Ergonomics, musculoskeletal disorders, treatment and return to work: a conceptual framework for intervention programs / Ergonomía, Trastornos Musculoesqueléticos, Tratamiento y Retorno al Trabajo – Marco Conceptual para programas de intervención

Musculoskeletal disorders are one of the most recurrent diseases among manual workers worldwide. The objective of this study was to analyze primary results of a systematic review on ergonomics, musculoskeletal disorders, treatment, and return to work in blue-collar work-ers to form a new conceptual framework applicable to intervention programs in this area. This study was based on the available scientific evidence we identified. Descriptive data and their trending topics areas were used to form the conceptual framework. The trend shows that working conditions can be represented as a three-axis scheme with a multidimensional conceptual framework considering ergonomic risks, the treatment of affected workers and the determinants related to working conditions. These results may help future research in the field of ergonomics as well as emerging topics focused on intervention programs.(AU)

Los trastornos musculoesqueléticos son una de las enfermedades más recurrentes entre los trabajadores que realizan operaciones manuales a nivel mundial. El objetivo de este estudio fue analizar los resultados primarios de una revisión sistemática sobre ergonomía, trastornos musculoesqueléticos, tratamiento y retorno al trabajo en trabajadores operativos para formar un nuevo marco conceptual aplicable a los programas de intervención en esta área. Este estudio se basó en la evidencia científica disponible identificada. Se utilizaron datos descriptivos y sus áreas de temas de tendencia para formar el marco conceptual. La tendencia muestra que las condiciones de trabajo pueden representarse como un esquema de tres ejes con un marco conceptual multidimensional que considera los riesgos ergonómicos, el tratamiento de los trabajadores afectados y los determinantes relacionados con las condiciones de trabajo. Estos resultados podrían ayudar a futuras investigaciones en el campo de la ergonomía, así como a temas emergentes centrados en programas de intervención.(AU)

Ergonomics, musculoskeletal disorders, treatment and return to work: a conceptual framework for intervention programs.

Musculoskeletal disorders are one of the most recurrent diseases among manual workers worldwide. The objective of this study was to analyze primary results of a systematic review on ergonomics, musculoskeletal disorders, treatment, and return to work in blue-collar workers to form a new conceptual framework applicable to intervention programs in this area. This study was based on the available scientific evidence we identified. Descriptive data and their trending topics areas were used to form the conceptual framework. The trend shows that working conditions can be represented as a three-axis scheme with a multidimensional conceptual framework considering ergonomic risks, the treatment of affected workers and the determinants related to working conditions. These results may help future research in the field of ergonomics as well as emerging topics focused on intervention programs.

Los trastornos musculoesqueléticos son una de las enfermedades más recurrentes entre los trabajadores que realizan operaciones manuales a nivel mundial. El objetivo de este estudio fue analizar los resultados primarios de una revisión sistemática sobre ergonomía, trastornos musculoesqueléticos, tratamiento y retorno al trabajo en trabajadores operativos para formar un nuevo marco conceptual aplicable a los programas de intervención en esta área. Este estudio se basó en la evidencia científica disponible identificada. Se utilizaron datos descriptivos y sus áreas de temas de tendencia para formar el marco conceptual. La tendencia muestra que las condiciones de trabajo pueden representarse como un esquema de tres ejes con un marco conceptual multidimensional que considera los riesgos ergonómicos, el tratamiento de los trabajadores afectados y los determinantes relacionados con las condiciones de trabajo. Estos resultados podrían ayudar a futuras investigaciones en el campo de la ergonomía, así como a temas emergentes centrados en programas de intervención.

Leaving no-one behind in the workplace health promotion: towards regulatory equity in the Ecuadorian micro-enterprises.

The purpose of workplace public health programmes and regulations is to promote safety and health for the entire working population nationwide. Some countries limit the scope of such programmes to medium or big-sized companies, leaving out small and micro-enterprises, thus discriminating against many workers exposed to risks. This Viewpoint aims to identify inequalities in occupational health generated by the new Regulation for Workplace Health Promotion (WHP) in Ecuador. We showed how the regulation excludes all micro-enterprises and displayed the essential role of micro-enterprises in the business fabric and the Ecuadorian labour market. More than 93% of the registered companies are micro-enterprises and these include more than 25% of the employees in the formal economy. Integrating occupational health into the public health system will require deep analysis to improve protection for the working population.

Mapping the conceptual structure of ergonomics, musculoskeletal disorders, treatment and return to work in manual jobs: A systematic review.

