RESUMEN
BACKGROUND AND AIMS: We aimed to assess the prevalence of familial hypercholesterolaemia (FH) and to determine the incidence of cardiovascular events during a 10-year follow up in individuals with FH, compared to unaffected individuals in a working, middle-aged/young population. METHODS AND RESULTS: 576,724 active workers (36 ± 10 years-old, 70% men) without cardiovascular disease were given regular health check-ups and followed for a median of 8.5 years (i.e., 4,123,927 person-years). The FH phenotype was defined according to validated low-density lipoprotein-cholesterol thresholds, adjusted for age and sex. The primary outcome was a first cardiovascular event, whether fatal or non-fatal. We found that 707 workers (0.12% or 1 in 816 individuals) met the criteria for a heterozygous FH phenotype. During the follow-up, cardiovascular events occurred in 23 of 707 (3.25%) subjects with the FH phenotype and in 3297 of 576,017 (0.57%) subjects without the FH phenotype (p<0.001). The hazard ratio (HR, assessed with a Cox regression model) for the primary outcome was 5.7 (99% CI 3.33-9.78), before adjustments, and 4.7 (99% CI 2.62-8.58) after adjusting for sex, age, smoking, blood pressure, and diabetes. The HRs were significant for both men and women, but the magnitude of the effect was greater for men than for women. CONCLUSIONS: Our findings confirmed the high incidence of cardiovascular disease in individuals with untreated FH. We showed that regular health check-ups in an active, and mostly young, working population could contribute to the early identification of FH. Therefore, this approach may provide an opportunity for early treatment.
Asunto(s)
Enfermedades Cardiovasculares , Hiperlipoproteinemia Tipo II , Adulto , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/prevención & control , LDL-Colesterol , Femenino , Humanos , Hiperlipoproteinemia Tipo II/diagnóstico , Hiperlipoproteinemia Tipo II/epidemiología , Hiperlipoproteinemia Tipo II/genética , Masculino , Persona de Mediana Edad , Fenotipo , Prevalencia , Factores de RiesgoRESUMEN
Recent studies in Spain have shown that males, younger workers, and people involved in manual jobs had the highest risk of suffering a work-related eye injury (WREI). This study aims to assess the predictors of sick leave associated with WREI and to compare them with risk factors of initial injury. A retrospective and descriptive study of WREI that causes sick leave of one or more days among workers from an insurance labor mutual company in Spain was conducted over a period from 2008 to 2018. The variables of the study were sex, age, occupation, and type of injury. A total of 9352 (18.6% of 50,265 WREI) cases and 113,395 total days of sick leave were observed, with an estimated EUR 4,994,009.59 of associated labor cost. The main predictors of sick leave related to WREI were found to be female (highest incidence; 25.9 (95% CI (24.8-27.1))), >55 years of age (highest incidence; 20.5 (95% CI (19.3-21.7))), not working in the industry (lowest incidence; 13.8 (95% CI (13.3-14.2))), and not suffering "other disorders of conjunctiva" (lowest incidence; 5.7 (95% CI (4.7-6.8))). The consequences associated with WREI are worse for female and older workers, despite the main risk of suffering WREI being observed in males and younger workers.
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Lesiones Oculares , Ausencia por Enfermedad , Femenino , Humanos , Masculino , Ocupaciones , Estudios Retrospectivos , España/epidemiologíaRESUMEN
OBJECTIVES: To analyze the differences in work-related eye injury trends among the different Autonomous Communities in Spain. METHODS: This was a descriptive, retrospective and longitudinal study based on a Social Security-affiliated mutual insurance company work injury and illness database for the period 2008-2018 that included all Spanish Autonomous Communities. Accidents that caused an injury to any ocular structure were analysed, and both the incidence of work-related eye-injuries per 100 000 insured workers and the relative risk of suffering an eye injury were compared. RESULTS: We observed a general decrease in work-related eye injuries in all of the communities, although with two distinct time periods. The annual percentage change decrease occurred in all communities until 2013. From 2013 to 2018, however, this decreasing trend was only observed in Asturias, Castilla-La Mancha, Canary Islands, Madrid, Murcia and Navarra. Castilla-La Mancha was the Autonomous Community with the highest incidence (886.56/100.000), as well as the highest relative risk of suffering an eye injury (RR 2.66; IC 95% 2.58 - 2.75). At the other end, the lowest incidence (82.25/100.000) and RR (RR 0.247; IC 95 % 0.22 - 0.28) were observed in Catalonia. CONCLUSIONS: We observed a statistically significance decrease in the incidence and relative risk of work-related eye injuries in all Autonomous Communities over the study period, although this trend changed from 2013 onward.
