Prevalence of Post-traumatic Stress Disorder and Depression After the September 19th, 2017 Earthquake in Mexico.

BACKGROUND AND AIM: Natural disasters cause mental disorders, the most frequent are Post-traumatic stress disorder (PTSD) and depression, which should be quickly identified for immediate psychological care. The aim of this study was to estimate the frequency of these disturbances in a population with social security, located in the states hit by the earthquake that took place on September 19th, 2017 in Mexico. METHODS: To identify persons with PTSD and depression, a random sample of the population was screened (1-2 months' post-earthquake) in primary health care clinics at the Mexican Institute of Social Security (IMSS). A questionnaire for the detection of mental conditions (The Screening Questionnaire for Disaster Mental Health, SQD) was used to select people for group therapy and/or psychotherapeutic support, when identified with severe PTSD and high risk of depression. RESULTS: Over 44,855 persons (67.9% females, 32.1% males), residents of Mexico City, the State of Mexico, Puebla, Morelos were surveyed. The prevalence of severe PTSD was 11.9% and depression 9.2%. The highest prevalence of PTSD was observed in Mexico City (12.8%) the state with more material damage. Women were at higher risk for PTSD (OR, 2.08; 95% CI 1.97-2.19, p = 0.000) and depression (OR, 1.86; 95% CI 1.72-2.01, p = 0.000). CONCLUSIONS: The prevalence of PTSD and depression was higher in those states with severe damage caused by the earthquake; women were more susceptible to mental disorders.

Seroprevalence of Pandemic A(H1N1) pmd09 Virus Antibodies in Mexican Health Care Workers Before and After Vaccination.

BACKGROUND AND AIMS: In April 2009, a new strain of influenza A(H1N1) was identified in Mexico and in the U.S. In June 2009, WHO declared this a pandemic. Health care workers constituted a risk group for their close contact with infected individuals. The aim was to estimate seropositivity for A(H1N1)pdm09 in health staff at the Instituto Mexicano del Seguro Social. METHODS: A two-stage cross-sectional study, before and after vaccination in the same workers, was performed on a random sample of health-care workers. A socio-occupational questionnaire was applied and serum antibodies against influenza A(H1N1)pdm09 were determined through neutralization of retroviral pseudotypes; two logistic regression models for both were constructed. RESULTS: The average (median/mean) age of 1378 participants from 13 work centers was 41.7 years and 68.7% (947) were women. Seroprevalence for the first stage was 26.5% (365) (7.4-43%) vs. 20.8% (11) in a control group from the blood bank; for the second stage, the vaccinated group was 33% (215) (18.2-47%) and 27% (196) (11.6-50%) for the unvaccinated group. In regression models, seropositivity was associated with occupational exposure to suspected influenza infected patients, being physicians, and being vaccinated. CONCLUSIONS: Seropositivity against pandemic virus is similar to what was reported, both for vaccinated (2.8-40.9%) and unvaccinated (18.8-64.7%). Low seroprevalence in the vaccinated group indicates that between 67% and 73% were susceptible to infection. Given the relatively low vaccine-induced seropositivity, it is imperative to increase, hygiene and safety for health staff and at-risk populations, and strengthen epidemiological surveillance.

[Estimation of health-care costs for cervical uterine neoplasm]. / Costos de atención médica por cáncer cervicouterino.

OBJECTIVE: to value diagnostic stage and direct costs due to cervical cancer in insured workers and IMSS beneficiaries patients, during first year of treatment. METHODS: 80 records of patients with confirmed diagnosis of cervical cancer during 2000-2003 were analyzed. The study was made under provider public health services perspective, with focus in costs incidence during 2009. RESULTS: 27 (34 %) of total records corresponding to insured worker and 53 (66 %) to beneficiaries. No differences were finding in diagnostic stage. In bout groups stage II was the most common. The cost due medical care adds up to $91,064.00 during first year of treatment in workers. The main costs were identified in sickness absence certification (31 %), image exams (24 %) consulting room (19 %), radiotherapy sessions (10 %) and hospitalization (9 %). CONCLUSIONS: cervical cancer is a frequent disease that affects women in their productive and reproductive age. Frequently their diagnosis is made in advanced stages, which increase medical attention cost. It is convenient to introduce more effective preventive actions, including the workplace.

