Evaluación de dos guías de valoración de riesgos laborales en el embarazo / Assessment of two guideliness for occupatinal risks in pregnacy

Objetivos: El reconocimiento en España de la prestación derivada de contingencia profesional por exposición a riesgoslaborales en el embarazo originó que diversas instituciones elaboraran guías para orientar la actuación de los profesionales.El objetivo de este trabajo es evaluar la calidad de los métodos utilizados en la elaboración de las guías de la Asociación deMutuas de Accidentes de Trabajo (AMAT) y de la Sociedad Española de Ginecología y Obstetricia (SEGO), así como elcontenido de sus recomendaciones.Métodos: Estrategia de consenso formal en dos fases: valoración individual y reunión presencial. Para evaluar la calidadse utilizó el instrumento AGREE II estructurado en seis áreas generales (alcance y objetivos, rigor, participación, claridad,aplicabilidad e independencia). Se calcularon las puntuaciones estandarizadas por áreas (% sobre la máxima puntuaciónposible en cada área) y las medianas de respuesta por ítem. También se analizó la concordancia en las respuestas de los cincoevaluadores. Se evaluaron las similitudes y diferencias en las recomendaciones de ambas guías y la adecuación de las recomendacionesatendiendo a la experiencia profesional de cada evaluador y a la documentación científica disponible.Resultados: Las dos guías obtuvieron una evaluación global similar de calidad (<50%). La aplicabilidad fue el área peorevaluada en ambas guías (7%). El porcentaje de acuerdo general entre evaluadores fue superior al 75%. Los evaluadores semostraron más heterogéneos en la valoración de la adecuación de las recomendaciones presentes en las guías.Conclusiones: Ambas guías deberían ser modificadas, especialmente para mejorar su calidad general y las recomendacionesincluidas(AU)

Objectives: As a consequence of new legislation in Spain establishing particular conditions for the control of occupationalexposures during pregnancy, different Spanish associations have developed guides for professional practice. This paper evaluates the methodological quality and content of the guidelines of the Asociación de Mutuas de Accidentes de Trabajo(AMAT), an association of occupational health insurance companies, and the Sociedad Española de Ginecología y Obstetricia(SEGO), the Spanish professional society of obstetrics and gynecology.Methods: Formal consensus strategy in two phases: individual assessment and face-to-face meeting. To assess the quality,the AGREE II instrument was used, divided into six general areas (goals and objectives, rigor, participation, clarity,applicability, and independence). Standardized scores were calculated by area (as a percent of maximum score in each area),together with the medians of response to each item. Concordance among the five reviewers was also analyzed. Similaritiesand differences were also assessed, as was the adequacy of the recommendations in both guides according to the reviewers’own experience and the available scientific literature.Results: Both guides obtained similar overall quality scores (<50%). Applicability showed the lowest scores in bothguides (7%). The percentage of agreement between raters was greater than 75%. The experts showed greater heterogeneityregarding the adequacy of the recommendations in the guidelines.Conclusions: Both guides should be modified, mostly to improve their overall quality and recommendations(AU)

[Health Surveillance Guide of workers using video display terminals: evaluation from a visual health perspective]. / Protocolo de vigilancia sanitaria de trabajadores con pantallas de visualización de datos: una valoración desde la perspectiva de la salud visual.

BACKGROUND: Visual health surveillance is essential in the protection of workers who use video display terminals (VDT). In Spain, the most used is the Specific Health Surveillance Guide published in 1999 by the Ministry of Health. The increase of the scientific production upon computer related occupational visual hazards and the experience in its applicability during the last decade justify the aim of this work: reviewing the quality of the guide from the point of view of visual health. METHODS: A consensus strategy was used among nine experts by means of a mixed groupal technique in two consecutive stages combining some aspects of the Delphi method and of the nominal group: individual evaluation of the guide using the consensus guide made by the authors based on the AGREE instrument and the subsequent meeting in order to reach an agreement and to fix the final recommendations for improving it. For the analysis the standardized score of the review domains was calculated: scope and purpose, stakeholder involvement, rigour of development, clarity and presentation and applicability. It was also calculated for the items.' Concordance in the answers of the experts was also analyzed. RESULTS: All domains obtained scores under 50%. The applicability, rigour and stakeholder involvement during the development of the guide, where the most deficient domains. Six out of the nine experts would not recommend the guide and think it should be remade. CONCLUSIONS: The guide does not reach the necessary quality for the surveillance of the visual health of the workers who use VDT. Efforts must be focussed to improve the guide.