OBJETIVOS: Analizar las diferencias en la evolución de las lesiones oculares en el trabajo entre las comunidades autónomas en España. MÉTODOS: Se llevó a cabo un estudio descriptivo, retrospectivo y longitudinal de los accidentes laborales y las enfermedades profesionales de una Mutua Colaboradora de la Seguridad Social entre las diferentes comunidades autónomas españolas en el intervalo de tiempo de 2008-2018. Se analizaron aquellos accidentes que provocaron lesión en alguna estructura ocular, comparándose la incidencia por cada 100 000 asegurados y el riesgo relativo (RR) de sufrir una lesión ocular en el trabajo. RESULTADOS: Se observó una disminución en la evolución de la incidencia de lesiones oculares en el trabajo en todas las comunidades, aunque con dos periodos diferenciados. El porcentaje de cambio anual disminuye en todas las comunidades hasta el 2013, pero entre 2013-2018 esta tendencia sólo se mantiene en Asturias, Castilla-La Mancha, Islas Canarias, Madrid, Murcia y Navarra. Castilla- La Mancha fue la comunidad autónoma con mayor incidencia (886.56/100 000) y riesgo relativo de sufrir una lesión ocular (RR 2.66; IC 95% 2.58 2.75), mientras Cataluña presentó la menor incidencia (82.25) y riesgo relativo (RR 0.25; IC 95 % 0.22 0.28). CONCLUSIONES: Durante el periodo 2008-2018 se produce una disminución en la incidencia de lesiones oculares en el trabajo en todas las comunidades autónomas con un cambio de tendencia a partir del año 2013.
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Lesiones Oculares , Lesiones Oculares/epidemiología , Lesiones Oculares/etiología , Humanos , Incidencia , Estudios Longitudinales , Estudios Retrospectivos , España/epidemiologíaRESUMEN
AIMS: Our primary objective was to improve risk assessment for fatal and non-fatal cardiovascular events in a working population, mostly young and healthy. METHODS: We conducted a prospective cohort study to derive a survival model to predict fatal and non-fatal 10-year cardiovascular risk. We recruited 992,523 workers, free of diagnosed cardiovascular disease at entry, over six years, from 2004-2009. We divided the sample into two independent cohorts: a derivation one (626,515 workers; from 2004-2006) and a temporal validation one (366,008 workers; over 2007-2009). Then, we followed both cohorts over 10 years and registered all fatal and non-fatal cardiovascular events. We built a new risk calculator using an estimation of cardiovascular biological age as a predictor and named it IberScore. There were remarkable differences between this new model and Systematic Coronary Risk Evaluation (SCORE) (in both the specification and the equation). RESULTS: Over the 10-year follow-up, we found 3762 first cardiovascular events (6) in the derivation cohort. Most of them (80.3%) were non-fatal ischaemic events. If we had been able to use our model at the beginning of the study, we had classified in the 'high-risk' or 'very high-risk' groups 82% of those who suffered a cardiovascular event during the follow-up. All the post-estimation tests showed superior performance (true positive rate: 81.8% vs 11.8%), higher discrimination power and better clinical utility (standardised net benefit: 58% vs 13%) for IberScore when compared to SCORE. CONCLUSION: Risk assessment of fatal and non-fatal cardiovascular events in young and healthy workers was improved when compared to the previously used model (SCORE). The latter was not reliable to predict cardiovascular risk in our sample. The new model showed superior clinical utility and provided four useful measures for risk assessment. We gained valuable insight into cardiovascular ageing and its predictors.
