Utilidad clínica de un modelo predictivo de riesgo cardiovascular en trabajadores / Clinical usefulness of a predictive model of cardiovascular risk among workers

La identificación de sujetos con alto riesgo cardiovascular constituye un desafío en población laboral. El proyecto IberScore ha derivado una función predictiva para eventos cardiovasculares a partir de una cohorte de 774.404 trabajadores, sin enfermedad cardiovascular previa y con 10 años de seguimiento. Durante el seguimiento, se identificaron 3.762 primeros eventos cardiovasculares en la cohorte de derivación (6‰; varones 90,7%; media edad=46,9±9,19 años). En el grupo con eventos se observó una presencia importante de factores de riesgo cardiovascular en la evaluación basal (tabaquismo 63,2%; dislipemia 20,6%; hipertensión 21,8%; diabetes 7,9%). Los resultados sugieren la utilidad clínica de un sistema de predicción del riesgo cardiovascular desarrollado específicamente en población trabajadora española. En esta población se produce un número no desdeñable eventos y hay una importante presencia de factores de riesgo, que pueden pasar desapercibidos debido al peso de la edad en los sistemas predictivos desarrollados para la población general

Identification of subjects at high cardiovascular risk is a challenge among working population. The IberScore Project has calculated a predictive function for cardiovascular events from a cohort of 774,404 Spanish workers without prior cardiovascular diseases, and 10-year follow-up. At follow-up, 3,762 first cardiovascular events were identified in the cohort of derivation (6‰; 90.7% men; mean age=46.9±9.19 years-old). In the group with events, it was observed a relevant presence of cardiovascular risk factors at baseline assessment (smoking 63.2%; dyslipidaemia 20.6%; hypertension 21.8%; diabetes 7.9%). The results suggest the clinical usefulness of a system to predict cardiovascular risk among specifically developed in Spanish working population. Among such population a significant number of events take place and there is a relevant presence of risk factors, which may go unnoticed due to the weight that age has in the predictive systems developed for the general population

Root caries analysis in working population of 35-44 years of age (Spain)

Background: The aim of this study was to analyse the influence of socio-demographic variables, toothbrushing frequency, frequency of snacking between meals, and tobacco and alcohol consumption, in root caries in the Spanish working population of Valencia and Murcia regions. Material and Methods: Cross sectional study of 458 workers 35-44 years of age, who underwent a routine workrelated check-up, from June 2009 to April 2010, and were also examined, following the WHO methodology, by a calibrated dentist. Stratified random sampling. Participants fulfilled a questionnaire comprising demographic data, toothbrushing frequency, snacking frequency and tobacco and alcohol consumption. Results: The DFS index (root caries) in the employed population of 35-44 years was 0.45 ± 1.3, with a root caries prevalence of 18.6% and an active root caries prevalence of 13.5%. Higher root caries prevalence and active root caries prevalence were associated with male gender, manual occupations, foreign country of origin, lower levels of education and income, lower brushing frequency and higher frequency of snacking between meals. The DFS index was associated with all studied socio-demographic variables, but gender, and it was also associated with brushing frequency. The mean number of root decayed teeth was associated with all socio-demographic variables, but country of origin, and it was also associated with brushing frequency. Conclusions: Adult workers 35-44 years of age showed worse root condition in regard to caries than general population of this age cohort. In this study, the frequency of toothbrushing and snacking between meals were the variables that influenced more in root caries (AU)

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Impacto de las nuevas guías estadounidense y británica en el manejo y el tratamiento de las dislipemias en una población laboral española / Impact of the New American and British Guidelines on the Management and Treatment of Dyslipidemia in a Spanish Working Population

Introducción y objetivos: La guía para el manejo y el tratamiento de las dislipemias del American College of Cardiology/American Heart Association estadounidense y la del National Institute for Health and Clinical Excellence británico recomiendan cambios importantes, como la supresión de los objetivos terapéuticos o la utilización de unas tablas de riesgo nuevas. Este estudio pretende evaluar el impacto de utilizar estas nuevas guías en comparación con lo que supone la aplicación de la guía europea. Métodos Estudio de tipo observacional realizado en trabajadores españoles. Se incluyó a todos los trabajadores reconocidos por la Sociedad de Prevención de Ibermutuamur durante el año 2011 y cuyo riesgo cardiovascular era evaluable. De cada sujeto, se calculó el riesgo cardiovascular utilizando las tablas Systematic Coronary Risk Evaluation para países de bajo riesgo y las tablas recomendadas por las guías estadounidense y británica. Resultados: Se incluyó a 258.676 trabajadores (el 68,2% varones; media de edad, 39,3 años). Según las tablas Systematic Coronary Risk Evaluation, el 3,74% de la población resultó ser de alto riesgo, mientras que según las tablas británicas eran el 6,85% y según las tablas estadounidenses, el 20,83%. Se debería tratar a más de 20.558 trabajadores si se sigue la guía estadounidense, 13.322 con la británica y 2.612 siguiendo las recomendaciones de las sociedades europeas. Con la guía estadounidense, el coste diario de estatinas se multiplicaría casi por 8. Conclusiones: La nuevas recomendaciones supondrían identificar a más pacientes de alto riesgo y tratar con hipolipemiantes a más población que con las recomendaciones europeas, lo que aumentaría los costes (AU)