BACKGROUND: Musculoskeletal disorders constitute one of the major health problems of workers exposed to manual work throughout the world. Nevertheless, there is no study that maps its conceptual structure based on a systematic methodology. OBJECTIVE: To identify the conceptual structure of ergonomics, MSDs, treatment and return to work in manual jobs in the last 12 years by applying a systematic co-word network analysis methodology which describes the replicability of the search filters and emphasizes the rigor that has to be followed in the creation of the network. METHODS: The search filter was customized for each bibliographic database, and followed the PRISMA 2020 flowchart for the screening process. For the creation of the network, the titles, abstracts, and keywords were used as the unit of analysis extracting the noun phrases of the first two units. In the normalization process, the terms of the search filter were deleted and their associated terms, and standardized the similar terms. Regarding the plotting of the network, Vosviewer was used applying the network settings based on content analysis. RESULTS: The co-word network shows three communities: Ergonomic assessment and workplace intervention tools, factors related to rehabilitation and return to work, and physical and mental overload management. For each community, there is a framework that explains the relationship within terms. CONCLUSION: This study is aligned with the replicability, robustness, and relevance recommendations in the implementation of rigorous scientometric studies. The occupational health community is encouraged to implement scientometric studies following a rigorous methodology and working in interdisciplinary team.

Fatal work accidents in Ecuador from 2014 to 2020: How the age of the deceased worker relates to the accidents' temporal and geographical characteristics.

This article analyzes the relationship between the age of male workers deceased in work accidents and temporal (year, month, day of the week, working shifts), geographic (provinces), and economic sector characteristics in which the accidents occurred in Ecuador between 2014 and 2020. Available data on fatal accidents from the Ecuadorian Social Security Institute (IESS) were collected. The results, which report both frequencies and proportions (rates), indicate that fatal accidents have decreased in the period, although the average age of deceased workers has increased. No significant differences were found regarding the month, day of the week, and work shift, nor in the frequency of accidents or the age of the deceased workers. However, differences were found in terms of geographical areas and sectors of economic activity. This study contributes to the literature as it is the first to analyze the temporal and geographical characteristics of fatal accidents about the age of the deceased worker.

Jornadas laborales prolongadas y lesiones por accidentes de trabajo: estimaciones de la Primera Encuesta sobre Condiciones de Seguridad y Salud en el Trabajo en Ecuador / Long working hours and occupational injuries: estimates from the First Survey on Safety and Health Conditions at Work in Ecuador

Objetivo: estimar la relación entre las jornadas de trabajo por semana y las lesiones por accidente de trabajo (LAT) en la población asalariada de la ciudad ecuatoriana de Guayaquil. Métodos: estudio transversal que empleó datos de la Primera Encuesta de Condiciones de Seguridad y Salud en el Trabajo para el Ecuador en 2017. Los encuestados fueron 1 005 trabajadores asalariados y se dividieron en dos grupos según las horas de trabajo semanales, ?43 y ?44 horas. La relación entre las jornadas laborales prolongadas y LAT por sexo se analizó mediante regresión logística (OR; IC95%) ajustado por características sociodemográficas (Modelo 1) y añadiendo las ocupacionales (Modelo 2). Resultados: El 30,9% de los trabajadores declaró trabajar 44 horas o más a la semana (50,7±6,3 horas) y la frecuencia de LAT en este grupo fue superior en los hombres (24,2%) respecto a las mujeres (12%). Las LAT en jornadas laborales prolongadas aumentaron con la edad en los hombres. Además, la probabilidad de sufrir una LAT fue mayor entre los hombres en comparación con la jornada de trabajo estándar, también para los ajustes del Modelo 1 y del Modelo 2. Conclusiones: Las jornadas laborales prolongadas están asociadas con las LAT en los hombres. En el caso de las mujeres no se observó una asociación estadísticamente significativa. La implementación de medidas preventivas que tomen en cuenta la duración de las jornadas de trabajo en las empresas podría resultar en una reducción de las LAT (AU)

Objective: to estimate the association between weekly working hours and occupational injuries (OI) among the salaried population in Guayaquil, Ecuador. Methods: a cross-sectional study that used data from the First Survey on Safety and Health Conditions at Work in Ecuador in 2017. The respondents were 1005 salaried workers, divid-ed into two groups according to weekly working hours, ≤43 and ≥44 hours. The relationship between long working hours and OI by gender was analyzed by using logistic regression (OR; CI 95%) adjusted for sociodemographic characteristics (Model 1) and also for occupa-tional characteristics (Model 2). Results: 30.9% of the workers declared ≥44 weekly working hours (50.7±6.3 hours) and the OI percentages in this group were higher in men (24.2%) compared to women (12%). OI among those working long hours increased with age in men. In addition, the odds of sustaining an OI were higher among men working long hours as compared to the stan-dard working day (OR = 3.08; 95% CI: 1.87–5.07), for Model 1 settings (OR = 2, 98; 95% CI: 1.79–4.95) and Model 2 (OR = 3.05; 95% CI: 1.82–5.11). Conclusions: Long working hours are associated with OI in men. In the case of women, despite the fact that the frequency of OI was higher in those exposed to long working hours compared to those exposed to standard working hours, no statistically significant associ-ations were observed. Implementation of preventive measures that consider the length of working hours in companies could result in the reduction of OI. (AU)