Medicina del trabajo y calidad de vida en el trabajo: hacia un enfoque integrador / Occupational medicine and quality of work life toward an integrative approach

La Medina del Trabajo (MT) tiene el objeto de promover y mantener el más alto grado de bienestar físico, mental y social de los trabajadores, la protección de los mismo frente a todo tipo de riesgo, adaptar el trabajo y su ambiente a sus capacidades psico-fisiológicas. En general la MT, ha seguido dos tendencias derivadas del modelo médico hegemónico: una que enfoca su esencia a la atención y compensación del daño y otra que se limitan a la prevención de accidentes y enfermedades de trabajo. Esto ha valido la crítica de otras disciplinas que ven a la MT como un área poco conocida y enfocada a lo orgánico-funcional más que a lo psico-social. Esta revisión describe los paradigmas de las ciencias de la salud; el trabajo como proceso social vinculada al proceso salud-enfermedad; se retoma el concepto de historia cultural de la enfermedad y se resalta el valor del estudio de la cantidad de vida en el trabajo (AU)

Occupational Medicine (OM) aims to promote and maintain the highest degree of physical, mental and social well-being of workers, protecting them against all kinds of risk, adapt the work and its environment to psycho-physiological capabilities. In general, OM has followed two trends derived from the hegemonic medical model: one that focuses its essence to care and compensation and another that were limited to the prevention of accidents and work diseases. This has earned the criticism of other disciplines that perceive OM as a little known area, more focused to the organic and functional to the psycho-social. This review describes the paradigms of health sciences; work as a social process linked to the health-disease process; it takes the concept of disease cultural history and highlights the value of the study of quality of work life (AU)

Prevalencia del síndrome de fatiga crónica en trabajadores de una fábrica mexicana de cierres / Prevalence of the chronic fatigue syndrome in workers of a Mexican factory of zippers

Antecedentes: El síndrome de fatiga crónica (SFC) se caracteriza por cansancio persistente e inexplicado a pequeños esfuerzos tanto físicos como mentales, y suele acompañarse de un contexto sintomático tipo inflamatorio; su curso crónico y persistente ocasiona limitación funcional. Es una entidad subdiagnosticada y de etiología múltiple: puede ser infecciosa, de origen ambiental, tóxico y psicosocial; con prevalencia que oscila entre el 2,6% y el 2,8% en la población general; su frecuencia en población trabajadora ha sido muy poco explorada. Objetivo: Determinar la prevalencia del SFC en trabajadores de una fábrica de cierres del estado de Hidalgo, México. Métodos: Estudio transversal que incluyó una muestra por conveniencia no aleatoria de 137/152 (90%) trabajadores de una fábrica de cierres localizada en el estado de Hidalgo, México, y en quienes se exploraron diversas variables sociodemográficas, clínicas y laborales; para el diagnóstico de SFC se aplicaron los criterios del Centro de Control de Enfermedades (CDC) 1994. Se realizó análisis simple descriptivo con cálculo de prevalencia puntual. Resultados: En la población trabajadora estudiada se encontró una prevalencia de 19,71%, sin encontrar diferencias proporcionales de las variables estudiadas, excepto en su distribución por sexo (p<0,05) con predominio del sexo femenino. Conclusión: La prevalencia de SFC en el grupo de trabajadores estudiados fue más elevada que la referida en población general. Los resultados se apegan a la idea que el trabajo podría contribuir de manera importante al desarrollo de SFC.

Background: Chronic fatigue syndrome (CFS) is characterized by persistent fatigue and unexplained to small physical and mental effort, and usually accompanied by an inflammatory symptomatic context, its course is chronic and persistent that cause functional limitation. It is an underdiagnosed entity with multiple etiologies: it may be infectious, environmental, toxic or psychological, with prevalence that ranges between 2,6% and 2,8% in the general population, its frequency among workers has been very little explored. Objective: To determine the prevalence of CFS in workers at a zipper factory in the state of Hidalgo, Mexico. Methods: Cross-sectional study included a non random convenience sample of 137/152 (90%) workers in a factory zippers located in the state of Hidalgo, Mexico, and who were explored in several sociodemographic, clinical and labor variables; for CFS diagnose criteria of the Center for Disease Control (CDC) 1994 were applied. Simple descriptive analysis was performed to estimate punctual prevalence. Results: We determined prevalence of 19.71% in the working population studied, no differences in proportion of the studied variables, except sex distribution (p <0.05) with female predominance. Conclusion: CFS prevalence in the group of workers studied was higher than that reported in general population. Results agree with the idea that work could contribute significantly to CFS development.

