Relación de los índices de adiposidad visceral (VAI) y disfuncional (DAI) con parámetros de obesidad / Visceral adiposity index (VAI) and dysfunctional adiposity index (DAI). Relationship with obesity parameters

Introducción La obesidad es una pandemia mundial con repercusión en morbilidad y mortalidad crecientes. Valoramos la fortaleza asociativa del índice de adiposidad visceral (VAI) y del índice de adiposidad disfuncional (DAI) en obesidad y riesgo asociado utilizando diversos métodos. Material y métodos Estudio transversal en 418.343 trabajadores de diferentes comunidades autónomas en España, estimando prevalencia de obesidad con: perímetro de cintura, Índice cintura/altura, IMC, CUN-BAE, ECORE-BF, RFM, Palafolls, IMG, METS-VF calculados ajustándose a sus fórmulas específicas. Se realizó análisis descriptivo de las variables categóricas y fortaleza asociativa de VAI y DAI para obesidad con curvas ROC considerando riesgo elevado cuando el valor AUC.0,8 y moderado con AUC.0,7 y.0,8. Se utilizó SPSS 27.0, considerando significación estadística p.0,05. Resultados La prevalencia de obesidad varía según el método utilizado, siendo alta con Palafolls (72,92% en mujeres y 86,98% en hombres) y baja con METS-VF (1,31% en mujeres y 8,54% en hombres). Los valores medios de VAI y DAI son siempre superiores en hombres. El AUC de la curva ROC para VAI fue alta con METS-VF: en mujeres 0,836 (intervalo de confianza del 95% [IC 95%] 0,829-0,843), en hombres 0,848 (IC 95% 0,845-0,850) y con perímetro de cintura en hombres: 0,819 (IC 95% 0,816-0,822). DAI fue alto para METS-VF en mujeres: 0,809 (IC 95% 0,801-0,817). Conclusiones La prevalencia de obesidad y riesgo relacionado difiere según el método de valoración utilizado. VAI muestra alta fortaleza asociativa en obesidad y masa grasa para METS-VF en ambos sexos y con perímetro de cintura en hombres; DAI para METS-VF en mujeres (AU)

Introduction Obesity is a global pandemic with a growing impact on morbidity and mortality. We assessed the associative strength of the Visceral Adiposity Index (VAI) and Dysfunctional Adiposity Index (DAI) in obesity and associated risk using different methods. Material and methods Cross-sectional study in 418 343 workers from different autonomous communities in Spain, estimating prevalence of obesity with: waist circumference, waist/height index, BMI, CUN-BAE, ECORE-BF, RFM, PALAFOLLS, IMG, METS-VF calculated according to their specific formulas. Descriptive analysis of categorical variables and associative strength of VAI and DAI for obesity was performed with ROC curves considering high risk when the AUC value.0.8 and moderate with AUC.0.7 and.0.8. SPSS 27.0 was used, considering statistical significance p.0.05. Results The prevalence of obesity varied according to the method used, being high with Palafolls (72.92% in women and 86.98% in men) and low with METS-VF (1.31% in women and 8.54% in men). The mean values of VAI and DAI are always higher in men. The AUC of the ROC curve for VAI was high with METS-VF: in women 0.836 (95%CI 0.829-0.843), in men 0.848 (95%CI 0.845-0.850) and with waist circumference in men: 0.819 (95%CI 0.816-0.822). DAI was high for METS-FV in women: 0.809 (95%CI 0.801-0.817). Conclusions The prevalence of obesity and related risk differs according to the assessment method used. VAI shows high strength of association with obesity and fat mass for METS-VF in both sexes and with waist circumference in men; DAI for METS-VF in women (AU)

[Visceral adiposity index (VAI) and dysfunctional adiposity index (DAI). Relationship with obesity parameters]. / Relación de los índices de adiposidad visceral (VAI) y disfuncional (DAI) con parámetros de obesidad.

