Dealing with the unknown: perceptions, fears and worries of SARS-CoV-2 infection among hospital workers.

OBJECTIVE: This study explores fears and worries regarding SARS-CoV-2 risk of infection and transmission to relatives, co-workers, and patients in relation to non-pharmacological preventive interventions among healthcare workers (including physicians, nurses, aides, cleaners, maintenance, and security staff) in a healthcare institution in Barcelona (Spain), during the first and second waves of the SARS-CoV-2 pandemic. METHOD: The research used an explorative qualitative approach. Six focus groups and ten individual interviews were conducted online and audio-recorded, transcribed verbatim and analysed using thematic analysis and mixed coding. RESULTS: Forty professionals participated in the study. Four common themes emerged in all groups: challenges related to the lack of pandemic preparedness, concerns about personal protective equipment, unclear guidelines for case and contact tracing, and communication-related difficulties. CONCLUSIONS: This study emphasizes the key recommendations to improve non-pharmacological preventive interventions to reduce workers' fears and worries about the risk of infection and spreading the infection to others, including families. Above all, these should include ensuring the availability, and correct use of adequate personal protective equipment, improve guidelines on case and contact tracing, and setting effective communication channels for all workers of the organization. These recommendations must be reinforced in maintenance and security personnel, as well as night shift nurses and aides, to also reduce health inequalities.

[Economic cost estimation of a sample of occupational disease cases accepted by the National Institute of Social Security and evaluated at Parc de Salut Mar, 2014-2021]. / Estimación económica de una muestra de casos de enfermedad profesional confirmados por el Instituto Nacional de la Seguridad Social atendidos en el Parc de Salut Mar, 2014-2021.

Underreporting of occupational diseases (OD) is a social and economic problem, because it has negative consequences for both the welfare of the affected workers and its impact on budgetary planning for the management of health services. We evaluated the healthcare costs of a sample of 13 cases of OD treated at a public hospital in Barcelona between 2014 and 2021, and officially accepted by the National Institute of Social Security (INSS). The total cost of care was €474,859, with an average cost of €36,528 per patient. By diagnostic group, the highest costs were associated with cancer cases, accounting for 79% of the total (€375,068). The findings of this study reflect the economic impact of health care provided by a public hospital to patients with an OD recognized by the INSS.

La infranotificación de enfermedades profesionales (EEPP) es un problema social y económico, pues repercute en el bienestar del trabajador afectado, y en las estimaciones presupuestarias que se planifican anualmente para la gestión de los servicios sanitarios. Los costes asistenciales fueron evaluados en una muestra de 13 casos de EEPP con resolución positiva por el Instituto Nacional de la Seguridad Social atendidos en el Parc de Salut Mar (Barcelona) entre 2014 y 2021. El coste de la asistencia generada del total de casos fue de 474.859 €, con un coste medio de 36.528 € por paciente. Por grupo diagnóstico, el coste más alto lo originaron los casos de cánceres que supusieron el 79% del gasto total (375.068 €). Los hallazgos del estudio reflejan el impacto económico que supone la asistencia sanitaria prestada por un hospital público a pacientes con una EEPP reconocida en el INSS.

[Precarious employment Measurement in Central America: psychometric properties based on the II Central American Survey of Working Conditions and Health]. / Medida de la precariedad laboral en Centroamérica: propiedades psicométricas en base a la II Encuesta Centroamericana de Condiciones de Trabajo y Salud.

OBJECTIVE: Identify the psychometric properties of a measure of Employment Precariousness (EP) in six Central American Spanish-speaking countries (Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, and Panama) through the items of the EPRES scale (Employment Precariousness Scale) included in the II Central American Survey of Working Conditions and Health (II ECCTS) of 2018. METHODS: The sample was 3,782 salaried persons, aged 18 and older, formal and informal, who participated in the II ECCTS. An EP measure of 10 items was constructed, grouped in the dimensions of temporality, salary, labor rights, and exercise of these rights. RESULTS: The sample was composed mostly of men, with a permanent contract, with a working age of between 2 to 5 years, a salary between $301 and $500s, who have labor rights and who exercise them. The factorial structure could not be verified. However, nine of the ten articles showed a high factorial load with their dimensions. A high acceptability of the EP measure was observed, and the Cronbach's Alpha coefficients of the dimensions were between 0.59 and 0.72, except for temporality (0.30). The reliability of the total scale was 0.68 and the EP patterns in women, youth, temporary and lower income countries were as expected. CONCLUSIONS: The EP measure constructed from the items available from the EPRES scale in the II ECCTS questionnaire shows acceptable psychometric properties to approximate the epidemiological quantification of job insecurity in Central America.