Letalidad por desplazamientos domicilio-trabajo-domicilio en el Ecuador, 2014-2019 y 2020 / Home-workplace-home commuting lethality in Ecuador, 2014-2019 and 2020

Objetivo: Evidenciar las diferencias de letalidad según lugar de ocurrencia (desplazamientos = in itínere y en jornada laboral) en el periodo entre 2014 a 2019 y 2020 en el Ecuador. Material y Métodos: Análisis de 104.396 casos (1,2% mortales) utilizando registros oficiales. Se estimaron Tasas de Letalidad (TL) y Razón de Tasas de Letalidad (RTL) por lugar de ocurrencia y separadas por sexo. Resultados: Las TL y RTL mostraron descensos importantes. Sin embargo, las probabilidades de fallecimiento in itínere fueron mayores en comparación a los accidentes mortales ocurridos en jornada laboral, de forma global [1,51 (IC95% = 1,13-2,04); p = 0,006], en hombres, [1,58 (IC95% = 1,38-1,82); p = 0,000] y, en específico, en mujeres, [5,93 (IC95% = 1,86-16,34); p = 0,001]. Conclusiones: Se deberían realizar estudios epidemiológicos específicos y prestar mayor interés a este problema de seguridad vial laboral en el diseño de estrategias de salud pública y laboral. (AU)

Objective: To demonstrate the differences in fatality rates by place of occurrence (commuting = in itínere and during working hours) in the period from 2014 to 2019 and 2020 in Ecuador. Material and Methods: Analysis of 104,396 cases (1.2% fatal) using official records. Lethality Rates (LR) and Lethality Rate Ratio (LRR) were estimated by place of occurrence and separated by sex. Results: LR and LRR showed significant decreases. However, the odds of in itínere fatalities were higher in comparison to work-related fatalities, overall [1.51 (95%CI = 1.13-2.04); p = 0.006], in men, [1.58 (95%CI = 1.38-1.82); p = 0.000] and specifically in women, [5.93 (95%CI = 1.86-16.34); p = 0.001]. Conclusions: Specific epidemiological studies should be carried out and more interest should be given to this occupational road safety problem in the design of public and occupational health strategies. (AU)

[Long working hours and occupational injuries: estimates from the First Survey on Safety and Health Conditions at Work in Ecuador]. / Jornadas laborales prolongadas y lesiones por accidentes de trabajo: estimaciones de la Primera Encuesta sobre Condiciones de Seguridad y Salud en el Trabajo en Ecuador.

OBJECTIVE: to estimate the association between weekly working hours and occupational injuries (OI) among the salaried population in Guayaquil, Ecuador.  Methods: a cross-sectional study that used data from the First Survey on Safety and Health Conditions at Work in Ecuador in 2017. The respondents were 1005 salaried workers, divided into two groups according to weekly working hours, ?43 and ?44 hours. The relationship between long working hours and OI by gender was analyzed by using logistic regression (OR; CI 95%) adjusted for sociodemographic characteristics (Model 1) and also for occupational characteristics (Model 2).  Results: 30.9% of the workers declared ?44 weekly working hours (50.7±6.3 hours) and the OI percentages in this group were higher in men (24.2%) compared to women (12%). OI among those working long hours increased with age in men. In addition, the odds of sustaining an OI were higher among men working long hours as compared to the standard working day (OR = 3.08; 95% CI: 1.87-5.07), for Model 1 settings (OR = 2, 98; 95% CI: 1.79-4.95) and Model 2 (OR = 3.05; 95% CI: 1.82-5.11).  Conclusions: Long working hours are associated with OI in men. In the case of women, despite the fact that the frequency of OI was higher in those exposed to long working hours compared to those exposed to standard working hours, no statistically significant associations were observed. Implementation of preventive measures that consider the length of working hours in companies could result in the reduction of OI.

OBJETIVO: estimar la relación entre las jornadas de trabajo por semana y las lesiones por accidente de trabajo (LAT) en la población asalariada de la ciudad ecuatoriana de Guayaquil.  Métodos: estudio transversal que empleó datos de la Primera Encuesta de Condiciones de Seguridad y Salud en el Trabajo para el Ecuador en 2017. Los encuestados fueron 1 005 trabajadores asalariados y se dividieron en dos grupos según las horas de trabajo semanales, ?43 y ?44 horas. La relación entre las jornadas laborales prolongadas y LAT por sexo se analizó mediante regresión logística (OR; IC95%) ajustado por características sociodemográficas (Modelo 1) y añadiendo las ocupacionales (Modelo 2). RESULTADOS: El 30,9% de los trabajadores declaró trabajar 44 horas o más a la semana (50,7±6,3 horas) y la frecuencia de LAT en este grupo fue superior en los hombres (24,2%) respecto a las mujeres (12%). Las LAT en jornadas laborales prolongadas aumentaron con la edad en los hombres. Además, la probabilidad de sufrir una LAT fue mayor entre los hombres en comparación con la jornada de trabajo estándar, también para los ajustes del Modelo 1 y del Modelo 2.  Conclusiones: Las jornadas laborales prolongadas están asociadas con las LAT en los hombres. En el caso de las mujeres no se observó una asociación estadísticamente significativa. La implementación de medidas preventivas que tomen en cuenta la duración de las jornadas de trabajo en las empresas podría resultar en una reducción de las LAT.

