Survival rates and worker compensation expenses in a national cohort of Mexican workers with permanent occupational disability caused by diabetes.

BACKGROUND: Permanent occupational disability is one of the most severe consequences of diabetes that impedes the performance of usual working activities among economically active individuals. Survival rates and worker compensation expenses have not previously been examined among Mexican workers. We aimed to describe the worker compensation expenses derived from pension payments and also to examine the survival rates and characteristics associated with all-cause mortality, in a cohort of 34,014 Mexican workers with permanent occupational disability caused by diabetes during the years 2000-2013 at the Mexican Institute of Social Security. METHODS: A cross-sectional analysis study was conducted using national administrative records data from the entire country, regarding permanent occupational disability medical certification, pension payment and vital status. Survival rates were estimated using the Kaplan-Meier method. Multivariate Cox proportional hazard model was used to estimate adjusted hazard ratios (HR) and 95 % confidence intervals (95 % CI) in order to assess the cohort characteristics and all-cause mortality risk. Total expenses derived from pension payments for the period were accounted for in U.S. dollars (USD, 2013). RESULTS: There were 12,917 deaths in 142,725.1 person-years. Median survival time was 7.26 years. After multivariate adjusted analysis, males (HR, 1.39; 95 % CI, 1.29-1.50), agricultural, forestry, and fishery workers (HR, 1.41; 95 % CI, 1.15-1.73) and renal complications (HR, 3.49; 95 % CI, 3.18-3.83) had the highest association with all-cause mortality. The all-period expenses derived from pension payments amounted to $777.78 million USD (2013), and showed a sustained increment: from $58.28 million USD in 2000 to $111.62 million USD in 2013 (percentage increase of 91.5 %). CONCLUSIONS: Mexican workers with permanent occupational disability caused by diabetes had a median survival of 7.26 years, and those with renal complications showed the lowest survival in the cohort. Expenses derived from pension payments amounted to $ 777 million USD and showed an important increase from 2000 to 2013.

Sick Leave Due to Ear Diagnoses, a Nationwide Representative Registry of Mexico.

Sickness absence from work is a measure of both poor health and social functioning. In order to assess the frequency of sick leave due to ear-related diagnoses, we performed a retrospective analysis on the registry of paid sick leave certificates supplied by the main social security institution in Mexico during the years 2018 and 2019, just prior to the SARS-CoV-2 pandemic. We observed that, in the two years, 22,053 sick leave certificates due to ear-related diagnoses were provided to 18,033 workers. The most frequent ear-related diagnoses were those of vestibular disorders (94.64%); among them, the most common diagnosis was Benign Paroxysmal Positional Vertigo (75.16%), followed by Labrynthitis and Meniere's disease (circa 8% each). A total of 4.63% of the diagnoses were related to external and middle ear disorders, and 0.71% were mainly related to hearing. Consistently, the highest cumulative days of sick leave required were given for the group of diagnoses related to vestibular disorders; although the less frequent diagnoses required the highest cumulative days per case (e.g., ototoxicity). During 2018 and 2019, the most frequent diagnoses of ear-related sick leave were due to vestibular diagnoses (particularly Benign Paroxysmal Positional Vertigo).

[Temporary disability in operated spine patients. Preliminary report]. / Incapacidad temporal para el trabajo en pacientes operados de columna. Reporte preliminar.

BACKGROUND: The spinal injuries in workers have become a large scale health problem. The purpose of this study is to review the differences in the spine pathologies from incapacity to work, as well as factors that could alter the recovery time and the possibility of returning the patient to work. METHODS: Statistical preliminary review study in 37 patients enrolled in the Instituto Mexicano del Seguro Social, workers, undertaken to spinal pathology surgery, comparing days of incapacity with proposed internationally, as well as his return to work. RESULTS: The results show that 37% of the patients studied are still active in the social security, 2 years after surgery. The days of disability generated by the pathology in this study group (212.3 days) are significantly higher than what is set on the Medical Disability Advisor (56 days, almost 4 times more). CONCLUSION: The study shows the need to develop the same analysis in other hospitals, comparing the proportion of cases that return to the work and total disability times for diagnostics.

Antecedentes: hoy en día, los problemas relacionados con padecimientos de la columna en trabajadores son de gran magnitud. Objetivo: revisar las diferencias en reincorporación laboral en pacientes con afecciones de la columna que generan incapacidad y los factores que podrían alterar el tiempo de recuperación y la posibilidad de reincorporar al paciente a su trabajo. Material y métodos: estudio preliminar, estadístico, de revisión de 37 pacientes trabajadores inscritos en el Instituto Mexicano del Seguro Social, operados por alguna afección de la columna vertebral en el que se compararon: días de incapacidad con lo propuesto internacionalmente y su retorno a laborar. Resultados: 37% de los pacientes estudiados continúan activos en la seguridad social dos años después de la intervención quirúrgica. Los días de incapacidad generados por este grupo de estudio (212.3 días) son significativamente mayores a lo que establece el Medical Disability Advisor (56 días, casi 4 veces más). Conclusiones: debido al tamaño de la muestra es necesario ampliar el estudio a otros centros de tratamiento dentro de la institución y comparar los resultados, principalmente lo relacionado con el retorno a laborar. La cirugía de columna no es garantía de retorno a laborar, lo que debe tenerse en cuenta al momento de plantearle al paciente los objetivos de la cirugía o un pronóstico laboral.