INTRODUCTION: Obesity is a global pandemic with a growing impact on morbidity and mortality. We assessed the associative strength of the Visceral Adiposity Index (VAI) and Dysfunctional Adiposity Index (DAI) in obesity and associated risk using different methods. MATERIAL AND METHODS: Cross-sectional study in 418 343 workers from different autonomous communities in Spain, estimating prevalence of obesity with: waist circumference, waist/height index, BMI, CUN-BAE, ECORE-BF, RFM, PALAFOLLS, IMG, METS-VF calculated according to their specific formulas. Descriptive analysis of categorical variables and associative strength of VAI and DAI for obesity was performed with ROC curves considering high risk when the AUC value.0.8 and moderate with AUC.0.7 and.0.8. SPSS 27.0 was used, considering statistical significance p.0.05. RESULTS: The prevalence of obesity varied according to the method used, being high with Palafolls (72.92% in women and 86.98% in men) and low with METS-VF (1.31% in women and 8.54% in men). The mean values of VAI and DAI are always higher in men. The AUC of the ROC curve for VAI was high with METS-VF: in women 0.836 (95%CI 0.829-0.843), in men 0.848 (95%CI 0.845-0.850) and with waist circumference in men: 0.819 (95%CI 0.816-0.822). DAI was high for METS-FV in women: 0.809 (95%CI 0.801-0.817). CONCLUSIONS: The prevalence of obesity and related risk differs according to the assessment method used. VAI shows high strength of association with obesity and fat mass for METS-VF in both sexes and with waist circumference in men; DAI for METS-VF in women.

Cardiometabolic profile of 15057 elderly Spanish workers: association of sociodemographic variables and tobacco consumption.

BACKGROUND: Aging of the world population is one of the most significant demographic changes of our time. Populations older than 60 years are heterogeneous, and age is an independent cardiovascular risk factor aggravated by frailty, obesity, and diabetes, and influenced by several factors, including sex and socioeconomic status. The objective of this study was to calculate cardiovascular risk in workers of both sexes over 60 years of age and to assess whether there are difference s by sex, social class, smoking, and type of job. METHODS: A cross-sectional study was carried out in 15,057 elderly Spanish workers from different autonomous communities in Spain and with different labor occupations. Anthropometric, sociodemographic, clinical, and laboratory values were determined. People were classified according to age from 60 to 64 years inclusive and from 65 to 69 years, smokers and non-smokers, and both blue-collar and white-collar workers. Subsequently, a multivariate analysis was carried out. RESULTS: Men, blue-collar workers, smokers, and aging were factors that influenced cardiovascular risk: with an OR of 3.27 (95% CI: 2.64-4.05) in people 65 years of age or older versus the younger group, and an OR of 3.15 (95% CI: 2.69-3.69) in smokers versus non-smokers. A stronger independent association was found between smoking, age, and cardiovascular risk. The risk of developing non-alcoholic fatty liver and liver fibrosis was much higher in men than in women, with an OR of 4.06 (95% CI: 3.66-4.50) for the former and an OR of 2.10 (95% CI: 1.95-2.26) for the BARD index. CONCLUSIONS: The highest risk groups were observed in male subjects with a history of smoking and blue-collar workers and, as such, should be considered for cardiovascular risk screening programs.

The CUN-BAE, Deurenberg Fat Mass, and visceral adiposity index as confident anthropometric indices for early detection of metabolic syndrome components in adults.