Asunto(s)
Enfermedades Cardiovasculares , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/epidemiología , Estudios de Cohortes , Humanos , Persona de Mediana Edad , Estudios Prospectivos , Medición de Riesgo , Factores de RiesgoRESUMEN
Objectives: The worldwide SARS-COV2 pandemic has impacted the health of workers and companies. The aim is to quantify it according to sick leave. Methods: Using ICD-9 codes, we analyzed Ibermutua records of all sick leaves during the first trimester of 2020, compared to during the same months of 2017, 2018, and 2019. We stratified the analysis by causes, patient sex, activity sectors, and regional data. All sick leaves were adjusted by the number of Ibermutua-affiliated persons in each period. Results: In March 2020, there was an unprecedented (116%) increase in total sick leaves, mainly due to infectious and respiratory diseases. Men and women were equally affected. All activity sectors were impacted, with the highest increase (457%) observed among health-related workers, especially due to contagious disease. The incidences of sick leaves were heterogeneous among different regions. Cost-analysis of sick leaves during the first trimester of 2020 compared with in previous years showed 40.3% increment (mean 2,813 vs. 2,005 per 100 affiliated workers). Conclusions: The SARS-COV2 pandemic is having a huge impact on workers' health, as shown by data regarding sick leaves in March 2020. This is associated with greater economic burden for companies, both due to the cost associated with sick leaves and the losses in productivity due to confinement.
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COVID-19 , Ausencia por Enfermedad , Femenino , Humanos , Masculino , Embarazo , Primer Trimestre del Embarazo , ARN Viral , SARS-CoV-2RESUMEN
OBJECTIVE: To describe the epidemiological characteristics and trends of work-related eye injuries (WREIs) in Spain over a 10-year period by sex, age and occupational sector. DESIGN AND SETTINGS: A descriptive, retrospective and longitudinal study based on data from workers insured by a labour insurance company in Spain from 2008 to 2018 was presented. The study considered the ratio of the number of WREI per 100 000 population and the relative risk of suffering an ocular injury. WREIs were characterised by sex, age and occupational sector of injured workers. PRIMARY AND SECONDARY OUTCOME MEASURES: Ratio of the number of WREI. PARTICIPANTS: In Spain, all workers are insured by a labour insurance company that provides cover in the event of work-related accidents. In this study, we have included all workers insured by one of these insurance companies, IBERMUTUA, with workers in all areas of Spain. RESULTS: The study included 50 265 WREI in the company over the 10-year period. Most of the injuries occurred in males (44 445; 88.4%), in 35-44 age group (15 992; 31.8%) and in industry workers (18 899; 42.6%). The average incidence was 429.75 per 100 000 workers insured and 4273.36 per 100 000 IBERMUTUA accidents (related and not related to eyes). Males, 16-24 age group and industry occupational sector group, have the highest incidence for WREI. The incidence of WREI decrease over the study period in all variables. Males have 6.56 (95% CI 6.38 to 6.75) times more risk of suffering WREI than females. 16-24 age group have 1.77 (95% CI 1.71 to 1.83) times more risk than in the group of workers older than 55. Finally, industry workers have 7.73 (95% CI 7.55 to 7.92) times more risk than services workers. CONCLUSIONS: The risks of suffering WREI is higher for males, younger and less experienced workers, and for those who works in a manual task.
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Lesiones Oculares , Traumatismos Ocupacionales , Accidentes de Trabajo , Lesiones Oculares/epidemiología , Lesiones Oculares/etiología , Femenino , Humanos , Estudios Longitudinales , Masculino , Traumatismos Ocupacionales/epidemiología , Estudios Retrospectivos , España/epidemiologíaRESUMEN
BACKGROUND: Several studies show a high percentage of eye injuries related to work compared to other origins. However, there are few studies that describe work-related eye injuries. METHODS: A descriptive, retrospective, and longitudinal study that describes the characteristics of work-related eye injuries in a group of insured workers. Eye injuries were classified according to the International Classification of Diseases (ICD-10) and analyzed over 10 years (2008-2018). RESULTS: Keratitis and conjunctivitis were the most prevalent injuries (26,674 (53.1%) and 15,906 (31.6%)). Keratitis and conjunctivitis also show the highest percentage of injury incidence per 100,000 insured workers in both sexes, any age group, and any occupation. The analysis of the cumulative percentage change and average annual percent change in incidences over ten years shows a decrease in the incidences of all injuries, except for other disorders of the eye and anexa. CONCLUSIONS: Most of the work-related eye injuries affect the most exposed eye structures in any line of work: the cornea and conjunctiva. Suitable protection of these eye structures will decrease the number of cases of work-related eye injuries.