[The teaching of occupational medicine in Mexican medical schools]. / Enseñanza de medicina del trabajo en el pregrado de las escuelas de medicina en México.

OBJECTIVE: To analyze the current situation of teaching occupational medicine (OM) in academic programs and medical schools in Mexico. MATERIAL AND METHODS: A descriptive survey was conducted and schools were identified through the main directories of medical schools. For the analysis of information descriptive and inferential statistics were used. RESULTS: A total of 75 medical schools were identified. In 39 (52%) the subject is mandatory, with a predominance in public schools (p< 0.02). Among the schools that offer the subject, only 15 (38%) have professors specialized in OM. CONCLUSIONS: Disparity in teaching basic aspects of OM in medical schools explains the little development and social and professional recognition of the specialty; it also highlights serious problems for public health, derived from the lack of prevention of risks in work environments.

Enseñanza de medicina del trabajo en el pregrado de las escuelas de medicina en México / The teaching of occupational medicine in Mexican medical schools

OBJETIVO: Analizar el estado actual de la enseñanza de medicina del trabajo (MT) en facultades y escuelas de medicina en México. MATERIAL Y MÉTODOS: Se llevó a cabo una encuesta descriptiva. Se identificaron facultades y escuelas a través de directorios de organizaciones de educación superior. Para el análisis de la información, se utilizó estadística descriptiva e inferencial. RESULTADOS: De las 75 escuelas y facultades de medicina, 39 (52 por ciento) ofrecen la asignatura como obligatoria, con predominio en planteles públicos (p< 0.02). Sólo 15 (38 por ciento) cuentan con especialistas en MT como profesores. CONCLUSIONES: La disparidad en la enseñanza de aspectos básicos sobre MT en el pregrado explica en parte el poco desarrollo y el pobre reconocimiento social y profesional de la especialidad, lo que desencadena problemas para la salud pública derivados de la escasa prevención de riesgos de trabajo y de conservación de la salud de los trabajadores en los centros laborales.

OBJECTIVE: To analyze the current situation of teaching occupational medicine (OM) in academic programs and medical schools in Mexico. MATERIAL AND METHODS: A descriptive survey was conducted and schools were identified through the main directories of medical schools. For the analysis of information descriptive and inferential statistics were used. RESULTS: A total of 75 medical schools were identified. In 39 (52 percent) the subject is mandatory, with a predominance in public schools (p< 0.02). Among the schools that offer the subject, only 15 (38 percent) have professors specialized in OM. CONCLUSIONS: Disparity in teaching basic aspects of OM in medical schools explains the little development and social and professional recognition of the specialty; it also highlights serious problems for public health, derived from the lack of prevention of risks in work environments.

Estimation of health-care costs for work-related injuries in the Mexican Institute of Social Security.

BACKGROUND: Data on the economic consequences of occupational injuries is scarce in developing countries which prevents the recognition of their economic and social consequences. This study assess the direct heath care costs of work-related accidents in the Mexican Institute of Social Security, the largest health care institution in Latin America, which covered 12,735,856 workers and their families in 2005. METHODS: We estimated the cost of treatment for 295,594 officially reported occupational injuries nation wide. A group of medical experts devised treatment algorithms to quantify resource utilization for occupational injuries to which unit costs were applied. Total costs were estimated as the product of the cost per illness and the severity weighted incidence of occupational accidents. RESULTS: Occupational injury rate was 2.9 per 100 workers. Average medical care cost per case was $2,059 USD. The total cost of the health care of officially recognized injured workers was $753,420,222 USD. If injury rate is corrected for underreporting, the cost for formal injured workers is 791,216,460. If the same costs are applied for informal workers, approximately half of the working population in Mexico, the cost of healthcare for occupational injuries is about 1% of the gross domestic product. CONCLUSIONS: Health care costs of occupational accidents are similar to the economic direct expenditures to compensate death and disability in the social security system in Mexico. However, indirect costs might be as important as direct costs.

[Clinical aptitude in occupational medicine residents]. / Aptitud clínica en residentes de medicina del trabajo.