There is no definition for the metabolic syndrome; visceral obesity, elevated lipids and glucose, and hypertension coexist. The aim of the study is to determine which anthropometric indicators best determine it. Cross-sectional study in 418,343 Spanish workers. Metabolic syndrome was determined using the NCEP-ATPIII, IDF and JIS criteria. The anthropometric variables studied were: body mass index, waist circumference, waist-to-height ratio, CUNBAE, Deuremberg formula, body fat index, body surface index, normalized weight adjusted index, body roundness index, body shape index, visceral adiposity index (VAI), dysfunctional adiposity index, conicity index, metabolic score for visceral fat (METS-VF), waist triglyceride index. In men, the anthropometric indices with the largest areas under the ROC curve are VAI with ATPIII criteria and JIS. If we use the IDF criteria: waist circumference and METS-VF, with the same result. In women, the largest areas under the curve were observed with the Deuremberg formula in both ATPIII and JIS while with the IDF criteria it is METS-VF. The most useful anthropometric indices for identifying metabolic syndrome are CUN-BAE and Deuremberg, followed by the VAI. A single definition of metabolic syndrome should be agreed to determine the best anthropometric index with predictive capacity for its diagnosis.

Prevalencia de diabesidad en población laboral española: influencia de variables sociodemográficas y consumo de tabaco / Prevalence of diabesity in the Spanish working population: influence of sociodemographic variables and tobacco consumption

Fundamento. La obesidad predispone a sufrir diabetes tipo 2 con tanta frecuencia que su combinación se denomina diabesidad. El objetivo de este estudio fue determinar la prevalencia de diabesidad en la población trabajadora y analizar las variables con las que se asocia. Material y métodos. Estudio transversal realizado entre enero de 2019 y junio de 2020 en 418.343 trabajadores de 18 a 67 años, de diferentes profesiones y áreas geográficas españolas. Se determinó la prevalencia de diabesidad con seis fórmulas diferentes para obesidad: IMC (índice de masa corporal), CUN BAE (Clínica Universidad de Navarra Body Adiposity Estimator), ECORE-BF (Equation Córdoba for Estimation of Body Fat), Fórmula Palafolls, IMG (índice de masa grasa) de Deuremberg y RFM (Relative Fat Mass). Se analizó la asociación entre diabesidad y edad, sexo, clase social y tabaco. Resultados. La prevalencia global de diabesidad osciló entre 2,6 % por el IMC y 5,8% por la fórmula Palafolls. La variable más relacionada con la diabesidad fue la edad mayor de 50 años (OR = 5,9; IC95%: 5,7-6,2 para IMC, y OR = 8,1; IC95%: 7,9-8,4 para IMG de Deuremberg). El sexo masculino y la clase social III se relacionaron con la diabesidad estimada con todas las escalas, ser fumador solo con la fórmula Palafolls. Conclusiones. La prevalencia de diabesidad varía en función de la fórmula empleada, con una prevalencia menor entre las mujeres y un aumento con la edad independientemente de la fórmula utilizada. Su prevalencia es mayor en las clases sociales más bajas.(AU)

Background. Obesity predisposes to type 2 diabetes so often that the combination is called diabesity. The aim of this study was to determine the prevalence of diabesity in the working population and to analyze the variables associated with it. Method. Cross-sectional study between January 2019 and June 2020 by 418,343 workers from 18 to 67 year-old, from different professions and Spanish geographic areas. The prevalence of diabesity was determined with six different formulae for obesity: BMI (body mass index), CUN BAE (Clínica Universidad de Navarra-Body Adiposity Estimator), ECORE-BF (Equation Córdoba for Estimation of Body Fat), Formula Palafolls, FMI (fat mass index) of Deuremberg and RFM (relative fat mass). The association between diabetes and age, sex, social class and tobacco was analyzed. Results. The global prevalence of diabetes ranged from 2.6% for BMI to 5.8% for the Palafolls formula. The variable most related to diabesity was age over 50 years (OR=5.9; 95%CI: 5.7-6.2 for BMI, and OR = 8.1; 95%CI: 7.9-8.4 for FMI of Deuremberg). Male sex and social class III related with diabesity estimated by all formulas, while being a smoker was only related with the Palafolls formula. Conclusion. Diabesity prevalence varies depending on the formula used, with much lower prevalence among women and increased with age independent of the formula used. Its prevalence is higher in the lower social classes.(AU)

[Prevalence of diabesity in the Spanish working population: influence of sociodemographic variables and tobacco consumption].