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Lesiones Oculares , Accidentes de Trabajo , Adolescente , Adulto , Lesiones Oculares/epidemiología , Femenino , Humanos , Incidencia , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , España/epidemiología , Adulto JovenRESUMEN
INTRODUCTION AND OBJECTIVES: To develop a predictive function of lifetime cardiovascular risk, including morbidity and mortality, in a healthy working population in Spain. METHODS: Retrospective cohort study. We selected healthy workers, aged 18 to 65 years, with no history of cardiovascular disease, who underwent a health assessment between 2004 and 2007. We used 70% of the cohort to develop the risk equation, and the remaining 30% to validate the equation. Four Cox proportional hazards models were constructed using cardiovascular events and competing events as dependent variables. The same models were replicated for men and women separately. Fatal and nonfatal events were assessed until 2014. RESULTS: A total of 762 054 individuals were selected. The mean age was 35.48 years and 71.14% were men. Significant risk variables in the model included manual occupations, being a smoker or exsmoker, diabetes mellitus, antihypertensive treatment, systolic blood pressure, total cholesterol, high-density lipoprotein cholesterol, and lipid-lowering treatment; in men, the model also included alcohol consumption, body mass index, a family history of early coronary disease in first-degree relatives, renal failure, and diastolic blood pressure. The area under the curve receiver operating characteristic was 0.84 (95%CI, 0.82-0.85) in men and 0.73 (95%CI, 0.66-0.80) in women. Calibration showed underestimation in low-risk deciles and overestimation in high-risk deciles. CONCLUSIONS: The new lifetime cardiovascular risk model has satisfactory discrimination and calibration, with better results in men than in women.
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Enfermedades Cardiovasculares/prevención & control , Predicción , Atención Primaria de Salud/métodos , Prevención Primaria/métodos , Medición de Riesgo/métodos , Adolescente , Adulto , Anciano , Enfermedades Cardiovasculares/epidemiología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Morbilidad/tendencias , Pronóstico , Estudios Retrospectivos , Factores Sexuales , España/epidemiología , Tasa de Supervivencia/tendencias , Adulto JovenRESUMEN
INTRODUCTION AND OBJECTIVES: The purpose of this study was to investigate whether changes in cardiovascular risk (CVR) are associated with the length and cost of sickness absence. METHODS: A prospective cohort of 179 186 participants was evaluated. Each participant's CVR (SCORE) was assessed on 2 consecutive medical examinations, approximately 1 year apart (365 ± 90 days). Cardiovascular risk was categorized as < 4% or ≥ 4%, and participants were divided into 4 groups according to changes in their risk between the 2 assessments. After the second CVR estimate, a 1-year follow-up was carried out to assess sickness absence. Differences between the 4 groups in terms of the total count of sickness absence days during the follow-up period were tested using Poisson regression models. RESULTS: After adjustment for covariates, participants who showed an improvement in CVR had a lower count of sickness absence days compared with both those who showed a worsening in risk and those who remained stable at ≥ 4% (RR, 0.91; 95%CI, 0.84-0.98). In comparison with participants whose CVR did not improve, more of the participants whose risk did improve had quit smoking (+17.2%; P < .001), and had controlled their blood pressure (+26.0%, P < .001), total cholesterol (+9.3%; P < .001), low-density lipoprotein cholesterol (+14.9%; P < .001), and triglyceride levels (+14.6%; P < .001). CONCLUSIONS: Our results suggest that an improvement in CVR profile is accompanied by a decrease in sickness absence during a 1-year follow-up.