Comportamiento de lesiones por accidente de trabajo no mortales y con incapacidad temporal, en personas afiliadas al régimen general de seguridad social en Ecuador. Análisis temporal y territorial en ocupaciones manuales de las industrias manufacturera y de construcción, 2014-2019 / Behavior of non-fatal occupational injuries with temporary disability among members of Ecuador's general social security system. Temporal and territorial analysis in manual occupations in the manufacturing and construction industry, 2014 - 2019 / Comportamento de lesões profissionais não fatais e temporariamente incapacitadas em pessoas filiadas ao sistema geral de segurança social no Equador. Análise temporal e territorial em ocupações manuais das indústrias manufatureiras e de construção, 2014-2019

El análisis de datos cuantitativos de siniestralidad laboral es importante para orientar la gestión preventiva en la República del Ecuador. Se presenta un estudio ecológico exploratorio de la incidencia de lesiones por accidente de trabajo no mortales y con incapacidad temporal, en ocupaciones manuales de las industrias manufacturera y de construcción en 23 provincias del país, para el período comprendido entre 2014 y 2019. Como fuente se utilizaron los registros oficiales de trabajadoras y trabajadores afiliados al régimen general de seguridad social. Se apli- có el programa estadístico SPSS versión 21.0 y Tableau versión 3.0; se agruparon las provincias del Ecuador en cuartiles según el valor de la tasa de incidencia de las lesiones por cada 1.000 personas afiliadas, considerando año y actividad económica. Las tasas de incidencia mues- tran patrones similares para los dos sectores económicos y un decrecimiento progresivo en el período analizado, con valores semejantes en 2019. Los valores más altos se presentan en las provincias de Azuay, Guayas, Pichincha y Tungurahua. Se concluye que existen importantes di- ferencias geográficas, lo que demanda estrategias de prevención y disminución de accidentes de trabajo con participación de los equipos interdisciplinarios relacionados, incluyendo terapeutas ocupacionales.

Analyzing quantitative data on occupational accidents is essential to guide preventive management in the Republic of Ecuador. An exploratory ecological study of the incidence of non-fatal and temporary incapacity occupational injuries in manual occupations in the manufacturing and construction industries in 23 provinces is presented for the period 2014-2019. Official registers of workers registered in the general social security system were used as a source. The statistical software SPSS version 21.0 and Tableau version 3.0 were applied; Ecuador provinces were grouped into quartiles according to the value of the incidence rate of injuries per 1,000 registered persons, considering the year and economic activity. Incidence rates show similar patterns for the two economic sectors and a progres- sive decrease over the period analyzed, with similar values in 2019. The highest values are found in Azuay, Guayas, Pichincha and Tungurahua provinces. It is concluded that there are significant geographical differences, which calls for strategies to prevent and reduce occupational accidents with the participation of related interdisciplinary teams, including occupational therapists.

A análise de dados quantitativos sobre acidentes de trabalho é importante para orientar a gestão preventiva na República do Equador. Um estudo ecológico exploratório da in- cidência de acidentes de trabalho não fatais e de invalidez temporária é apresentado em ocupações manuais nas indústrias de manufatureira e de construção em 23 províncias do país, para o período entre 2014 e 2019. Como fonte, foram utilizados os registros oficiais dos trabalhadores filiados ao regime geral de previdência social. Os programas estatísticos SPSS (versão 21.0) e Tableau (versão 3.0) foram aplicados; as províncias do Equador foram agrupadas em quartis, de acordo com o valor da taxa de incidência de lesões por 1.000 afiliados, considerando ano e atividade econômica. As taxas de incidência apresentam padrões semelhantes para os dois setores econômicos e uma diminuição progressiva no pe- ríodo analisado, com valores semelhantes em 2019. Os maiores valores encontram-se nas províncias de Azuay, Guayas, Pichincha e Tungurahua. Conclui-se que existem diferenças geográficas importantes, que demandam estratégias de prevenção e de redução dos aciden- tes de trabalho com a participação de equipes interdisciplinares relacionadas, incluindo terapeutas ocupacionais.

[Safety and Health at Work in Ecuador]. / Seguridad y salud en el trabajo en Ecuador.