OBJETIVO: Establecer las propiedades psicométricas de una medida de Precariedad Laboral (PL) en seis países centroamericanos de habla española (Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua y Panamá) mediante un conjunto de ítems incluidos en la II Encuesta Centroamericana de Condiciones de Trabajo y Salud (II ECCTS) de 2018 que se correspondían con ítems de la Escala de Precariedad Laboral (EPRES). Método: A partir de una muestra de 3.782 personas asalariadas de 18 años o más, formales e informales, en la II ECCTS, se construyó una medida de PL de 10 ítems representando cuatro dimensiones: temporalidad, salario, derechos y ejercicio de derechos. RESULTADOS: La muestra estuvo compuesta en su mayoría por hombres, con contrato permanente, con antigüedad laboral de entre 2 a 5 años, un salario entre 301 a 500 dólares, que reportaban tener derechos laborales y ejercerlos. La estructura factorial no pudo ser comprobada. Sin embargo, nueve de los diez ítems arrojaron alta carga factorial en sus dimensiones correspondientes. Se observó una alta aceptabilidad de medida de PL y los coeficientes de Alpha de Cronbach de las cuatro dimensiones fueron >0,59 excepto para temporalidad (0,30). La confiabilidad de la escala fue de 0,68 y los patrones de PL en mujeres, jóvenes, temporales y países con menores ingresos fueron los esperados.   Conclusiones: La medida de PL construida a partir de ítems disponibles de la escala EPRES en el cuestionario de la II ECCTS evidencia propiedades psicométricas aceptables para aproximarnos a la cuantificación epidemiológica de la precariedad laboral en Centroamérica.

[Proposal for a summary index of the non-pharmacological preventive measures adopted against SARS-CoV-2 in companies, the case of Parc de Salut Mar (Barcelona).] / Propuesta de un índice que resume las medidas preventivas no farmacológicas adoptadas frente al SARS-CoV-2 en las empresas, el caso del Parc de Salut Mar (Barcelona).

INTRODUCTION: Construct a numerical index of non-pharmacological preventive measures against Sars-CoV-2 based on the experience of Parc de Salut Mar (PSMar), a healthcare institution in Barcelona. METHOD: The construction of the index was carried out in three phases. The identification and selection of the variables to be included based on semi-structured interviews with key informants and documental revision. The definition of the dimensions (consisting of one or more variables) and, finally, the operationalisation of the index on the basis of these dimensions. The index was estimated in the PSMar, and in its two main centres, the Hospital del Mar and the Hospital de la Esperanza. RESULTS: Twenty-one variables were identified and categorised into six dimensions: personal protective equipment, individual organisational measures, collective organisational measures, epidemiological surveillance measures, training activities and protocol development. During the first wave, the Hospital del Mar index remained above the value obtained at the Hospital de la Esperanza, while in the second wave both indexes showed similar values until week 36, when the Hospital del Mar index began to show higher values. These oscillations were mainly due to the dimensions of personal protective equipment and training activities. CONCLUSIONS: The proposed index shows the difficulties in implementing the various non-pharmacological preventive measures in the first weeks of the pandemic. This tool can be useful for evaluating the activities carried out by the Occupational Risk Prevention Services in the face of the pandemic, with the appropriate adaptations to the reality of each individual company.