Introduction and Objectives The guidelines of the American College of Cardiology/American Heart Association and the British National Institute for Health and Clinical Excellence on the management and treatment of dyslipidemia recommend significant changes, such as the abolition of therapeutic targets and the use of new risk tables. This study aimed to evaluate the impact of the use of these new guidelines compared with the application of European guidelines. Methods Observational study conducted among Spanish workers. We included all workers registered with the Sociedad de Prevención de Ibermutuamur in 2011 whose cardiovascular risk could be evaluated. Cardiovascular risk was calculated for each worker using the Systematic Coronary Risk Evaluation cardiovascular risk tables for low-risk countries, as well as the tables recommended by the American and British guidelines. Results A total of 258 676 workers were included (68.2% men; mean age, 39.3 years). High risk was found in 3.74% of the population according to the Systematic Coronary Risk Evaluation tables and in 6.85% and 20.83% according to the British and American tables, respectively. Treatment would be needed in 20.558 workers according to the American guidelines and in 13.222 according to the British guidelines, but in only 2612 according to the European guidelines. By following the American guidelines, the cost of statins would increase by a factor of 8. Conclusions: The new recommendations would result in identifying more high-risk patients and in treating a larger fraction of the population with lipid-lowering drugs than with the European recommendations, which would result in increased costs (AU)

Impact of the new American and British guidelines on the management and treatment of dyslipidemia in a Spanish working population.

INTRODUCTION AND OBJECTIVES: The guidelines of the American College of Cardiology/American Heart Association and the British National Institute for Health and Clinical Excellence on the management and treatment of dyslipidemia recommend significant changes, such as the abolition of therapeutic targets and the use of new risk tables. This study aimed to evaluate the impact of the use of these new guidelines compared with the application of European guidelines. METHODS: Observational study conducted among Spanish workers. We included all workers registered with the Sociedad de Prevención de Ibermutuamur in 2011 whose cardiovascular risk could be evaluated. Cardiovascular risk was calculated for each worker using the Systematic Coronary Risk Evaluation cardiovascular risk tables for low-risk countries, as well as the tables recommended by the American and British guidelines. RESULTS: A total of 258,676 workers were included (68.2% men; mean age, 39.3 years). High risk was found in 3.74% of the population according to the Systematic Coronary Risk Evaluation tables and in 6.85% and 20.83% according to the British and American tables, respectively. Treatment would be needed in 20 558 workers according to the American guidelines and in 13,222 according to the British guidelines, but in only 2612 according to the European guidelines. By following the American guidelines, the cost of statins would increase by a factor of 8. CONCLUSIONS: The new recommendations would result in identifying more high-risk patients and in treating a larger fraction of the population with lipid-lowering drugs than with the European recommendations, which would result in increased costs.

Hábitos de higiene bucodental en la población trabajadora española / Oral hygiene habits in the Spanish working population

Objetivo: analizar los hábitos de higiene bucodental de la población trabajadora española. Método: estudio observacional de una muestra de 5.176 trabajadores que acudieron a realizarse un examen de Salud Laboral entre abril de 2008 y junio de 2011. Muestreo estratificado aleatorio. Los participantes completaron un Cuestionario sobre Salud Bucodental con información sobre variables demográficas, laborales y hábitos de salud bucodental. Resultados: el 63,7% de los sujetos (IC 95%: 62,4-65,0) refirieron cepillarse los dientes más de una vez al día (82,6% de las mujeres y 50,9% de los hombres), mientras que el 60,6% (IC 95%: 59,2-62,0) no usaban la seda dental y solo un 6,4% (IC 95%: 5,7-7,1) lo hacían más de una vez al día. Los hábitos de higiene más deficitarios se asociaron con ser varón, ocupaciones manuales y menores estudios e ingresos (p<0,05). Los hábitos de higiene bucodental de la población trabajadora española presentan importantes áreas de mejora (AU)

Methods: a cross sectional study of 5,176 workers, who underwent a routine work-related medical check-up from April 2008 to June 2011. Stratified random sampling. Participants fulfilled a questionnaire comprising demographic, occupational and oral hygiene habits items. Results: 63.7% (CI 95% 62.4-65.0) of workers referred to brush their teeth more than once per day (82.6% of females and 50.9% of males), while 60.6% (CI 95% 59.2-62.0) of them referred not to floss at all, and only 6.4% (CI 95% 5.7-7.1) of workers used dental floss more than once per day. Poorer oral hygiene habits were associated with male workers, blue-collar occupations, lower income and lower education level (p<0.05). Our results suggest that oral hygiene habits in the Spanish working population show important areas for improvement (AU)

[Prevalence of tobacco consumption among working population after the law 42/2010, Spain]. / Prevalencia de consumo de tabaco en población trabajadora tras la entrada en vigor de la Ley 42/2010.