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Enfermedades Cardiovasculares/epidemiología , Enfermedades Profesionales/epidemiología , Ausencia por Enfermedad/estadística & datos numéricos , Absentismo , Accidentes de Trabajo/economía , Accidentes de Trabajo/estadística & datos numéricos , Adulto , Anciano , Antihipertensivos/uso terapéutico , Enfermedades Cardiovasculares/economía , LDL-Colesterol/metabolismo , Costo de Enfermedad , Dislipidemias/tratamiento farmacológico , Dislipidemias/economía , Dislipidemias/epidemiología , Femenino , Humanos , Hipertensión/tratamiento farmacológico , Hipertensión/economía , Hipertensión/epidemiología , Hipolipemiantes/uso terapéutico , Masculino , Persona de Mediana Edad , Enfermedades Profesionales/economía , Estudios Prospectivos , Factores de Riesgo , Ausencia por Enfermedad/economía , España/epidemiología , Triglicéridos/metabolismoAsunto(s)
Enfermedades Cardiovasculares , Trastorno Depresivo , Antidepresivos , Depresión , Humanos , Masculino , Factores de RiesgoRESUMEN
BACKGROUND: Metabolically healthy obese (MHO) phenotype may present with distinct characteristics compared with those with a metabolically unhealthy obese phenotype. Epidemiologic data on the distribution of these conditions in the working population are lacking. We aimed to evaluate the prevalence and clinical characteristics of MHO and other obese/non-obese metabolic phenotypes in a working population. METHODS: Cross-sectional analysis of all subjects who had undergone a medical examination with Ibermutuamur Prevention Society from May 2004 to December 2007. Participants were classified into 5 categories according to their body mass index (BMI); within each of these categories, participants were further classified as metabolically healthy (MH) or metabolically unhealthy (MUH) according to the modified NCEP-ATPIII criteria. A logistic regression analysis was performed to evaluate some clinically relevant factors associated with a MH status. RESULTS: In the overall population, the prevalence of the MHO phenotype was 8.6%. The proportions of MH individuals in the overweight and obese categories were: 87.1% (overweight) and 55.5% (obese I-III [58.8, 40.0, and 38.7% of the obese I, II, and III categories, respectively]). When the overweight and obese categories were considered, compared with individuals who were MUH, those who were MH tended to be younger and more likely to be female or participate in physical exercise; they were also less likely to smoke, or to be a heavy drinker. In the underweight and normal weight categories, compared with individuals who were MH, those who were MUH were more likely to be older, male, manual (blue collar) workers, smokers and heavy drinkers. Among participants in the MUH, normal weight group, the proportion of individuals with a sedentary lifestyle was higher relative to those in the MH, normal weight group. The factors more strongly associated with the MUH phenotype were BMI and age, followed by the presence of hypercholesterolemia, male sex, being a smoker, being a heavy drinker, and lack of physical exercise. CONCLUSIONS: The prevalence of individuals with a MHO phenotype in the working population is high. This population may constitute an appropriate target group in whom to implement lifestyle modification initiatives to reduce the likelihood of transition to a MUH phenotype.
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Obesidad/epidemiología , Obesidad/fisiopatología , Adulto , Factores de Edad , Consumo de Bebidas Alcohólicas/epidemiología , Índice de Masa Corporal , Colesterol/sangre , Estudios Transversales , Ejercicio Físico , Femenino , Conductas Relacionadas con la Salud , Estado de Salud , Humanos , Estilo de Vida , Masculino , Persona de Mediana Edad , Sobrepeso/epidemiología , Sobrepeso/fisiopatología , Fenotipo , Prevalencia , Conducta Sedentaria , Factores Sexuales , Fumar/epidemiologíaRESUMEN
OBJECTIVES: The aim of this study is to analyze the association between the exposure to psychosocial risk factors at work and the incidence of occupational injuries (OIs). METHODS: A prospective dynamic cohort study (nâ=â16,693) of 1-year follow-up. Psychosocial risk factors at work were assessed with the Spanish version of Copenhagen Psychosocial Questionnaire. Incidence rates of OI per 1000 workers-year were calculated and associations between psychosocial risk factors and OI were estimated by Poisson regression models. RESULTS: Unfavorable levels of esteem in men [rate ratio (RR)â=â1.28], and unfavorable levels of social support and quality of leadership (RRâ=â1.87), psychological demands (RRâ=â2.20), and active work and possibilities for development (RRâ=â1.83) among women, were associated with OI incidence. CONCLUSIONS: Poor quality of psychosocial work environment increases the incidence of OI. Psychosocial intervention programs could be helpful in order to reduce OI incidence rates and their associated costs.