Introducción: Construir un índice numérico con las medidas preventivas no farmacológicas frente a Sars-CoV-2 a partir de la experiencia del Parc de Salut Mar (PSMar), una institución sanitaria en Barcelona. Método: La construcción del índice se ha realizado en tres fases. La identificación y selección de las variables incluidas a partir de entrevistas semiestructuradas a informantes clave y la revisión documental. La definición de las dimensiones (con una o más variables) y la operacionalización del índice (a partir de las dimensiones). Se ha estimado el índice en el PSMar, y en sus dos principales centros, el Hospital del Mar y el Hospital de la Esperanza. Resultados: Se identificaron 21 variables, clasificadas en 6 dimensiones: equipos de protección individual, medidas organizativas individuales, medidas organizativas colectivas, medidas de vigilancia epidemiológica, actividades formativas, y elaboración de protocolos. Durante la primera ola, el índice en el Hospital del Mar se mantuvo por encima del valor obtenido en el Hospital de la Esperanza; en la segunda ola ambos índices presentaron valores similares hasta la semana 36, cuando el hospital del Mar comenzó a presentar valores superiores. Estas oscilaciones se debieron principalmente a los equipos de protección individual y actividades formativas. Conclusiones: El índice propuesto muestra las dificultades para aplicar las medidas preventivas no farmacológicas en las primeras semanas de la pandemia. Esta herramienta puede ser útil para evaluar las actividades desarrolladas frente a la pandemia por parte de los Servicios de Prevención de Riesgos Laborales, con las oportunas adaptaciones a la realidad de cada empresa.

Informal Employment, Working Conditions, and Self-Perceived Health in 3098 Peruvian Urban Workers.

Peru has one of the highest informal employment rates in Latin America (73%). Previous studies have shown a higher prevalence of poor self-perceived health (P-SPH) in informal than in formal workers. The aim of this study was to analyze the role of working conditions in the association between informality and SPH in an urban working population in Peru. We conducted a cross-sectional study based on 3098 workers participating in the working conditions survey of Peru 2017. The prevalence of P-SPH and exposure to poor working conditions were calculated separately for formal and informal employment and were stratified by sex. Poisson regression models were used to assess the association between P-SPH and informal employment, with crude and adjusted prevalence ratios (PR) for working conditions. Informal employment affected 76% of women and 66% of men. Informal workers reported higher exposition to poor working conditions than formal workers and reported worse SPH. Informal workers had a higher risk of P-SPH than formal workers: PR 1.38 [95% CI: 1.16-1.64] in women and PR 1.27 [95% CI: 1.08-1.49] in men. Adjustment by working conditions weakened the association in both sexes. In women, this association was only partially explained by worse working conditions; PR 1.23 [95% CI: 1.04-1.46]. Although some of the negative effect of informal employment on workers´ health can be explained by the characteristics of informality per se, such as poverty, a substantial part of this effect can be explained by poor working conditions.

[Presentation of the UNIA FORUM on Workplace Safety and Health "Telework, reality and regulation: from protection to the health of workers". La Rábida, Huelva (Spain), November 2021]. / Presentación del FORO UNIA de Seguridad y Salud en el Trabajo "Teletrabajo, realidad y regulación: de la protección a la salud de las personas trabajadoras". La Rábida, Huelva (España), noviembre 2021.

La protección de la salud de las personas trabajadoras es una exigencia básica en el desarrollo de las relaciones sociales, políticas y comerciales presentes y futuras entre la Unión Europea y los países de Latinoamérica y el Caribe, entre otras regiones del mundo. La armonización del marco normativo y su aplicación real es un objetivo compartido por todas las partes. Dicho objetivo está alineado con los Objetivos de Desarrollo Sostenible de la Agenda 2030, en concreto el número 8, relacionado con el trabajo decente y productivo. Con estos planteamientos como premisa principal, el Vicerrectorado de Calidad, Igualdad y Responsabilidad Social y la Sede Santa María de la Rábida de la Universidad Internacional de Andalucía (UNIA), han promovido un Foro Iberoamericano que ha servido para poner sobre la mesa temas de actualidad en materia de salud laboral y prevención de riesgos laborales, debatidos en profundidad con expertos en la materia y agentes sociales y económicos de toda Iberoamérica. De esta forma, se han extraído conclusiones operativas que pueden ser de utilidad para los decisores de políticas públicas de nuestros países.….