BACKGROUND: Obesity predisposes to type 2 diabetes so often that the combination is called diabesity. The aim of this study was to determine the prevalence of diabesity in the working population and to analyze the variables associated with it. METHOD: Cross-sectional study between January 2019 and June 2020 by 418,343 workers from 18 to 67 year-old, from different professions and Spanish geographic areas. The prevalence of diabesity was determined with six different for-mulae for obesity: BMI (body mass index), CUN BAE (Clínica Universidad de Navarra Body Adiposity Estimator), ECORE-BF (Equation Córdoba for Estimation of Body Fat), Formula Palafolls, FMI (fat mass index) of Deuremberg and RFM (relative fat mass). The association between diabetes and age, sex, social class and tobacco was analyzed. RESULTS: The global prevalence of diabetes ranged from 2.6% for BMI to 5.8% for the Palafolls formula. The variable most related to diabesity was age over 50 years (OR?=?5.9; 95%CI: 5.7-6.2 for BMI, and OR?=?8.1; 95%CI: 7.9-8.4 for FMI of Deuremberg). Male sex and social class III related with diabesity estimated by all formulas, while being a smoker was only related with the Palafolls formula. CONCLUSION: Diabesity prevalence varies depending on the formula used, with much lower prevalence among women and increased with age independent of the formula used. Its prevalence is higher in the lower social classes.

Thyroid as a target of adjuvant autoimmunity/inflammatory syndrome due to mRNA-based SARS-CoV2 vaccination: from Graves' disease to silent thyroiditis.

BACKGROUND: As COVID-19 became a pandemic, the urgent need to find an effective treatment vaccine has been a major objective. Vaccines contain adjuvants which are not exempt from adverse effects and can trigger the autoimmune/inflammatory syndrome induced by adjuvants (ASIA). There is very little information about autoimmune endocrine disease and the ASIA after the use of mRNA-based SARS-CoV2 vaccination. CASE SERIES: We report three cases and also review the literature showing that the thyroid gland can be involved in the ASIA induced by the mRNA-based SARS-CoV2 vaccination. We present the first case to date of silent thyroiditis described in the context of SARS-CoV2 vaccination with Pfizer/BioNTech. Also, we discuss the first subacute thyroiditis in the context of SARS-CoV2 vaccination with the Moderna's vaccine. Finally, we provide another case to be added to existing evidence on Graves' disease occurring post-vaccination with the Pfizer/BioNTech vaccine. DISCUSSION: Adjuvants play an important role in vaccines. Their ability to increase the immunogenicity of the active ingredient is necessary to achieve the desired immune response. Both the Moderna and the Pfizer/BioNTech vaccines use mRNA coding for the SARS-CoV2 S protein enhanced by adjuvants. In addition, the cross-reactivity between SARS-CoV2 and thyroid antigens has been reported. This would explain, at least, some of the autoimmune/inflammatory reactions produced during and after SARS-CoV2 infection and vaccination. CONCLUSION: The autoimmune/inflammatory syndrome induced by adjuvants involving the thyroid could be an adverse effect of SARS-CoV2 vaccination and could be underdiagnosed.

Relación entre el consumo de alcohol y el riesgo de diabetes tipo 2 en los trabajadores / Relationship Between Alcohol Consumption and Risk Of Diabetes Type 2 in Workers

