Riesgo cardiovascular en la población laboral: Impacto en aspectos preventivos / Cardiovascular risk in the working population: Impact on the preventive aspects

Parámetros de obesidad en la población laboral española y la relación con los parámetros de riesgo cardiovascular. Objetivo: Establecer relaciones entre la obesidad y los diferentes parámetros de riesgo cardiovascular que faciliten la implantación de estrategias preventivas en el ámbito laboral. Método: Estudio transversal realizado a 1,447 trabajadores de empresas del sector servicios (terciario) de España. Se parte de los valores de la FAO (Food and Agriculture Organization) para la catalogación de sobrepeso/obesidad y se realiza el estudio bivariante con parámetros analíticos, de obesidad, estilo de vida, cálculo de la edad del corazón y riesgo cardiovascular-Framingham. Resultados: El sobrepeso muestra relaciones estadísticas significativas con riesgo incrementado de hipertensión arterial, glucemia basal y diabetes, incremento de grasa corporal, visceral y perímetro de cintura, menor masa muscular, índices elevados de lípidos, estilos de vida no saludables y coexistencia con patologías de riesgo cardiovascular. Los parámetros de edad del corazón, los años perdidos y Framingham son mayores en personas con sobrepeso. Conclusiones: La actuación preventiva desde las empresas parte de un conocimiento previo de la situación de riesgo cardiovascular de los trabajadores, facilitando una planificación más eficaz y menor coste de las acciones en promoción de la salud e intervención coordinadas con los especialistas involucrados en su control y seguimiento.

Obesity parameters in Spanish working population and its relation to cardiovascular risk parameters. Objective: Linking obesity and cardiovascular risk various parameters to facilitate the implementation of preventive strategies in the workplace. Method: Cross-sectional study of 1,447 workers in companies in the service sector (tertiary) of Spain. Values are part of FAO cataloging of overweight/obesity and bivariate study is performed with laboratory parameters, obesity, lifestyle, age calculation heart and Framingham-cardiovascular risk. Results: Overweight show significant statistical relationships with increased risk of blood pressure, fasting glucose and diabetes, increased body fat, waist circumference and visceral fat, decreased muscle mass, high levels of lipids, unhealthy life styles and coexistence with pathologies of cardiovascular risk. Parameters of heart age, lost years and Framingham are higher in overweight people. Conclusions: Preventive action from companies start with a prior knowledge of the situation of workers relative to cardiovascular risk, thus facilitating better planning and lower cost actions in health promotion and intervention, coordinated with specialists involved in control and monitoring.

[Sick leaves caused by psychiatric diseases in Spain during 2011]. / La incapacidad temporal en España por algunas enfermedades psiquiátricas. (Trastornos esquizofrénicos, trastorno bipolar y trastornos ansiosos, depresivos y adaptativos).

BACKGROUND: Psychiatric and mood disorders may hamper the efficiency of workers and cause absenteeism. MATERIAL AND METHODS: Revision of sick leaves related to schizophrenia, bipolar diseases, anxiety, depression and adaptive disorders that were granted in Spain in the period January- December 2011. The mean number of days off work for each disease and the costs per each labor day lost were calculated. RESULTS: The total number of labor days lost for schizophrenia, bipolar diseases and mood disorders were 72,831; 899,107 and 3,666,055 days, respectively. The mean duration of sick leaves for the same diagnoses were 84; 100 and 64 days/year respectively. The total indirect costs of sick leaves for psychiatric diseases during 2011 were € 100 million approximately, corresponding to 4% of costs for all diseases. CONCLUSIONS: The high costs of absenteeism derived from psychiatric diseases should prompt measures to promote a better adaptation to work environments of people suffering these ailments.

Intensive care unit discharge to the ward with a tracheostomy cannula as a risk factor for mortality: a prospective, multicenter propensity analysis.

OBJECTIVE: To analyze the impact of decannulation before intensive care unit discharge on ward survival in nonexperimental conditions. DESIGN: Prospective, observational survey. SETTING: Thirty-one intensive care units throughout Spain. PATIENTS: All patients admitted from March 1, 2008 to May 31, 2008. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: At intensive care unit discharge, we recorded demographic variables, severity score, and intensive care unit treatments, with special attention to tracheostomy. After intensive care unit discharge, we recorded intensive care unit readmission and hospital survival. STATISTICS: Multivariate analyses for ward mortality, with Cox proportional hazard ratio adjusted for propensity score for intensive care unit decannulation. We included 4,132 patients, 1,996 of whom needed mechanical ventilation. Of these, 260 (13%) were tracheostomized and 59 (23%) died in the intensive care unit. Of the 201 intensive care unit tracheostomized survivors, 60 were decannulated in the intensive care unit and 141 were discharged to the ward with cannulae in place. Variables associated with intensive care unit decannulation (non-neurologic disease [85% vs. 64%], vasoactive drugs [90% vs. 76%], parenteral nutrition [55% vs. 33%], acute renal failure [37% vs. 23%], and good prognosis at intensive care unit discharge [40% vs. 18%]) were included in a propensity score model for decannulation. Crude ward mortality was similar in decannulated and nondecannulated patients (22% vs. 23%); however, after adjustment for the propensity score and Sabadell Score, the presence of a tracheostomy cannula was not associated with any survival disadvantage with an odds ratio of 0.6 [0.3-1.2] (p=.1). CONCLUSION: In our multicenter setting, intensive care unit discharge before decannulation is not a risk factor.

[No traumatic labor accident risk in diabetic patient. View from the Spanish legislation]. / Diabetes, accidente de trabajo y daño laboral. Revisión desde la legislación española.

The Spanish legislation includes the concept of industrial accidents and industrial damage since 1900, although since then in our country some legislative changes have been made, reaching the current Occupational Risk Prevention Law (ORPL) of 1995 and the legislation emanating from it. This is a controversial concept, if we talk about nontraumatic labor injury that carries consequences in the workplace, civil, criminal and contentious administrative disputes, and economic gains. It differs from others in both in qualifying risk and their benefits; the concept also exists in the other European Union countries and in different Spanish-American countries. Therefore the objective of the paper is to discuss the concept of traumatic industrial accident and non-traumatic labor injury in Spain from the point of view of our law and to establish future benchmarks with professionals of other countries around us for enabling collaboration and joint improvement of the safety and about the health of workers.