Identificación y reconocimiento de enfermedades profesionales en siete hospitales públicos de España / Identification and recognition of occupational diseases in seven public hospitals in Spain

Antecedentes: La infra-notificación y reconocimiento de enfermedad profesional (EP) es un problema secular en España y demás países europeos. El proyecto de Carga de la Enfermedad Profesional en España (CEPS) pretende contribuir a resolver este problema. Objetivo: Describir el proceso de identificación y reconocimiento de EP en siete hospitales españoles entre 2017 y 2019. Material y Métodos: En los siete hospitales que participan en el estudio se creó una unidad de patología laboral (UPL) la cual estimulaba en los servicios asistenciales la identificación de posibles EP atendidas en el hospital. Los pacientes confirmados por la UPL fueron acompañados en el proceso de reconocimiento. Resultados: En este periodo fueron derivados 308 casos, y en 154 (62%) se confirmó la sospecha EP. De éstos, 78 (65%) han sido reconocidos. La tasa de confirmación (casos confirmados/ derivados) varió según hospitales (de un 25% en el Badalona Serveis Assistencials a un 100% en el Hospital Universitario Fundación Jiménez Díaz) y grupos de diagnósticos (de un 13% para trastornos musculoesqueléticos a un 100% para patologías varias). La tasa de reconocimiento (casos confirmados/casos reconocidos) varió según centro, diagnóstico, sexo y edad, siendo más alta en mujeres, con ≥ 55 años y diagnosticados con patologías varias (oculares, infecciosas, mentales, entre otras). Conclusión: Las UPL contribuyen significativamente en el proceso de identificación y reconocimiento de EP, lo que los pacientes posiblemente no hubieran obtenido de otra forma (AU)

Background: Under-reporting and recognition of occupational disease (OD) is a secular problem in Spain and other European countries. The burden of occupational disease in Spain project (CEPS) aims to contribute. Objective: To describe the process of identification and recognition of OD in seven Spanish between 2017 and 2020. Material and Methods: In the seven hospitals that participate in the study an occupational pathology unit (OPU) was created. The OPU encouraged the healthcare services to identify possible OD treated in the hospital. The patients confirmed by the OPU were accompanied in the recognition process. Results: 308 cases were referred in this period and 154 OD was confirmed (62%). Of these, 78 have been recognized (65%). The confirmation rate (confirmed/ referred cases) varied according to hospitals (from 25% at the Badalona Serveis Assistencials to 100% at the Hospital Universitario Fundación Jiménez Díaz) and diagnosis groups (from 13% for musculoskeletal disorders to 100% for various pathologies). The recognition rate (confirmed/ recognized cases) varied according to hospitals, diagnosis, sex and age, being higher in women, aged ≥ 55 years and diagnosed with various pathologies (ocular, infectious, mental, among others). Conclusion: OPU contribute significantly in the process of identification and recognition of OD, which the patients might not have obtained otherwise (AU)

Do birthrates contribute to sickness absence differences in women? A cohort study in Catalonia, Spain, 2012-2014.

AIMS: This study explores the differences in sickness absence trends in women according to reproductive age group and medical diagnoses. METHODS: Data were obtained from two administrative registries: the Continuous Working Life Sample and the Catalonian Institute of Medical Evaluations from 2012 to 2014, containing 47,879 female employees. Incidence rates and incidence risk ratios derived from Poisson and negative binomial models were calculated to compare sickness absence trends among reproductive age groups based on Catalonian birthrates: early-reproductive (25-34 years old), middle-reproductive (35-44) and late-reproductive (45-54), according to diagnostic groups, selected diseases, type of contract, occupational category, and country of origin. RESULTS: Younger women show a higher incidence of overall sickness absence compared to late-reproductive-aged women. Incidence risk ratios of sickness absence decreased significantly from early-reproductive to late-reproductive age for low back pain, hemorrhage in early pregnancy, nausea and vomiting, and abdominal and pelvic pain. DISCUSSION: The higher incidence of sickness absence due to pregnancy-related health conditions in early-reproductive women compared to other reproductive age groups, may explain the sickness absence differences by age in women. Proper management of sickness absence related to pregnancy should be a goal to reduce the sickness absence gap between younger and older women.

[Outbreak study of workers with irritative symptomswoking in the microbiology and clinical analysis laboratories of a tertiary public hospital]. / Estudio epidemiológico de un brote de casos con síntomas irritativos en trabajadores del laboratorio de microbiología y análisis clínicos en un hospital público de tercer nivel.