Introducción. El consumo de alcohol daña la mayoría de los órganos y sistemas de nuestro organismo, con un efecto nocivo sobre la diabetes tipo 2. En nuestro país, el consumo de alcohol es tolerado y socialmente bien considerado, lo que provoca que una parte importante de la población tenga una ingesta excesiva de alcohol. Por tanto, quisimos evaluar el efecto de la ingesta excesiva de alcohol en la población trabajadora y su efecto sobre el riesgo de desarrollar diabetes tipo 2. Métodos. Estudio descriptivo y transversal en 55.147 trabajadores españoles en el que se evaluó el efecto del consumo excesivo de alcohol sobre el riesgo de desarrollar diabetes tipo 2. El riesgo de diabetes se evaluó con las escalas Findrisk y QDScore. El consumo de alcohol se evalúa con la unidad de bebida estándar, equivalente a 10 g de alcohol. Se considera consumo excesivo cuando se superan semanalmente 35 unidades de bebida estándar en hombres y 20 en mujeres. Resultados. El consumo excesivo de alcohol en comparación con no beber, beber poco o moderadamente aumenta el riesgo de diabetes tipo 2 en ambas escalas de riesgo. La razón de probabilidades es 12,22 (IC 95 11,51-12,99) para la escala Findrisk y 13,36 (IC 95% 12,04-14,69) para el riesgo relativo con QDScore. Conclusión. El consumo excesivo de alcohol aumenta el riesgo de diabetes tipo 2 con las escalas Findrisk y QDScore en la población laboral española

Introduction. Alcohol consumption damages most of the organs and systems of our organism, with a harmful effect on type 2 diabetes. In our country, alcohol consumption is tolerated and socially well regarded, which causes an important part of the population to have an excessive alcohol intake. Therefore, we want to evaluate the effect of excessive alcohol intake in the working population and its effect on the risk of developing type 2 diabetes. Methods. Descriptive and cross-sectional study in 55,147 Spanish workers in which the effect of excessive alcohol consumption on the risk of developing type 2 diabetes was assessed. Diabetes risk was assessed with the Findrisk and QDScore scales. Alcohol consumption is assessed with the standard drinking unit, equivalent to 10g of alcohol. Excessive consumption is considered when 35 standard drinking unit in men and 20 in women are exceeded weekly. Results. Heavy drinking compared to no, low or moderate drinking increases the risk of type 2 diabetes on both risk scales. The Odds ratio is 12.22 (CI 95 11.51-12.99) for the Findrisk scale and 13.36 (CI 95% 12.04-14.69) for the relative risk with QDScore. Conclusion. Excessive alcohol consumption increases the risk of type 2 diabetes with the Findrisk and QDScore scales in the Spanish working population

Bayesian network modeling: A case study of an epidemiologic system analysis of cardiovascular risk.

An extensive, in-depth study of cardiovascular risk factors (CVRF) seems to be of crucial importance in the research of cardiovascular disease (CVD) in order to prevent (or reduce) the chance of developing or dying from CVD. The main focus of data analysis is on the use of models able to discover and understand the relationships between different CVRF. In this paper a report on applying Bayesian network (BN) modeling to discover the relationships among thirteen relevant epidemiological features of heart age domain in order to analyze cardiovascular lost years (CVLY), cardiovascular risk score (CVRS), and metabolic syndrome (MetS) is presented. Furthermore, the induced BN was used to make inference taking into account three reasoning patterns: causal reasoning, evidential reasoning, and intercausal reasoning. Application of BN tools has led to discovery of several direct and indirect relationships between different CVRF. The BN analysis showed several interesting results, among them: CVLY was highly influenced by smoking being the group of men the one with highest risk in CVLY; MetS was highly influence by physical activity (PA) being again the group of men the one with highest risk in MetS, and smoking did not show any influence. BNs produce an intuitive, transparent, graphical representation of the relationships between different CVRF. The ability of BNs to predict new scenarios when hypothetical information is introduced makes BN modeling an Artificial Intelligence (AI) tool of special interest in epidemiological studies. As CVD is multifactorial the use of BNs seems to be an adequate modeling tool.

[Occupational disability in epilepsy. The assessment criteria]. / La incapacidad laboral en epilepsia. Criterios de valoración.