OBJECTIVE: To determine clinical aptitude (AC) in occupational medicine residents. METHODS: An instrument based on real clinical cases was built and validated to assess AC, which was composed by surveillance indicators of the workers health (SIWH) and occupational-medical evaluation indicators (0ME) In the study participated 22 undergraduate students (UE), 40 residents of first year (R1) and 36 of second year (R2). The instrument was validated by experts. RESULTS: Internal consistency of the instrument was 0.93 by Kuder-Richardson. Regarding global AC, 96 % of UE were situated in a random level and 4 % in a very low level. 15 % of R1 was situated in a random level, 50 % in a very low level, 30 % low level and 5 % in medium level; whereas R2 3 % was positioned in a random level, 28 % in a very low level, 50 % in low level and 19 % in medium level. A significant difference was found between R1 and R2 in occupational-medical evaluation (p < 0.009), but not in SIWH. Two centers showed statistical difference in both indicators.

El subregistro de accidentes de trabajo en una Unidad de Medicina Familiar del Instituto Mexicano del Seguro Social. Subregistro de accidentes de trabajo en asegurados / No disponible

Objetivo: Determinar el subregistro de los accidentes de trabajo en una Unidad de Medicina Familiar (UMFX) escogida, inicialmente atendidos en el servicio de urgencias de un Hospital General de Zona (HGZ), del Instituto Mexicano del Seguro Social (IMSS) en el año 2002. Material y métodos: Es un estudio transversal que utilizó información de la fuente original del HGZ que otorga la primera atención médica. Se elaboró una cédula de registro con las diversas fuentes de información, efectuando confrontación, seguimiento y análisis estadístico de las mismas. Resultados: De 6551 probables accidentes de trabajo atendidos en el HGZ, se seleccionaron 821 casos adscritos a la UMFX escogida. Se conformaron tres grupos de acuerdo con su dictamen: Grupo I= SÍ de trabajo, 35.4% (290); Grupo II=NO de trabajo, 4.6% (38), y el Grupo III= no calificados y atendidos en urgencias, 60% (493); este último representa el subregistro de los accidentes de trabajo. Conclusiones: El subregistro del 60% es de los más altos reportado en la literatura, lo cual representa para el IMSS, los trabajadores y el país graves repercusiones económicas y sociales no cuantificadas

Objective: To determine the Occupational Accidents Subregistry at a selected Family Medicine Unit (FMUX) initially treated at a Mexican Institute of Social Security (IMSS) General Zone Hospital (HGZ) during the year 2002. Materials and Methods: This is a transversal study utilizing information from the original source, the HGZ primary-care hospital-facility. We elaborated a registry permit with diverse information sources, and conducted confrontation, follow up, and statistical analysis of these sources. Results: Of 6,551 probable occupational accidents treated at the HGZ Emergency Room, we selected 821 cases ascribed to the selected FMUX. We made up three groups according these dictates: Group I = YES, occupational, 35.4% (290); Group II = NO, occupational, 4.6% (38), and Grupo III = not qualified and treated at the Emergency Room, 60% (493); the latter group represented the occupational accidents registry. Conclusions: The subregistry of 60% is one of the highest reported in the literature, this representing for the IMSS, its workers, and the country of Mexico severe, non-quantified, social and economic repercussions

[Reflecting about 40 years of occupational medicine in Mexico]. / Reflexiones en torno a los 40 años de la medicina del trabajo en México.

Thirty-eight years ago, occupational medicine was recognized as medical specialty in Mexico. Its achievements have been discreet and its evolution has been marked by situations that have questioned its credibility, relevance and viability, despite its significant value for the Mexican health care institutions, for the public and for the private sector. This paper addresses the importance of the field of occupational medicine, showing its social relevance and makes some remarks about the essential quality of the specialists that this discipline requires.

[Reliability and validity of a generic job exposure matrix applied on a small-business]. / Matriz de expocición ocupacional genérica. Consistencia y validez al aplicarla en una pequeña empresa.