BACKGROUND: The aim of this study was to analyze the impact on tobacco consumption among working population of the Law 42/2010, which amends smoking regulations in Spain. METHODS: Data were obtained from 413,473 Occupational Health check-ups, conducted between July of 2009 and June of 2011, in the Society for Prevention of a Mutual Insurance Company. We analyzed changes in the biannual percentage of smokers and the magnitude of tobacco consumption among smokers in the overall set of medical check-ups, by gender, age, occupational level (manual vs. non-manual workers), and in the specific occupational subgroup of waiters, barmen and similar workers (chi-square test). RESULTS: In the overall set of medical check-ups, the percentage of smokers decreased by 5% (from 40.3% to 35.3%) over the period of study (p <0.001) and the group of smokers with lower daily consumption (< 10 cigarettes) became the most frequent (p <0.001). In the group of waiters, barmen and similar workers the differences in the biannual percentage of smokers did not reach statistical significance (p =0.07). In this group, smokers of < 10 cigarretes/ day also became the most common consumption group (increasing from 40.5% to 48.8%) and the percentage of 21-40 cigarretes/day decreased from 10.6% to 4% (p =0.008). CONCLUSIONS: These results suggest that the new regulation has been accompanied by a significant reduction in smoking among Spanish workers and strongly support population-level measures against tobacco consumption.

Sobrepeso y obesidad en personal médico en España; resultados del estudio ICARIA / Overweight and obesity among physicians in Spain; results from the ICARIA Study

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Prevalencia de consumo de tabaco en población trabajadora tras la entrada en vigor de la Ley 42/2010 / Prevalence of tobacco consumption among working population after the Law 42/2010, Spain

Fundamentos: El objetivo del presente trabajo consistió en analizar el impacto sobre el consumo de tabaco en población trabajadora de la Ley 42/2010 que modifica la normativa antitabaco en España. Métodos: Se obtuvieron datos de 413.473 reconocimientos médicos de Salud Laboral, realizados entre julio de 2009 y junio de 2011, en la Sociedad de Prevención de una Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social. Se analizó la evolución semestral del porcentaje de fumadores y la magnitud del consumo de tabaco en el total de reconocimientos, segmentando por sexo, edad, nivel ocupacional (trabajos manuales vs. no manuales) y en el subgrupo específico de camareros, bármanes y asimilados (test de chi2). Resultados: En el total de reconocimientos, el porcentaje de fumadores descendió un 5% (del 40,3% al 35,3%) a lo largo del periodo de estudio (p<0,001) y el grupo de fumadores con menor consumo diario (≤10 cigarrillos) se convirtió en el más frecuente (p<0,001). En el grupo de camareros, bármanes y asimilados las diferencias en el porcentaje semestral de fumadores no alcanzaron significación estadística (p=0,07). En este grupo, los fumadores de ≤10 cigarrillos/día también se convirtieron en el grupo de consumo más frecuente (pasando del 40,5% al 48,8%) y el porcentaje de fumadores de 21-40 cigarrillos/día disminuyó del 10,6% al 4% (p=0,008). Conclusiones: Los resultados sugieren que la nueva normativa se ha acompañado de una importante reducción del tabaquismo entre la población trabajadora española y respaldan fuertemente las medidas de lucha contra el tabaco de alcance poblacional(AU)

Background: The aim of this study was to analyze the impact on tobacco consumption among working population of the Law 42/2010, which amends smoking regulations in Spain. Methods: Data were obtained from 413,473 Occupational Health check-ups, conducted between July of 2009 and June of 2011, in the Society for Prevention of a Mutual Insurance Company. We analyzed changes in the biannual percentage of smokers and the magnitude of tobacco consumption among smokers in the overall set of medical check-ups, by gender, age, occupational level (manual vs. non-manual workers), and in the specific occupational subgroup of waiters, barmen and similar workers (chi-square test). Results: In the overall set of medical check-ups, the percentage of smokers decreased by 5% (from 40.3% to 35.3%) over the period of study (p <0.001) and the group of smokers with lower daily consumption (≤ 10 cigarettes) became the most frequent (p <0.001). In the group of waiters, barmen and similar workers the differences in the biannual percentage of smokers did not reach statistical significance (p =0.07). In this group, smokers of ≤ 10 cigarretes/ day also became the most common consumption group (increasing from 40.5% to 48.8%) and the percentage of 21-40 cigarretes/day decreased from 10.6% to 4% (p =0.008). Conclusions: These results suggest that the new regulation has been accompanied by a significant reduction in smoking among Spanish workers and strongly support population-level measures against tobacco consumption(AU)