Epilepsy is a chronic disease cursing with recurrent and paroxysmal crises due to anomalies in the electrical activity of brain, and is controllable in most of the patients by using antiepileptic drugs, in single or combination therapy. Probably one of the most complex aspects of epilepsy is the assessment of disability for work of the affected person. For this purpose, multiple factors need to be taken into account for homogeneous decision-making, and according to criteria of approval and within the principle of equity inherent in the granting of Social Security disability benefits. This requires the cooperation of all professionals involved in the different specialties, with reports using common criteria and taking into account the disease itself, as well as the effects of the prescribed treatments, the effects of which can contribute to the limitations in the performance of certain professions of risk.

[Pain and workplace. Sociodemographic variables influence in therapeutic response and labor productivity]. / Dolor y trabajo. Influencia de variables sociodemográficas en la respuesta terapéutica y la productividad laboral.

INTRODUCTION: Pain is a major cause of medical consultation. The complexity of managing it is due to its long duration and intensity, and it sometimes requires a combination of multiple drugs. The objective of this study is to assess the use of drugs for pain in workers, the clinical response obtained, its influence on estimating work productivity, its relationship to sociodemographic variables, and the type of drug used. MATERIAL AND METHODS: A cross-sectional study on 1,080 workers, aged 18-65 years, during periodic surveys to monitor their health in companies in the service sector in Spain. Treatments used, clinical efficacy, influence on work productivity and sociodemographic variables (age, gender) are evaluated. The Brief Pain Inventory questionnaire, validated for Spain, was used to assess pain, and the SPSS(®) 20.0 package for the statistical analysis. RESULTS: NSAIDs and simple analgesics have higher percentages of improvement in pain (P=.032 and P<.0001, respectively). Men respond better to NSAIDs, and women to simple analgesics. Improved productivity is higher in men than in women (P=.042). No significant differences were observed for age, pain improvement or productivity, except in those over 55 years. CONCLUSIONS: The analgesic prescription pain conditions must consider the age and gender of the patient, as well as the type of drug. The choice of drug should be based on the aetiology and aspects unrelated to the clinical variables, such as sociodemographic, work or psychosocial.

[Dry eye syndrome. Occupational risk factors, valuation and prevention]. / Síndrome del ojo seco. Factores de riesgo laboral, valoración y prevención.

Dry eye syndrome in the workplace is associated with new ways of working, with increasing use of screens and electronic devices and environmental conditions encountered in modern office designs and other environments. Also affect occupational exposure to ionizing radiation, chemicals or atmospheric dust with increased ocular dryness. The study of pathophysiological aspects and laboral causality of the dry eye, must be to develop joint task in Occupational Health, Public Health in coordination with and responsible for the national health system, which would involve primary and secondary preventive measures more effective and proper diagnosis, control and monitoring of the disease, A better knowledge of occupational hazards and actions agreed and coordinated between occupational physicians, preventers, primary care physicians and specialist physicians, such as ophthalmology, will get results much more effective when earlier and optimize available resources.

[Chronic migraine and work: occupational risks and prevention]. / Migraña crónica y trabajo. Riesgos laborales y aspectos preventivos.

Chronic migraine is a clinically difficult to manage primary headache which affects the quality of life of the patients. This impact is important in the occupational world, where along with the clinical aspects of the disease, the therapies used for the control of the symptoms or preventive aspects, must be assessed. The side effects of the drugs and the limitations associated with their symptoms are aspects to highlight in occupational health, especially in individual workplaces, where there is a high risk of work-related injuries. The medical officer must assess the occupational risks of particular importance in the progression of this disease, as well as preventive actions, within the ambit of the current Spanish legislation, that may be favorable for both the company and the worker. The coordinated medical intervention and knowledge of these occupational aspects can provide clinically relevant tools, andoccupational and social optimization in the use of available resources.

[Colorectal cancer in Spain: Temporary disability and preventive occupational strategies]. / El cáncer colorrectal en España. Costes por incapacidad temporal y opciones preventivas desde las empresas.