La República del Ecuador (en adelante Ecuador) puede ser considerada como uno de los países latinoamericanos más privilegiados por sus contrastes geográficos, variedad climática y amplia biodiversidad. La Cordillera de los Andes divide al Ecuador en tres regiones (Amazonía, Sierra y Costa del Pacífico) con marcadas diferencias culturales. Además, existen el conjunto de las Islas Galápagos como cuarta región. La población (2020) es de 17,5 millones de habitantes (51% son mujeres) y la esperanza de vida aumentará significativamente en los próximos años (2010 fue de 75 años y para el 2030 será de 80,5 años). En contraste, los indicadores de salud, económicos y laborales muestran un paronarma preocupante. La tasa de mortalidad en los últimos años ha aumentado ligeramente, en 2014 fue de 4,1 por cada 1000 habitantes y en 2019 fue de 4,3 por cada 1000 habitantes. En 2019, la primera causa de muerte fueron las enfermedades isquémicas del corazón, tanto en mujeres y hombres, y en adultos de 30 a 64 años los accidentes de transporte. Aunque la economía de Ecuador ha mostrado un crecimiento hasta mediados de la última década, la caída del precio internacional del petróleo provocó una recesión económica, con pérdidas de plazas de empleo adecuado desde 2015 y que se mantienen progresivamente en la actualidad. El empleo informal ha crecido rápidamente, situándose en el 46,7% en 2019, y en condiciones precarias de trabajo y ausencia derechos de protección social. Desafortunadamente, la crisis sanitaria por el SARS-CoV-2 ha provocado aún más un entorno desfavorable y retroceso en los objetivos marcados para reducir las desigualdades sociales….

Association between informal employment and mortality rate by welfare regime in Latin America and the Caribbean: an ecological study.

OBJECTIVE: We aimed to estimate the association between informal employment and mortality in Latin America and the Caribbean (LAC) by comparing welfare state regimes. DESIGN: Ecological study using time-series cross-sectional analysis of countries. Informality was estimated from household surveys by the Center for Distributive, Labor and Social Studies in collaboration with the World Bank, and the adult mortality rates for 2000-2016 were obtained from the WHO databases. Countries were grouped by welfare state regimes: state productivist, state protectionist and familialist. We calculated the compound annual growth rate for each country and performed linear regression between the informality and the adult mortality rates stratified by sex and welfare state regime. SETTING: Seventeen countries from LAC with available data on informality and adult mortality rates for 2000-2016. PRIMARY OUTCOME MEASURE: The association between informality and mortality by welfare state regime. RESULTS: Between 2000 and 2016, mortality rates decreased an average 1.3% per year and informal employment rates 0.5% per year. We found a significant positive association between informality and mortality rates (women: R2=0.48; men: R2=0.36). The association was stronger among the state regime countries (women: R2=0.58; men: R2=0.77), with no significant association among the familialist countries. CONCLUSION: Informal employment negatively impacts population health, which is modified by welfare state regimes. Addressing informal employment could be an effective way to improve population health in LAC. However, linkage with public health and labour market agendas will be necessary.

Pérdidas laborales asociadas a la mortalidad por lesiones en accidentes de tránsito: estimaciones provinciales de ecuador / Labor productivity losses associated with road traffic injury fatalities: Provincial estimates of Ecuador

RESUMEN Objetivo Estimar los años potenciales de vida perdidos (APVP) y los años potenciales de vida laboral perdidos (APVLP) en la población en edad laboral asociados a los fallecimientos prematuros por lesiones en accidentes de tránsito para las 24 provincias de Ecuador. Métodos Se emplearon fuentes de información estadística (registro de defunciones CIE-10 V01 a V89 y censo poblacional) para estimar los APVP y APVLP en edades laborales (15 a 64 años de edad) por sexo y provincias. Además, se calcularon la tasa cruda y específica (edades laborales) y la edad media (IC95%). Resultados La mayoría de las muertes en edad laboral por lesiones en accidentes tránsito estuvo en hombres con edades jóvenes y en las provincias de las regiones amazónica (Orellana y Sucumbíos) y la costa del Pacífico del país (Los Ríos). El número de APVLP se estima en 69 314 años, mientras que los APVP asciende a 94 567 años, las provincias de Guayas y Pichincha acumulan la mayor cantidad de APVP y APVLP. Conclusiones Los años perdidos estimados por muertes prematuras por esta causa representan un problema de salud pública y un importante coste laboral para el desarrollo del país. Los resultados encontrados refuerzan la necesidad de intensificar la mejora de programas y actuaciones públicas en seguridad vial.

ABSTRACT Objetive To estimate the potential years of life lost (YPLL) and the potential years of wor-king life lost (YPPLL) in the working-age population associated with premature deaths from injuries in traffic accidents for the 24 provinces of Ecuador. Methods Statistical information sources (ICD-10 V01 to V89 death registry and population census) were used to estimate the YPLL and YPPLL for working ages (15 to 64 years of age) by sex and provinces. Additionally, the crude and specific rate (working ages) and the mean age (95% CI) were calculated. Results Most deaths of working age for injuries in traffic accidents was in men younger ages and in the provinces of the Amazon regions (Orellana and Sucumbíos) and the Pacific coast of the country (Los Ríos). The number of YPLL is estimated at 69,314 years, while the YPPLL amounts to 94,567 years, the provinces of Guayas and Pichincha accumulate the highest amount of YPLL and YPPLL. Conclusions Estimated lost years for this cause premature deaths represent a public health problem and a major labor cost for the development of the country. The results reinforce the need to strengthen public programs and improve road safety performances.