BACKGROUND: In April 2018, an unusually high number of eye, throat and nose irritative symptoms, nonspecific gastrointestinal symptoms and dizziness were identified in workers in the microbiology (LAM) and clinical analysis (LCA) laboratories of a tertiary public hospital in Mallorca; these symptoms were also associated with perception of unusual odors. OBJECTIVE: To confirm the presence of an outbreak, identify its causes, and contribute to itsprevention and control. METHODS: Epidemiological study of the outbreak involving qualitative and quantitative methods. The qualitative component was based on conducting focus groups The quantitative study allowed us to develop epidemic curves, based on employee visits to the hospital'soccupational health service (OHS) due to either symptoms or episodes of sickness absence (SA). Lastly, available industrial hygiene reports were reviewed to examine possible relationships with the distribution of cases. RESULTS: Two operational case definitions were established through the focus groups, along with identification of possible explanations for the outbreak based on employee perception.The quantitative study confirmed the outbreak in the LAM, but not in the LCA. The SA episodes in the LAM between weeks 16 and 39 exceeded the number of expected cases fourfold. We also detected an excess of visits to the OHS during the same time period. CONCLUSIONS: The quantitative study confirmed an epidemic outbreak that has since ended, although the qualitative study indicated the persistence of bad smell and discomfort. The improvement of epidemiological surveillance systems as a result of the study will facilitate the monitoring and control of future possible outbreaks.

ANTECEDENTES: En abril de 2018 se detectó un número inusualmente elevado de síntomas irritativos, digestivos y mareos en trabajadores de los laboratorios de microbiología (LAM) y análisis clínicos (LAC) de un hospital de tercer nivel de Mallorca, asociados a olores también inhabituales. OBJETIVO: Confirmar la existencia del brote, identificar sus causas, y contribuir a su control y prevención. MÉTODOS: Estudio epidemiológico del brote con componentes cualitativo y cuantitativo. El primero se basó en la técnica de Grupos Focales (GF). El estudio cuantitativo permitió elaborar las curvas epidémicas, en base a las visitas de los trabajadores al Servicio de Salud Laboral (SSL) y los episodios de incapacidad temporal (IT). Finalmente, se revisaron los informes higiénicos disponibles, valorando las posibles relaciones con la distribución de los casos. RESULTADOS: Mediante los GF se establecieron dos definiciones operativas de caso y se identificación las posibles explicaciones del brote según las percepciones de los trabajadores. El estudio cuantitativo confirmó la existencia de un brote en el LAM, descartándolo en el LAC. Los episodios de IT en el LAM entre las semanas 16 y 39 excedieron en cuatro veces el número de casos esperados. El número de visitas al SSL también mostró un exceso de casos en las mismas semanas. CONCLUSIONES: El estudio cuantitativo confirma la existencia de un brote epidémico que ha finalizado, si bien el estudio cualitativo pone de manifiesto la continuación de los malos olores y molestias. La mejora de los sistemas de vigilancia epidemiológica facilitará la monitorización y control de otros posibles brotes en el futuro.

[Work-Related Fatal Traffic Injuries in Spain According to Travelling Reasons and Sex(2010-2013)]. / Lesiones mortales de tráfico en España relacionadas con el trabajo según el motivo del desplazamiento y según sexo (2010-2013).

OBJECTIVE: Most studies about work-related traffic injuries in Spain are based in labor administration information. The aim of this study was to carry out a description of fatal work-related traffic injuries in Spain according to travelling reason between 2010 and 2013, based on the Transport Authority database. METHODS: Descriptive study of fatal work-related traffic injuries that drivers between 16 and 70 years old suffered, whose reason for travelling was recorded as labour, occurred during working or commuting hours, between 2010 and 2013. In order to assess statistically significant differences according to the reason for travelling (during working and commuting hours) in the distributions of the variables included, and separately for men and women, appropriate statistical tests were calculated for each variable. In particular, socio-demographic, driver-related, travelling conditions, and contributing factors at the time of the accident variables were taken into account. RESULTS: The total number of fatal work-related traffic injuries was 847, a 88.3% in men and 53,1% during working hours. Fatal work-related traffic injuries among men were significantly more frequent during working hours when the driver was a professional (74.7%), with an industrial vehicle or van (67.7%), and in routes longer than 50 kilometres (60.5%). Among women, fatal collisions occurred during commuting hours while driving their own car (98.7%), with a private car or motorcycle (98.7%) and in routes lower than 50 kilometres (79.6%). CONCLUSIONS: These results show a different pattern of fatal work-related traffic injuries according to reason for travelling, during working or commuting hours, between men and women. This should be deeply studied to direct road and occupational policies more precisely.