OBJECTIVE: to evaluate the reliability and validity of a generic job exposure matrix (JEM) applied in a small business. METHODOLOGY: procedures to evaluate a JEM integrated by six sections: the number of exposed workers per area, frequency of exposure, time of exposure time, level of exposure, safety controls, and proximity to source of exposure, was evaluated. The JEM also obtains information about possible health effects from exposure to occupational/environment agents. Two observers estimated the risk of exposure to epoxy resins on 31 workers of an epoxy resin facility in Mexico City. The rater agreements between the two observers were assessed through percent agreement (PA), weighted kappa (kappa(w)) and the intraclass correlation coefficient (ICC). RESULTS: disagreements were greater for the number of exposed workers (PA = 61.3, kappa(w) = 0.24, ICC = 0.33), level of exposure (PA= 66.7, kappa(w) = 0.25, ICC= 0.56), and safety controls (PA = 54.8, kappa(w) = 0.23, ICC = 0.69) sections. Percent agreement and kappa(w) were 64% and 0.58, respectively. In accordance with Landis and Koch, Altman, Fleiss, and Byrt classifications for the interpretation of kappa value, the weighted kappa (0.58) ranged from moderate to a fair good level. CONCLUSIONS: despite the discordance in some sections, the JEM proved to be useful to identify the risk of exposure in this type of small business.

Occupational health in Mexico.

This article describes the current situation of occupational health (OH) in Mexico, including socioeconomic context, legislation, health system, and educative and investigative resources, as well as the practice of OH. Workplace accidents per 100 workers decreased from 7.23 to 2.3 workers in 20 years; deaths decreased from 1.68 to 0.9 per 10,000 workers, while the occupational disease rate increased from 0.6 to 1 per 10,000 workers. This can be interpreted as an improvement in preventive measures as well as problems of recognition and registry. In Mexico OH faces challenges that range from needs for professional training and performance to needs for development of legal measures, coordination, information, and research.

[Reflections on the board of occupational medicine in Mexico]. / Certificación en medicina del trabajo. Una reflexión.

In January 2005, the National Normative Committee of Medical Specialties Boards withdrew their certification to the Mexican Board of Occupational Medicine. The Mexican Board of Occupational Medicine declared they did not need recognition from the National Normative Committee of Medical Specialties Boards and could operate independently. The implications of this state of affairs are critical in that they affect aspects beyond awarding diplomas and acknowledging professional competence in the fields of quality of medical attention, educational standards, law and ethics.

[Potential under-registration of occupational accidents in the Mexican Institute of Social Security]. / El subregistro potencial de accidentes de trabajo en el Instituto Mexicano del Seguro Social.

OBJECTIVE: To assess the potential under-registration of work-related accidents in the Mexican Institute of Social Security. MATERIAL AND METHODS: A countrywide cross-sectional study was carried out with information collected from 27 district offices of the Mexican Institute of Social Security (MISS), on workers seen at MISS emergency rooms during November 2001 because of a probable accident at work. We compared these reports to official records of work-related accidents to estimate the proportion of incomplete reports. Data analysis consisted of descriptive statistics for each variable; the annual estimation of incomplete reporting proportions was made by multiplying by twelve months; 95% confidence intervals were estimated using Poisson's exact method for a proportion. RESULTS: Data from 27 out of 37 MISS district offices revealed that 7211 cases were not recognized as work accidents, accounting for an underestimation of 26.3%, ranging between 0 and 68% among the different district offices. The accidents that were most frequently left unregistered were mild and blunt injuries. CONCLUSIONS: Under-registration can affect worker compensation plans and the financial balance of the institution's occupational risk insurance. Research is needed to investigate and eliminate the causes of under-registration. Employers, the industry, and health institutions should be involved in this effort. The English version of this paper is available at: http://www.insp.mx/salud/index.html.

El subregistro potencial de accidentes de trabajo en el Instituto Mexicano del Seguro Social / Potential under-registration of occupational accidents in the Mexican Institute of Social Security

OBJETIVO: Evaluar el potencial subregistro de casos de accidentes de trabajo atendidos en el Instituto Mexicano del Seguro Social. MATERIAL Y MÉTODOS: Estudio transversal llevado a cabo en México con información a escala nacional proveniente de 27 Delegaciones del Instituto Mexicano del Seguro Social (IMSS) sobre trabajadores atendidos por probable accidente de trabajo, según declaración del trabajador en su primera atención en los servicios de urgencia de hospitales del IMSS durante el mes de noviembre de 2001, que posteriormente se comparó con los registros de casos reclamados o reconocidos oficialmente como accidentes de trabajo, lo que permitió identificar la proporción de los mismos que no terminaron el proceso de calificación. El análisis de la información se hizo a través de estadística descriptiva para cada variable; la estimación anual de las proporciones encontradas se realizó mediante la multiplicación por 12 meses y los intervalos de confianza se estimaron en 95% con el método exacto de Poisson para una proporción. RESULTADOS: La información de 27 de 37 Delegaciones del IMSS reveló que 7 211 casos no fueron reconocidos como accidentes de trabajo en el periodo de estudio; lo que equivaldría a un subregistro de accidentes de trabajo nacional de 26.3%, con variaciones en las Delegaciones de 0 a 68%. Los diagnósticos más frecuentes fueron contusiones y heridas leves. CONCLUSIONES: El subregistro encontrado puede afectar las prestaciones a trabajadores y el equilibrio financiero del seguro de riesgos de trabajo. Sin embargo, todavía es necesario investigar sus causas y los factores para abatirlo, debiendo participar empresarios, instituciones de trabajo y de salud.