Understanding the Relationship between Situational Strength and Burnout: A Multi-Sample Analysis.

Many studies have examined the effect of situational strength (clarity, consistency, constraints, and consequences) on organisational behaviour, but little has been investigated about its health effects. This study aimed to analyse the relationship between situational strength and burnout. Specifically, we examined whether situational strength characteristics may be associated with burnout, whether these characteristics are risk (or protective) factors for burnout, and whether a strong situation is related to higher levels of burnout. Examining three samples from different occupations, it was found that clarity and consistency are negatively associated with burnout, being protective factors, while constraints are positively associated with burnout, being risk factors. These results are consistent across the samples. In addition to the direct effects, interaction effects between clarity and consistency in the office employee's sample (two-way interaction), between constraints and consequences in the samples of office employees and teachers (two-way interaction), and among clarity, consistency, and constraints in the salespeople's sample (three-way interaction) were also significant, explaining from 20% to 33% of the variance of burnout. We concluded that situational strength is associated not only with behaviour but also with health. The theoretical and practical implications of these findings are discussed.

Salaried Workers' Self-Perceived Health and Psychosocial Risk in Guayaquil, Ecuador.

Self-perceived health is an important indicator of occupational health. This research explored the relationship between poor self-perceived health and exposure to psychosocial risk factors, taking into account potential socio-demographic, occupational, and employment determinants. Using data from the First Survey of Occupational Safety and Health Conditions, covering 1049 salaried workers in Guayaquil, Ecuador, descriptive and stratified binary logistic regression analyses (odds ratios with corresponding 95% confidence intervals) were carried out. A significant relationship was found between exposure to psychosocial risk factors and the probability of presenting poor self-perceived health by socio-demographic, occupational, and employment characteristics. Occupational exposure factors to psychosocial risks were predictors of self-perceived ill health and were related to the variables analyzed; the most frequently expressed factors among the respondents were cognitive demands (DCOG) and job insecurity (IL). The results have implications in terms of designing effective workplace interventions pursuant to ensuring the health and well-being of employees.

Health inequity in workers of Latin America and the Caribbean.

BACKGROUND: Latin America and the Caribbean (LAC) is the world's most inequitable region in terms of wealth distribution. The full scale of social inequalities in health has been hidden by the lack of reliable data. This study aimed to measure and compare health inequalities in the working population within and between 15 countries of LAC. METHODS: A sample of 180,163 workers aged 18 years and older was drawn from the most recent national surveys of working conditions or health in 15 LAC countries. Poor self-perceived health (P-SPH) was used as a health indicator, and age, education level, and occupational category as inequality stratifiers. We calculated four measures: absolute and relative population-attributable risks, the Kuznets and weighted Keppel indexes. RESULTS: P-SPH prevalence ranged from 9% in men from Uruguay to 50% in women from Nicaragua. It was higher in women than in men in most countries. A clear gradient was shown, in which young people in non-manual skilled jobs and high education had the lowest prevalence. Nearly 45% of cases that reported P-SPH among men and 35% among women could be avoided if all the groups received a higher level of education. Also, approximately 42% of P-SPH reported by men and 31% by women could be avoided if they all shared the working and employment conditions of non-manual skilled jobs. CONCLUSIONS: Wide health inequalities were found between occupational and educational groups in LAC. However, country borders appear to be an even more important stratifier in the production of health inequalities. Urgent interventions to improve worker's health are needed in countries where prevalence of poor self-perceived health is high. Strengthening occupational health surveillance system in LAC countries should become a priority, in order to track the interventions to reduce occupational health inequity.

Saúde do trabalhador no Equador: uma comparação com inquéritos sobre condições de trabalho na América Latina / Occupational health in Ecuador: a comparison with Latin-American surveys on working conditions / La salud ocupacional en Ecuador: una comparación con las encuestas sobre condiciones de trabajo en América Latina

Resumo Introdução: o Equador realizou recentemente seu primeiro inquérito sobre condições de trabalho. Objetivo: descrever as condições de trabalho e emprego e o estado de saúde dos trabalhadores equatorianos em uma amostra que permita comparação com inquéritos latino-americanos anteriores. Métodos: uma amostra de 1.713 trabalhadores foi selecionada do primeiro inquérito sobre condições de trabalho no Equador. Prevalências e intervalos de confiança de 95% (IC95%) foram calculados e comparados com inquéritos anteriores na Colômbia, Argentina, Chile, América Central e Uruguai. Resultados: homens foram frequentemente mais expostos a trabalho em condições perigosas, sendo as mais relatadas trabalho com ruído (81% dos homens e 69% das mulheres) e com movimentos repetitivos (56% dos homens e 48% das mulheres). Cerca de 31% dos homens e 19% das mulheres trabalhavam mais de 40 horas por semana. Quase 11% das mulheres e dos homens relataram uma autopercepção de saúde ruim. A prevalência de agravos ocupacionais foi a mais alta da região: 15% para homens e 8,4% para mulheres. Conclusão: este é um primeiro levantamento das condições de trabalho e emprego e do estado de saúde de trabalhadores no Equador. Harmonizar e aperfeiçoar os Inquéritos sobre Condições de Trabalho na América Latina deve ser uma meta prioritária para melhorar a vigilância em saúde do trabalhador na região.