La mayoría de los estudios sobre las lesiones de tráfico relacionadas con el trabajo (LTT) en España se basan en información de la administración laboral. El objetivo de este estudio fue realizar una descripción de las LTT mortales en España según el motivo de desplazamiento entre 2010 y 2013.

[Incidence of non-work-related sickness absence in Spain by economic activity of the company]. / Incidencia de la incapacidad temporal por contingencia común en España según la actividad económica de la empresa.

INTRODUCTION: The management of sickness absence due to non-work-related diseases in Spain has typically focused on the control of its duration. The goal of this study was to provide estimates for the incidence of sickness absence due to nonwork-related diseases by economic activity to help shift the focus of management of sickness absence towards prevention. METHODS: Retrospective study based on 646,337 workers and 133,812 episodes of sickness absence started in 2009, from the Working Continuous Life Sample. Incidence rate and its 95% confidence interval (CI) were calculated using Poisson regression models, crude and adjusted for age, company size, and occupational category, separately for men and women. RESULTS: The overall incidence rate was 29.8 per 100 person-years; 24.7 (95%CI: 24.5-24.9) in men and 36.3 (36.0- 36.5) in women. By economic activity, the highest crude incidence rates in men were found in "Water supply, sanitation and wastes" (35.4) and "Health activities" (33.9); for women, "Health activities" (48.3), "Public administration" (41.2) and "Transportation and storage" (41.0) were the highest sectors. CONCLUSIONS: Companies can compare their sickness absence incidence rates to these benchmark values to determine if they are within the expected reference range, which may guide management decisions more towards the prevention of sickness absence.

OBJETIVO: La gestión de la incapacidad temporal por contingencias comunes (ITcc) en España se centra más en el control de su duración que en prevenir su incidencia. El objetivo de este trabajo es proporcionar valores de la incidencia de ITcc por ramas de actividad económica para orientar su gestión hacia la prevención. MÉTODOS: Estudio retrospectivo basado en 646.337 afiliados al régimen general incluidos en la Muestra Continua de Vidas Laborales de 2009, que notifican 133.812 primeros episodios de ITcc iniciados en 2009. La tasa de incidencia, y su IC95%, se calculó con modelos de regresión de Poisson, cruda y ajustada por edad, tamaño de la empresa y categoría ocupacional, separadamente para hombres y mujeres. RESULTADOS: La tasa de incidencia total por 100 personas-años fue de 29,8 (hombres: 24,7; IC95%:24,5-24,9 y mujeres: 36,3; IC95%: 36,0-36,5). Según ramas de actividad económica, las tasas de incidencia crudas más elevadas en los hombres fueron "Suministro de agua, saneamiento y residuos" (35,4) y "Actividades sanitarias" (33,9), y en las mujeres en "Actividades sanitarias" (48,3), "Administración pública" (41,2) y "Transporte y almacenamiento" (41,0). CONCLUSIONES: Las empresas podrán comparar su incidencia de ITcc con estos valores de referencia para determinar si su incidencia está dentro del rango de valores esperados, lo que puede ayudarles a tomar decisiones orientadas a la prevención de las bajas por enfermedad común.

[Participation to improve working conditions: evidence and experience]. / Participación para mejorar las condiciones de trabajo: evidencias y experiencias.

Participation of stakeholders is a key requirement for the success of public health programmes. Working and employment conditions are major determinants for people's health and wellbeing, and workplaces are ideal environments to implement programmes with a very direct level of participation. In Spain, the main regulatory framework for occupational health and safety, Law 31/1995, establishes the principles of "efficiency, coordination and participation" as a necessary basis for workers' health protection. This same Law establishes the role of the health and safety workers' representative, responsible for occupational risk prevention, and the occupational health and safety committee, a body with equal representation and the same objectives at the heart of the company. Among recent experiences of participation in occupational health, participatory ergonomics programmes have stood out. The aim of these programmes is to improve working conditions with a view to reducing musculoskeletal disorders, which is a very common and highly prevalent work-related injury in Spain. This study describes the characteristics and results of some experiences of participatory ergonomics carried out recently in Spain, from which relevant learning can be extrapolated about processes, facilitators and barriers in order to extend such programmes to other areas of occupational and public health.