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Salud Laboral , Traumatismos Ocupacionales/epidemiología , Lugar de Trabajo/psicología , Adulto , Movilidad Laboral , Femenino , Humanos , Incidencia , Liderazgo , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores de Riesgo , Autoimagen , Factores Sexuales , Apoyo Social , España/epidemiología , Encuestas y Cuestionarios , Adulto JovenRESUMEN
BACKGROUND: Recent guidelines recommend assessment of lifetime cardiovascular risk on the basis of traditional risk factors in adults who are not at high short-term risk. The aim of this study is to determine the implications of estimating the lifetime cardiovascular risk in individuals in a large occupational cohort in Spain. DESIGN: National cross-sectional study in an occupational cohort with an in-person interview including laboratory tests. METHODS: Volunteer workers who were examined between January 2011 and December 2011 were included. A total of 580,236 workers were eligible during this year and 259,834 were examined (participation rate of 44.7%). Short-term (10-year) and lifetime cardiovascular risk were estimated using the American College of Cardiology (ACC) and the American Heart Association (AHA) tool and the QRISK2 and QRISK. RESULTS: Sixty-eight per cent were male, mean age was 39 years, with an age range of 16 to 75 years. Total number of individuals included in this study was 258,676. The percentage of patients at high short-term risk was 6.85% (95% confidence interval (CI) 6.75%-6.95% and 20.83% (95% CI 20.60%-21.07%) with the QRISK2, and the ACC/AHA risk equations, respectively. Of the percentage of patients classified as not at high risk with the different tools 1.61% (95% CI 1.55%-1.66%) were high lifetime risk on QRISK, and 27.41% (95% CI 27.11%-27.70%) on ACC/AHA risk. CONCLUSIONS: Application of lifetime cardiovascular risk engages greater numbers of individuals at high risk with substantial differences between the different methods available. These differences can have important clinical implications specifically in the percentage of candidates for lifestyle changes and eventually lipid lowering drugs.
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Enfermedades Cardiovasculares/etiología , Técnicas de Apoyo para la Decisión , Adolescente , Adulto , Factores de Edad , Anciano , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/prevención & control , Estudios de Cohortes , Estudios Transversales , Femenino , Humanos , Hipolipemiantes/uso terapéutico , Estilo de Vida , Masculino , Persona de Mediana Edad , Salud Laboral , Valor Predictivo de las Pruebas , Medición de Riesgo , Factores de Riesgo , Conducta de Reducción del Riesgo , España , Factores de Tiempo , Adulto JovenRESUMEN
BACKGROUND: The role of prior cardiovascular risk (CVR) in the multifactorial process of returning to work after a cerebrovascular event has not been adequately investigated. Therefore, the objective of the present study was to analyse the association between previous CVR level, cardiovascular risk factors (CVRFs) and return-to-work (RTW) following cerebrovascular disease. DESIGN: This was a prospective observational study. METHODS: We analysed a cohort of 348 patients who had experienced an episode of cerebrovascular disease-related work absence. These individuals were selected from the ICARIA study (Ibermutuamur CArdiovascular RIsk Assessment). Global CVR was assessed using the SCORE system. We investigated the association between demographics, work-related variables, CVRFs and RTW following a cerebrovascular event. RESULTS: We found that a total of 254 individuals (73.0%; 95% CI: 68.3-77.7) returned to work after cerebrovascular disease. Also, we observed a median loss of 12 working years due to disability. Moreover, adjusting for potential confounders revealed that low CVR level and the absence of the following CVRFs was associated with a higher likelihood of RTW: low vs moderate-to-high CVR level (OR: 2.55; 95% CI: 1.42-4.57), no hypertension before stroke (OR: 1.95; 95% CI: 1.11-3.41), non-smoker status (OR: 2.26; 95% CI: 1.30-3.93) and no previous diabetes (OR: 2.46; 95% CI: 1.26-4.79). CONCLUSIONS: Low CVR, along with the absence of several CVRFs, can be used to predict RTW rates following cerebrovascular events. Therefore, controlling hypertension, tobacco consumption and diabetes might contribute to the effectiveness of multidisciplinary rehabilitation and/or secondary/tertiary prevention programs for cerebrovascular disease.