BACKGROUND: Colorectal cancer is one of the most frequent cancers in both sexes and the most frequent in the developed countries, if men and women are considered together as a group. It has an important associated morbidity and mortality in all countries and constitutes a public health problem with a high direct and indirect economic cost. The number of workdays lost due to temporary disability (TD) is one of the quantifiable references of these indirect costs. AIMS: To determine the indirect cost associated with TD due to colorectal cancer in Spain during the year 2011, a cost that aids in the prevention cost/benefit estimation. METHODS: The number of TD processes, the number of workdays lost due to TD, and the mean duration of those processes, based on the CIE 9-MC codes related to this pathology, as well as the calculated cost, using the Spanish minimum wage as a reference, during the period of January to December 2011, were all reviewed. RESULTS: Colorectal cancer in Spain during 2011 represented 1,046 TD processes, 202,784 workdays lost, and a mean process duration of 194 days/year. The resulting cost of the pathology due to TD was 4,335,521.92 euros. CONCLUSIONS: These results are beneficial for evaluating the usefulness of implementing public health support strategies for a greater reduction in colorectal cancer prevalence and mortality, and an improvement in quality of life of the affected individuals and their families, together with an economic savings resulting from a reduction in TD as a consequence of this disease.

[Work disability criteria in breast cancer]. / Criterios de incapacidad laboral en cáncer de mama.

Breast cancer is one of the most frequent neoplasia in women, with an increasing prevalence in Europe and also in Spain. Although the predominance over the male sex is clear, we should not forget the cases where men are affected, even more so when in this case the risks attached to the type of job become more important. The importance of the indirect costs of this illness arises from: the high prevalence in people of working age, long periods of work disability, and permanent disability when the limitations are incompatible with the work activity once all the options of job readjustment and return to work have been exhausted. We will review the current criteria in order to establish some orientating guidelines that can be useful in the daily practice for Occupational Medicine professionals, General Practitioners and other specialists, always in collaboration with the medical teams from the National Health Service in charge of the evaluation of disabilities.

[Allergies in occupational health. Prevention aspects]. / Las alergias en salud laboral. Aspectos preventivos.

The concern in all countries of occupational health has led to the study of occupational risk factors and their impact on health. But maintaining the health of workers is increasingly complex, especially in occupational allergic diseases, which have increased in parallel with the increased use in industries of potentially irritating chemicals or allergens, leading to skin or respiratory sensitization. Diseases arising from these immunological substances are classified by Spanish Legislation as occupational diseases, as set out in Royal Decree 1299/2006, of November 10, 2006 (Group 1, Group 4 and Group 5). The most important ones in occupational medicine are allergic respiratory diseases and dermatological allergic diseases, although there are other allergies of interest, such as those involving mucous membranes (allergic eye diseases). A joint collaboration between the different medical disciplines involved to improve prevention at work is highly desirable.

Phytate (myo-inositol hexaphosphate) and risk factors for osteoporosis.

Several risk factors seem to play a role in the development of osteoporosis. Phytate is a naturally occurring compound that is ingested in significant amounts by those with diets rich in whole grains. The aim of this study was to evaluate phytate consumption as a risk factor in osteoporosis. In a first group of 1,473 volunteer subjects, bone mineral density was determined by means of dual radiological absorptiometry in the calcaneus. In a second group of 433 subjects (used for validation of results obtained for the first group), bone mineral density was determined in the lumbar column and the neck of the femur. Subjects were individually interviewed about selected osteoporosis risk factors. Dietary information related to phytate consumption was acquired by questionnaires conducted on two different occasions, the second between 2 and 3 months after performing the first one. One-way analysis of variance or Student's t test was used to determine statistical differences between groups. Bone mineral density increased with increasing phytate consumption. Multivariate linear regression analysis indicated that body weight and low phytate consumption were the risk factors with greatest influence on bone mineral density. Phytate consumption had a protective effect against osteoporosis, suggesting that low phytate consumption should be considered an osteoporosis risk factor.