Globalization and the transfer of hazardous industry: asbestos in Mexico, 1979-2000.

This study quantified asbestos use in Mexico in the past decade and evaluated available data on mortality due to malignant mesothelioma in Mexico between 1979 and 2000. Mortality data were analyzed from secondary databases of the Mexican Social Security System and the Ministry of Health. Data on the import and export of asbestos in Mexico were obtained from the Ministry of Trade and Industrial Development of Mexico. Deaths due to pleural mesothelioma significantly increased in this period. Although the import of asbestos declined, the number of Mexican products that contain asbestos tripled. Export of Mexican asbestos-containing products to Central America grew rapidly in the last ten years of the study. Mexico continues the appreciable use of asbestos and has experienced a significant increase in the occurrence of the sentinel asbestos-related disease, malignant mesothelioma. Given the many limitations to the control of hazardous work exposures in Mexico, a ban on asbestos is advocated as the most feasible means of limiting an epidemic of asbestos-related disease.

Factores de riesgo para la astenopía en operadores de terminales de computadoras / Risk factors for asthenopia among video display terminal operators

Objetivo. Establecer si la incidencia de astenopía (fatiga visual) es mayor en operadores de terminales de computadoras que en trabajadores administrativos no expuestos, así como identificar los factores de riesgo asociados. Material y métodos. Se estudió una muestra de 35 operadores de terminales de computadoras y 70 trabajadores administrativos no expuestos, de ocho centros de cómputo de una institución educativa. Se analizaron los siguientes factores: iluminación, contraste, tipo de luz, de pantalla, campo electrostático, distancia de observación, tipo y horas de trabajo, edad, uso de lentes correctivos, antigüedad y trabajo extra. La astenopía se identificó clínicamente por la presencia de por lo menos un signo y un síntoma durante la jornada de trabajo. Se utilizó la prueba chi cuadrada con corrección de Yates para evaluar la diferencia entre grupos, y un modelo de regresión logística para el análisis de los factores de riesgo. Resultados. Se determinó astenopía en el 68.5 por ciento de los operadores a diferencia del 47.7 por ciento de los no expuestos (p< 0.05). De los factores analizados, únicamente el correspondiente a las más de cuatro horas de trabajo continuo frente a la terminal demostró una asociación significativa con la astenopía (p< 0.05). Conclusiones. Se sugiere establecer pausas durante el trabajo con terminales a fin de evitar la fatiga visual. Por otra parte, es recomendable realizar estudios más extensos en la población mexicana para establecer criterios de seguridad y normar el trabajo con terminales de computadoras

Objective. To study the incidence of asthenopia among computer terminal operators as compared to unexposed administrative workers and to identify the risk factors associated with this condition. Material and methods. A sample of 35 computer terminal operators and 70 unexposed administrative workers from eight computing centers at an educational institution were included in the study. The risk factors studied were: lighting, contrast, type of lighting, screen type, electrostatic field, eye to monitor distance, time and number of hours worked, age, use of corrective lenses, seniority and overtime. Asthenopia was clinically identified as the presence of at least one sign and symptom present in a given workday. Results. Asthenopia was found in 68.5% of the exposed group and in 47.7% of the unexposed group (p< 0.05). Among the risk factors studied, working for more than four hours at the video display terminal was shown to have a significant association with asthenopia (p< 0.05). Conclusions. A recommedation is made to take breaks during the workday at computer terminals in order to avoid visual fatigue. Also, more extensive studies should be carried out in our population to establish safety criteria and to standardize work activities using computer terminals.