Abstract Introduction: Ecuador has recently implemented its First Working Conditions Survey. Objective: to describe working and employment conditions and workers' health status in Ecuador in a sample that allows comparison with previous Latin American surveys. Methods: a sample of 1,713 workers was drawn from the First Working Conditions Survey in Ecuador. Prevalence and a 95% confidence Interval (95%CI) were calculated and compared with previous Latin American surveys in Colombia, Argentina, Chile, Central America, and Uruguay. Results: men were more often exposed to hazardous working conditions, with noise (81% of men and 69% of women), and repetitive movements (56% and 48%, respectively) being the most frequently reported. About 31% of men and 19% of women worked more than 40 hours per week. Almost 11% of both women and men reported poor self-perceived health status. The prevalence of occupational injury was the highest in the region: 15% for men and 8.4% for women. Conclusions: this is a first approach to the working and employment conditions and workers' health status in Ecuador. To harmonize and improve Working Conditions Surveys in Latin America should be a priority goal for enhancing regional occupational health surveillance.

Resumen Introducción: Ecuador ha realizado recientemente su primera encuesta sobre las condiciones de trabajo. Objetivo: describir las condiciones de trabajo y empleo y el estado de salud de los trabajadores en Ecuador en una muestra que permita la comparación con encuestas anteriores en América Latina. Métodos: se seleccionó una muestra de 1.713 trabajadores de la Primera Encuesta de Condiciones de Trabajo en el Ecuador. Se calculó la prevalencia y el intervalo de confianza del 95% (IC95%) y se comparó con las encuestas anteriores realizadas en América Latina - Colombia, Argentina, Chile, América Central y Uruguay. Resultados: hombres se exponen con mayor frecuencia a condiciones de trabajo peligrosas, siendo las más frecuentes el ruido (81% de los hombres y 69% de las mujeres) y los movimientos repetitivos (56% y 48%, respectivamente). Alrededor del 31% de los hombres y el 19% de las mujeres trabajan más de 40 horas por semana. Casi el 11% de las mujeres y de los hombres reportaron mala salud autopercibida. La prevalencia de lesiones ocupacionales fue la más alta de la región: el 15% para los hombres y el 8,4% para las mujeres. Conclusiones: este es un primer acercamiento a las condiciones de trabajo y empleo y al estado de salud de los trabajadores en el Ecuador. Armonizar y mejorar las Encuestas de Condiciones de Trabajo en América Latina debería ser un objetivo prioritario para mejorar la vigilancia de la salud ocupacional en esta región.

Sistema de indicadores de morbilidad y mortalidad por accidentes de tráfico: una revisión sistemática / System of morbidity and mortality indicators for traffic accidents: a systematic review

RESUMEN Objetivo Elaborar un sistema de indicadores de morbilidad y mortalidad por accidentes de tráfico, con el fin de mejorar los procesos de recopilación y registro de la información de seguridad vial en el país. Materiales y Métodos Revisión sistemática cualitativa de artículos científicos publicados en revistas indexadas en las principales bases de datos (Scopus, PubMed, Lilacs, SciELO, Google Scholar), sobre accidentes de tráfico desde el año 1995 hasta el año 2015. La información recolectada pasó por 4 fases de revisión. Resultados Se seleccionaron 84 indicadores, agrupados en nueve dimensiones: accidentalidad, morbilidad, mortalidad, temporalidad, geoespacial, sociodemográfica, parque vehicular, impacto en salud pública, tipos y causas. Conclusiones Una gestión eficaz sobre seguridad vial exige que cada país cuente con un sistema de indicadores efectivo e institucionalizado que permita recolectar, analizar y gestionar la información de forma rápida y oportuna, enmarcada en el campo de la investigación científica, para difundir a la comunidad y organismos responsables de la seguridad vial, con miras a la adopción de medidas preventivas y correctivas. Por lo que, se recomienda a los organismos competentes de seguridad vial del país incorporar el sistema de indicadores elaborado en la presente investigación, lo cual permitirá contar con un sistema de registro de datos confiables.