Plan integral de prevención del tabaquismo desde los servicios de prevención: experiencia pionera en Baleares / Integral plan for prevention of tobacco smoking addiction based on the preventive medicine services: a pioneer experience inthe baleric islands

Lograr que los Servicios de Prevención de Baleares estén formados para abordar unplan integral frente al tabaquismo en su respectivas empresas con una metoldología homogénea. Personas y métodos: Partiendo de la experiencia piloto de GESMA se elabora un documento de trabajo donde se recogen las distitnas fases para conseguir la implantación de un programa integral de prevención frente al tabaquismo en la empresa. Se establece un programa formativo, con contenidos teóricos y prácticos, para todos los profesionales sanitarios de los Servicios de Prevención interasados. Finalmente se establece un sistema de tutela para la implantación del programa en las empresas. Resultados: Al programa formativo acuden 57 profesionales que representan a 27 servcios de prevención diferentes (el total de trabajadores representados es superior a 150.000, lo que supone más del 70% de los trabajadores protegidos). El número de servicios que ya han implantado el plan es de 11 (40,74 % d elos que acudieron a la formación). Está previsto que este número aumente durante este año. Conclusiones: Creemos que es importante potenciar el papel de los Servicios de Prevenicón frente al tabaquismo. Consideramos que esta actividad, pionera en España, ha resultado muy útil y que debería valorarse la posibilidad de exportaria al resto de las comunidades (AU)

Aims: To achieve that the Preventive Medicine Services in the Balearic islands may be fully and correctly trained in implementing an integrated plan against tobacco addiction intheir respective enterprises applying a homogeneous methodology. Subjects and methods: Based on the GESMA (Gestión Sanitaria de Mallorca, Mallorca Health Care Management) pilot experience, a working document has been prepared that conjoins and summarises the various phaes for achieving the implementation of an integrated prevention programme against tobaco smoking addiction at the workplace. A training programme with theoretical and practical curricula is established for all health care professionals working in the interested Preventive Medicine Services. Finally, a tutorship system is proposed formimplementing this programme in the various enterprises. Resutls: The activities of the training programme were attended by 57 health care professionals representing 27 independent Preventive Medicine Services (encompassing over 150.000 workers or over 70% of all protected workers). The number of Servies having already implemented the Plan is 11 (40,74%) of those attending the training programme); it is foreseen that this number will increase during the present year. Conclusions; We believe it is important to enhace the role of Preventive Medicien Services against tobacco smoking addiction. We hold that this activity, a pioneer one in Spian, has been quite useful, and that the posibility should be seriously considered to export it to the remainder of the Autonomous Communities in Spain (AU)

Prevalencia del grado de somnolencia diurna en trabajadores pertenecientes al Ministerio de Defensa / Prevalence of daytime sleepiness level between board workers at the Ministry of Defence

Se realiza un estudio descriptivo transversal para valorar la prevalencia de somnolencia diurna en el ámbito laboral mediante la aplicación de la escala de Epworth en 242 trabajadores pertenecientes al ámbito del Ministerio de Defensa. El 27,7% de los trabajadores presentan niveles elevados o excesivos. No se encuentra relación entre los niveles de somnolencia y diversas variables sociodemográficas como edad, sexo o nivel de estudios, pero si con la turnicidad. A tenor de los resultados obtenidos creemos que esta escala es una herramienta útil como screening para detectar de manera precoz posibles alteraciones y que por este motivo incluirse de forma rutinaria en los reconocimientos médicos laborales (AU)

At transverse descriptive study is done for evaluation of daytime sleepiness prevalence in the job place applying the Epworth´s scale to 242 workers of the Ministry of Defence´s board. High or excessive levels were found in 27,7% of them. There´s no supported relationship between somnolence levels and certain social demographic variables like age, sex or studies degree, but it seems to be significant with job turns. With such obtained results, the mentioned scale reveals itself as useful for screening, at the early detection of possible damages. That argues its inclusion in the routine labour health examinations (AU)