datos a Cataluña. MÉTODOS: La población de referencia es aquella afiliada a cualquier régimen de la Seguridad Social de Cataluña en 2009. Se han considerado agentes cancerígenos los clasificados por la IARC (International Agency for Research on Cancer) en los grupos 1 y 2A relacionados con exposiciones laborales. Se ha utilizado la prevalencia de exposición de CAREX ESP 2007 adaptada a la clasificación económica Clasificación Catalana de Actividades Económicas (CCAE 09). Además, se han consultado actuaciones de técnicos de los Centres de Seguretat i Salut Laboral de la Generalitat de Catalunya, y bases de datos relacionadas con este tema. RESULTADOS: Las exposiciones laborales estimadas más comunes a agentes cancerígenos han sido para radiación solar, sílice cristalina, humos diesel, radón y polvo de madera, aunque con datos considerados en buena medida no extrapolables a Cataluña. Además, se han detectado 217 situaciones de exposición para 25 agentes cancerígenos que no se habían considerado en el sistema CAREX ESP 2007. CONCLUSIONES: Las estimaciones de trabajadores expuestos en Cataluña a agentes cancerígenos en 2009 en base al sistema CAREX ESP 2007 podrían diferir de la realidad. Se considera necesario desarrollar un sistema CAREX CAT con incorporación de datos de exposición propios de Cataluña.

[Validation of the Copenhagen Burnout Inventory to assess professional burnout in Spain].

BACKGROUND: The Copenhagen Burnout Inventory (CBI) is a public domain questionnaire measuring the degree of psychological fatigue experienced in three subdimensions of Burnout: personal (PB), work-related (WB), and client-related Burnout (CB). The study aimed to examine the acceptability, reliability and construct validity of the Spanish version of CBI. METHOD: The study population consisted of 479 workers of educational centers, social work centres, healthcare centres and workers within the industry sector. Data was collected in 2009 through a self-administered questionnaire including the three CBI scales, sixteen scales of psychosocial work environment (COPSOQ ISTAS21) and perceived general and mental health and vitality (SF-36). RESULTS: Response rate was 78.7%. The three scales have an inter-item correlation average between 0.42 and 0.60 and a corrected item-total correlation between 0,49 and 0,83. The internal consistency of the three scales had Cronbach's α values of 0.90 for PB, 0.83 for WB and 0.82 for CB. CONCLUSIONS: Burnout was related to both psychosocial work environment and wellbeing measures in the expected direction and intensity. The items of the three scales show good discrimination capacity, good consistency and homogeneity. The three CBI scales have an acceptable internal consistency reliability index, slightly higher in PB. The discrimination capacity of the scales is verified through the discrimination index and the different levels between occupations and activities. These results demonstrate that the Spanish version of the CBI is a reliable and valid instrument for measuring Burnout.