ABSTRACT Objective Prepare a system of morbidity and mortality indicators for traffic accidents, to propose its implementation in Ecuador, in order to improve the processes for collecting and recording road safety information in the country. Materials and Methods Qualitative systematic review of scientific articles published in journals indexed in the main databases (Scopus, PubMed, Lilacs, SciELO, Google Scholer), on traffic accidents from 1995 to 2015. The information collected went through 4 phases review. Results 84 indicators were selected, grouped into nine dimensions: accident rate, morbidity, mortality, temporality, geospatial, socio-demographic, vehicle fleet, impact on public health, types and causes. Conclusions An effective management of road safety requires that each country have an effective and institutionalized system of indicators that allows the collection, analysis and management of information in a fast and timely manner, framed in the field of scientific research, to disseminate to the community and organizations. responsible for road safety, with a view to adopting preventive and corrective measures. Therefore, it is recommended that the competent road safety agencies of the country incorporate the system of indicators developed in this research, which will allow them to have a reliable data registration system.

I Encuesta sobre Condiciones de Seguridad y Salud en el Trabajo para Ecuador. Principales resultados en la ciudad de Quito, 2016 / I Survey on Safety and Health Conditions at the Workplace in Ecuador. Main Results in Quito, 2016

OBJETIVO: Describir las condiciones de trabajo y el estado de salud de la población trabajadora afiliada a la seguridad social de la ciudad de Quito, Ecuador. MATERIALES Y MÉTODOS: Estudio descriptivo basado en los resultados de la Primera Encuesta sobre Condiciones de Seguridad y Salud en el Trabajo (I-ECSST). Se entrevistó entre abril y junio de 2016 a 741 personas en su domicilio. El diseño muestral fue probabilístico, bietápico y estratificado por las 32 parroquias urbanas de la ciudad de Quito. RESULTADOS: Un porcentaje considerable de los trabajadores estaba expuesto a factores de riesgos ergonómicos. En particular, el 60% de los trabajadores encuestados manifestó realizar movimientos repetitivos en su actividad laboral. Se observó una alta prevalencia de dolores o molestias de espalda (50%), cabeza (40%) y miembros superiores (26%). El 13% de los trabajadores declaró haber sufrido un accidente de trabajo en el último año. CONCLUSIONES: La I-ECSST revela multitud de factores de riesgos laboral presentes en los lugares de trabajo que pueden estar ocasionando daños a la salud de la población trabajadora. Estos resultados podrían servir para guiar a las políticas públicas orientadas a mejorar la salud de la población trabajadora

OBJECTIVE: To describe working conditions and health problems at the working-age population in the Ecuadorian social security system of Quito. MATERIALS AND METHODS: Descriptive study based on the results of the First Survey on Safety and Health at Work (I-ECSST, by its Spanish acronym). 741 people were interviewed at home between April and June 2016. The sampling design was probabilistic, multistage and stratified by 32 urban parishes. RESULTS: A considerable proportion of workers were exposed to ergonomic risk factors. In particular, 60% of surveyed workers evidenced repetitive movements throughout their work activity. A high prevalence of pains and problems were evidenced as follows: back (50%), head (40%) and upper limb (26%). 13% of workers reported having suffered a work-related accident in the previous year. CONCLUSIONS: The I-ECSST reveals a multitude of occupational risk factors at workplaces that may be causing damage to the health of the working population. These results could be helpful in guiding public policies in order to improve the health of the working population

Diseño y validación de un cuestionario para el diagnóstico de riesgos psicosociales en empresas ecuatorianas / Design and validation of a questionnaire for the diagnosis of psychosocial risks in Ecuatorian companies

OBJETIVO: presentar el diseño, construcción y validación de un cuestionario para el diagnóstico de riesgos psicosociales en Ecuador, conformado por 58 ítems que evalúan el riesgo psicosocial a través de 8 dimensiones. Diseño: estudio transversal en 2 fases: (i) diseño del marco conceptual y construcción del cuestionario y; (ii) valoración de la validez y consistencia interna aplicado en una muestra de 3.225 trabajadores de empresas ecuatorianas. Resultados: El cuestionario posee una alta fiabilidad en términos de consistencia interna (Alfa de Cronbach = 0,968) y una adecuación satisfactoria de los datos a la matriz factorial (KMO = 0,980; Bartlett = 93818,0, <0,05). Conclusiones: se recomienda el uso de este cuestionario como instrumento para el diagnóstico preliminar, permitiendo el diseño e implementación de futuros programas de prevención de riesgos psicosociales en empresas de más de 10 trabajadores en el país.

Abstract: Objective: to present the design, construction and validation of a questionnaire for the diagnosis of psychosocial risks in Ecuador, consisting of 58 items that assess psychosocial risk through 8 dimen sions. Design: cross-sectional study in 2 phases: (i) design of the conceptual framework and construction of the questionnaire and; (ii) assessment of the validity and internal consistency applied to a sample of 3.225 workers from ecuadorian companies. Results: The questionnaire has a high reliability in terms of internal consistency (Cronbach's alpha = 0,968) and a satisfactory adaptation of the data to the factorial matrix (KMO = 0,980; Bartlett = 93818,0, <0,05). Conclusions: the use of this questionnaire is recommended as an instrument for preliminary diagnosis, allowing the design and imple mentation of future psychosocial risk prevention programs in com panies with more than 10 workers in the country.