[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.

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.

[Migraine medical control and related variables. Results of the European Work and Migraine survey]. / Control médico en migraña y variables relacionadas. Resultados de la encuesta europea Trabajo y Migraña.

OBJECTIVE: This purpose of this work is to determine the care preferences and the required use of medical care by migraine patients in the different countries of Europe, and the observed differences depending on their social and demographic conditions. MATERIAL AND METHODS: Cross-sectional observational study by anonymous web survey of 3,342 patients from Spain, Italy, France, Portugal, Ireland, United Kingdom, Germany, and a mixed group of countries not included in the initial design. VARIABLES: age, gender, country, type of location, level of studies and rural or urban area. The demand for care is collected by neurologist, primary care doctors/family/general practitioners, by occupational health doctors, nurses, by other doctors/other specialists, non-medical control/self-control. RESULTS: The patients more seen by a neurologist were about 21-60years old and with a high cultural level. Primary care/family doctor care is higher in urban areas. Occupational medicine, nursing, and other specialties predominate in large cities. Self-control is greater in patients aged 21-40years and in women. Spain and Germany are the countries with the greatest demand for care in Neurology and Primary Care. CONCLUSIONS: The medical demand for migraine care in Europe shows irregular results according to countries, with it being a priority in neurology and with less participation of Primary Care physicians, work doctors, nurses, or other specialties. Differences are observed by age, gender, and cultural level both in the demand for care and in the choice of specialist. It is important to take into account the percentage of patients who have no medical control.

[Blood pressure and sleep apnoea hypopnoea syndrome in workers. STOP-Bang test versus Epworth test]. / Presión arterial y síndrome de apnea-hipopnea del sueño en trabajadores. Test STOP-Bang frente a la escala de Epworth.

INTRODUCTION: OSAHS is associated with an increased risk of cardiovascular disease and stroke. Arterial hypertension is a key risk factor to consider due to its impact on health. METHOD: Cross-sectional study carried out on Spanish public service workers. The nocturnal apnoea risk using the Epworth and STOP-Bang questionnaires and their influence on the mean values of blood pressure are assessed. RESULTS: The detection of OSAHS using the Epworth test and, particularly with the STOP-Bang shows a significant relationship with the mean values of blood pressure, with differences between both questionnaires. CONCLUSION: The Epworth and STOP-Bang questionnaires are useful for the initial detection of OSAHS and a higher prevalence of high blood pressure. Both can be used in screening procedures in occupational health.

[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.