[Public health competencies and contents in Spanish university degree programs of physical therapy, occupational therapy, environmental science, dentistry and veterinary science]. / Competencias y contenidos comunes de salud pública en los programas universitarios de grado: fisioterapia, terapia ocupacional, ciencias ambientales, odontología y veterinaria.

OBJECTIVE: To identify the basic competencies and contents related to public health to be included in degree programs according to the perspective of lecturers from various Spanish universities. METHOD: In the context of the Second Workshop on Public Health Contents in Degree Programs (Mahon, 19 to 20 September 2012), 20 lecturers from different Spanish universities were distributed in five working groups. The lecturers had been selected from the instructional guides on public health and epidemiology published on the web sites of the Rectors' Conference of Spanish Universities. Each group worked on a degree program and the results were discussed in plenary sessions. RESULTS: The activities and competencies related to the three basic functions of public health were identified in all degree programs. Most of the professional competencies identified were related to the function of «assessment of population health needs¼. The contents proposed by the working groups related to epidemiology, basic concepts in public health, public health intervention, health management, and health policy. The main common topics among the degrees concerned the first three contents. CONCLUSIONS: Public health professional competencies and contents were identified in the degree programs examined. These results may serve as a starting point for a more detailed review of public health programs across degree levels and the search for a consensus on the common content that should be included in each of them.

[Distribution of the duration of nonoccupational sick leave by medical diagnosis (Catalonia, Spain, 2006-2008)]. / Distribución de la duración de la incapacidad temporal por contingencia común por diagnóstico médico (Cataluña, 2006-2008).

We present a simple and practical tool that allows the usual distribution of the duration of non-occupational sick leave to be determined by medical diagnosis. A total of 2,646,352 episodes of medically certified sick leave, registered by the Catalan Institute of Medical Evaluations for the period 2006-2008, were followed to closure and were entered into a spreadsheet. Given its asymmetric distribution, the median duration of sick leave was 9 days. Musculoskeletal disorders were the most frequent diagnostic group (22.5%), while neoplasms had the longest median duration (56 days). The most common specific diagnoses were diarrhea-gastroenteritis (8.2%; median: 3 days) and acute rhinopharyngitis (5.2%; median: 4 days). The distribution of the duration of sick leave in a population varies by diagnosis and is asymmetric, with most episodes being much shorter than the mean duration. This finding is important for better clinical and administrative management of sick leave episodes.

[Scientific evidence and legal liability in occupational health: indemnity claim based on lack of safety and hygiene controls after a worker's death due to mesothelioma]. / Evidencia científica y responsabilidad legal en salud laboral: recargo de prestaciones por falta de medidas de seguridad e higiene tras la muerte por mesotelioma de un trabajador.

The aim of this paper is to reflect, under the precautionary principle, on the relationship between scientific causation and legal liability in connection with a lawsuit regarding compensation for lack of occupational safety and hygiene controls following the death of a worker with mesothelioma that had been previously accepted as an occupational disease. The worker had spent 28 years as a shipyard welder, with a diagnosis of occupationally-related mesothelioma in 2007, and who died in 2009. After reviewing the advances in a) scientific knowledge on the health effects of asbestos exposure, which were consolidated between 1955 and 1976, and b) the development of a regulatory framework for the protection of workers in Spain that began generically in 1940 and became more specific in 1982, we conclude that our case probably would have benefited from application of the precautionary principle, which is now widely accepted.

El objetivo es reflexionar, bajo el principio de precaución, sobre la relación entre causalidad científica y responsabilidad legal, a propósito de una demanda en materia de recargo de prestación por falta de medidas de seguridad e higiene tras la muerte de un trabajador por mesotelioma, reconocida previamente como enfermedad profesional. Se trata de un trabajador que tras 28 años como soldador en unos astilleros, se le reconoció en 2007 un mesotelioma como enfermedad profesional, falleciendo en 2009. Después de valorar que a) el conocimiento científico de la relación de la exposición a amianto y el mesotelioma se consolida entre 1955 y 1976, y b) que la normativa legal para la protección de los trabajadores en España se inicia en 1940 con carácter genérico y en 1982 de manera específica, concluimos que nuestro caso posiblemente se hubiera beneficiado si el principio de precaución, que ahora está ampliamente aceptado, se hubiera aplicado.