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Trastornos Cerebrovasculares/rehabilitación , Reinserción al Trabajo , Adulto , Trastornos Cerebrovasculares/diagnóstico , Trastornos Cerebrovasculares/epidemiología , Comorbilidad , Diabetes Mellitus/epidemiología , Femenino , Humanos , Hipertensión/epidemiología , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Medición de Riesgo , Factores de Riesgo , Conducta de Reducción del Riesgo , Fumar/efectos adversos , Fumar/epidemiología , Prevención del Hábito de Fumar , España/epidemiología , Factores de Tiempo , Evaluación de Capacidad de TrabajoRESUMEN
AIMS: We investigated the potential influence of a moderate-to-high cardiovascular (CV) risk (CVR) (defined as a Systematic COronary Risk Evaluation model, or SCORE ≥ 4%), in the absence of an established CV disease, on the duration and cost of CV and non-CV sick leave (SL) resulting from common and occupational accidents or diseases. METHODS AND RESULTS: We conducted a prospective cohort study on 690 135 workers with a 1-year follow-up and examined CV- and non-CV-related SL episodes. To obtain baseline values, CVR factors were initially assessed at the beginning of the year during routine medical examination. The CVR was calculated with the SCORE charts for all subjects. Moderate-to-high CVR was defined as SCORE ≥ 4%. A baseline SCORE ≥ 4% was associated with a higher risk for long-term CV and non-CV SL, as revealed by follow-up assessment. This translated into an increased cost, estimated at 5 801 464.18 per year. Furthermore, pharmacological treatment for hypertension or hyperlipidaemia was significantly associated with longer SL duration. CONCLUSION: Moderate-to-high CVR in asymptomatic subjects was significantly associated with the duration and cost of CV and non-CV SL. These results constitute the first body of evidence that the SCORE charts can be used to identify people with a non-established CV disease, which might ultimately translate into more lost workdays and therefore increased cost for society.
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Enfermedades Cardiovasculares/economía , Ausencia por Enfermedad/economía , Accidentes de Trabajo/economía , Accidentes de Trabajo/estadística & datos numéricos , Adolescente , Adulto , Distribución por Edad , Anciano , Costos y Análisis de Costo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores de Riesgo , Distribución por Sexo , España , Factores de Tiempo , Adulto JovenRESUMEN
BACKGROUND AND OBJECTIVE: To analyze non-work-related sickness absence (NWR-SA) due to inguinal hernia and the factors related to its duration, paying particular attention to the pre-surgical period of NWR-SA. MATERIAL AND METHODS: Prospective cohort study was conducted on 1,003 workers with an episode of NWR-SA due to an inguinal hernia, belonging to the insured population of a mutual insurance company. We assessed the duration of the NWR-SA episodes and the main demographic, occupational and clinical variables potentially related to it. Cox regression analyses were conducted to establish the predictors of NWR-SA duration. RESULTS: The mean duration of NWR-SA due to inguinal hernia was 68.6 days. After multivariate analysis (Cox regression), having a pre-surgical period of NWR-SA (HR = 0.35; 95%CI: 0.28-0.43), manual occupations (HR=0.68; 95%CI: 0.49-0.95), construction sector (HR=0.71; 95%CI: 0.58-0.88), direct payment methods by a Mutual Insurance Company during sick leave in self-employed workers (HR=0.58; 95%CI, 0.41-0.82), or employees (HR=0.51; 95%CI: 0.36-0.72), comorbidity (HR=0.45; 95%CI:0.34-0.59), and surgery performed under an entity other than the Public Health System or a mutual insurance company (HR=0,76; 95%CI: 0.59-0.97) were associated with longer NWR-SA. The Mutual Insurance Company always performed the surgery when a pre-surgery period of NWR-SA existed (mean duration=47 ±39.6 days); that was associated with shorter periods of post-surgical NWR-SA (P=.001). CONCLUSIONS: The NWR-SA due to inguinal hernia is a multifactorial phenomenon in which the pre-surgery period plays an important role. The collaboration between organizations involved in the management of NWR-SA seems to be an effective strategy for reducing its duration.
Asunto(s)
Hernia Inguinal , Ausencia por Enfermedad , Adulto , Femenino , Hernia Inguinal/cirugía , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores de Tiempo , Adulto JovenRESUMEN
OBJECTIVES: The aim of this study was to analyse the association between job stress and occupational injuries. METHODS: A prospective cohort study in a sample of 10 667 workers belonging to the insured population of the Mutual Insurance Company in Spain. Job stress was assessed with the Spanish version of the Job Stress Survey. A 1-year follow-up of the workers' clinical records was conducted to determine the incidence of occupational injuries, and the incidence rate per 1000 workers-year was calculated. The associations between the incidence of occupational injuries, job stress and job stress components (job pressure (JP) and lack of organisational support (LOS)) were assessed calculating the rate ratio (RR) and its CI of 95% using Poisson regression models. RESULTS: After adjusting for confounders, a significant association between LOS and increased incidence of occupational injuries was found. Such an association was observed for the LOS index (RRa=3.11, 95% CI 1.53 to 6.31), LOS severity (RRa=2.64, 95% CI 1.31 to 5.33) and LOS frequency (RRa=2.67, 95% CI 1.32 to 5.38) scales in women. There was no significant association between job stress or its components and the incidence of occupational injuries among men. CONCLUSIONS: This prospective study found evidence of an association between the LOS and the incidence of occupational injuries in women, with potential implications for the prevention of accidents at work.