Prevalencia de peso insuficiente, sobrepeso y obesidad en población laboral activa española / Prevalence of underweight, normal weight, overweight, obesity and excess weight the in Spanish active working population

Objetivo: Determinar la prevalencia de peso insuficiente, normopeso, sobrepeso, obesidad y sobrecarga ponderal en poblaciónlaboral activa española.Métodos: Estudio descriptivo transversal de prevalencia con base poblacional en el que participaron 374.562 trabajadoresde las diferentes comunidades autónomas españolas, realizado en 2008. Para la determinación del peso insuficiente, normopeso,sobrepeso, obesidad y sobrecarga ponderal se realizaron mediciones ponderales individuales, calculándose el índicede masa corporal (peso/talla en metro2) y aplicando los criterios del Consenso SEEDO de 2007.Resultado: La prevalencia global de peso insuficiente, normopeso, sobrepeso, obesidad y sobrecarga ponderal fue, respectivamente,1,4%, 41,1%, 40,1%, 17,5% y 57,5%, Las mujeres presentaron una prevalencia mayor para el peso insuficiente,mientras que en los hombres lo fue para el sobrepeso y la obesidad. Por comunidades el peso insuficiente fue más prevalenteen La Rioja y la mayor sobrecarga ponderal se encontró en Castilla-La Mancha y Andalucía.Conclusiones: Es muy elevado el exceso de peso en la población trabajadora española estudiada, con una tendencia alalza en los últimos años. Se recomiendan medidas intervencionistas para mejorar esta situación. Los datos registrados eneste estudio pudieran servir de referencia para este colectivo de la población(AU)

Objective: To determine the prevalence of underweight, normal weight, overweight, obesity and excess weight in theSpanish active working population.Methods: A cross-sectional study of population-based prevalence, involving 374,562 workers from different Spanishregions, conducted in 2008. We measured weight and height and calculated the body mass index [BMI] (weight/height in meter2) applying the criteria of the Spanish Society for the Study of Obesity (SEEDO). Results: The overall prevalence of underweight, normal weight, overweight, obesity and excess weight was 1.4%, 41.1%,40.1%, 17.5% and 57.5%, respectively. Women had a higher prevalence of underweight, while in men it was for overweightand obesity. Underweight was more prevalent in La Rioja region, while excess weight were more common in the Castilla-La Mancha and Andalusia regions.Conclusions: Excess weight in the Spanish working population studied was very high, with an upward trend in recentyears. Intervention measures are recommended to improve this situation. The data recorded in this study may serve as referencefor this population(AU)

Prevalencia de peso insuficiente en trabajadores jóvenes atendidos por la Sociedad de Prevención de Ibermutuamur durante el año 2008 / Underweight prevalence among young workers evaluated by the society for the prevention of ibermutuamur during 2008

Objetivos: El propósito de este trabajo es evaluar la prevalencia del peso insuficiente en población trabajadora activa menor de 25 años por comunidades autónomas españolas. Material y método: Estudio observacional transversal en el que se evaluaron 42.086 trabajadores entre el 1/01/2008 y el 31/12/2008. El peso insuficiente se definió como IMC < 18,5. Resultados: Se encontraron 1.716 casos con peso insuficiente para una prevalencia global del 4,08%; 959 mujeres (8,02%) y 757 hombres (2,51%), con diferencias significativas entre comunidades. Conclusiones: La prevalencia de peso insuficiente encontrada indica que es un problema frecuente al que hay que prestarle atención. Tendría interés incluir este tipo de cribado para la detección temprana de estos casos, con la consiguiente posibilidad de un tratamiento precoz y una mejora de la salud. Recomendamos ontinuar profundizado en este tipo de cribados y aplicar las adecuadas estrategias preventivas (AU)

Objective: The purpose of this study was to evaluate the prevalence of underweight in active working population in Spain by Autonomous Community. Design: This is a cross-sectional study in which workers were studied 42,086 young people between 1/01/2008 and 31/12/2008. Underweight was defined as BMI < 18.5. Results: Of the 42,086 workers studied, 1,716 cases were underweight for an overall prevalence of 4.08%; 959 women (8.02%) and 757 men (2.51%). The differences found between communities were significant. Conclusions: Underweight prevalence among young workers found indicates a common problem that needs attention. Deepened interest to continue such screening and apply appropriate preventive strategies (AU)