Asunto(s)
Salud Laboral , Traumatismos Ocupacionales/etiología , Ocupaciones , Estrés Psicológico/complicaciones , Adulto , Distribución por Edad , Estudios de Cohortes , Intervalos de Confianza , Femenino , Humanos , Incidencia , Puntaje de Gravedad del Traumatismo , Masculino , Persona de Mediana Edad , Traumatismos Ocupacionales/epidemiología , Traumatismos Ocupacionales/psicología , Innovación Organizacional , Distribución de Poisson , Estudios Prospectivos , Medición de Riesgo , Distribución por Sexo , España/epidemiología , Lugar de Trabajo/psicología , Adulto JovenRESUMEN
OBJECTIVES: To analyze the duration of non-work-related sick leave due to anxiety disorders and to identify demographic, occupational and clinical variables that may contribute to its prediction. METHODS: We performed a prospective cohort study of 1,161 workers with an episode of non-work-related sick leave due to an anxiety disorder, belonging to the insured population of a mutual insurance company. We assessed the duration of non-work-related sick leave episodes and the main potentially related demographic, occupational and clinical variables. All non-work-related sick leave processes were followed-up until discharge. Cox regression analyses were conducted to establish the predictors of non-work-related sick leave duration. RESULTS: The median duration of non-work-related sick leave due to anxiety disorders was 83 days. In a multivariate analysis, the following factors were identified as being significantly associated with increases in the duration of sick leave (p <0.05): age of over 35 years, lower educational level (primary school studies, secondary school studies or high-school diploma vs. university degree), and the existence of comorbidity and unemployment occurring during the sick leave. In contrast, being separated or divorced was associated with an earlier return to work (p <0.05). CONCLUSIONS: Anxiety disorders are associated with long periods of non-work-related sick leave compared with other disorders and standard time duration. Demographic, occupational and clinical variables collected at the initial assessment of the sick leave episode would help to identify groups with an increased risk of prolonged sick leave, requiring strategies to facilitate return to work.
Asunto(s)
Trastornos de Ansiedad , Reinserción al Trabajo/estadística & datos numéricos , Ausencia por Enfermedad/estadística & datos numéricos , Adulto , Trastornos de Ansiedad/epidemiología , Estudios de Cohortes , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores de Tiempo , Adulto JovenRESUMEN
BACKGROUND: The aim of this study was to analyze the impact on tobacco consumption among working population of the Law 42/2010, which amends smoking regulations in Spain. METHODS: Data were obtained from 413,473 Occupational Health check-ups, conducted between July of 2009 and June of 2011, in the Society for Prevention of a Mutual Insurance Company. We analyzed changes in the biannual percentage of smokers and the magnitude of tobacco consumption among smokers in the overall set of medical check-ups, by gender, age, occupational level (manual vs. non-manual workers), and in the specific occupational subgroup of waiters, barmen and similar workers (chi-square test). RESULTS: In the overall set of medical check-ups, the percentage of smokers decreased by 5% (from 40.3% to 35.3%) over the period of study (p <0.001) and the group of smokers with lower daily consumption (< 10 cigarettes) became the most frequent (p <0.001). In the group of waiters, barmen and similar workers the differences in the biannual percentage of smokers did not reach statistical significance (p =0.07). In this group, smokers of < 10 cigarretes/ day also became the most common consumption group (increasing from 40.5% to 48.8%) and the percentage of 21-40 cigarretes/day decreased from 10.6% to 4% (p =0.008). CONCLUSIONS: These results suggest that the new regulation has been accompanied by a significant reduction in smoking among Spanish workers and strongly support population-level measures against tobacco consumption.