Occupation and Sickness Absence in the Different Autonomous Communities of Spain.

The occupation of a worker is a determining factor of sickness absence (SA) and can influence both the beginning and continuation of the latter. This study describes SA in Spain, separately in the different Autonomous Communities (AC) in relation to the occupation of workers, with the aim of determining the possible differences in its frequency and duration, relating it also to the diagnosis. A total of 6,543,307 workers, aged 16 years and older, who had at least one episode of SA in the year 2019, constituted the study sample. The obtained results indicate that SA is more frequent and shorter in more elemental occupations. The average duration increases with age and is longer in women, except in technical and administrative occupations, where there is no gender divide. Sickness absences caused by musculoskeletal and mental disorders are more frequent in the lower occupational classes, although their average duration is shorter than in other, more qualified groups. The ACs with shorter duration in almost all the occupational groups are Madrid, Navarre and the Basque Country. In conclusion, SA is more frequent and shorter in lower occupational classes.

Descriptive study of sickness absence in Spanish regions in 2018: database study.

OBJECTIVES: To provide a wide and thorough description of sickness absence (SA) in Spain, focussing on the different regions of the country and the main characteristics of SA. METHODS: A study of the SA spells in Spain, managed by the medical units of the National Institute of Social Security in 2018. The geographical scope of this observational study is the regions (Autonomous Community). Incidence, prevalence, and average duration SA in employees and self-employed are described. The study also describes the differences between non-work-related SA and work-related SA. In age and sex variables, the incidence and the average duration are described. The average duration by Diagnostic Chapters (International Classification of Diseases, 10th Revision (ICD-10)) and the highest number of SA spells by occupational activity and diagnosis are analysed. RESULTS: A total of 540 045 SA spells are analysed by non-work-related SA and 63 441 by work-related SA. The national average prevalence in non-work-related SA spells is 32.98/1000 among employed and 30.48/1000 among self-employed; in work-related SA spells, the prevalence is 3.99/1000. The national incidence in non-work-related SA spells is 24.8/1000 for employees and 9.51/1000 for self-employed workers; in work-related SA spells the incidence is 3.55/1000. The average duration is 58.67 days, with the longest duration being neoplasms and the shortest corresponding to infectious disease. The Community of Madrid shows the lowest prevalence, incidence and average duration in work-related SA. Influenza is the diagnosis that generates the largest number of SA spells. Activities of call centres and temporary employment agency activities are the occupations that have the highest number of SA spells. CONCLUSIONS: The biggest differences are found in the incidence and average duration, between the non-work-related SA spells and work-related SA. If those characteristics of the SA in which a region is more in deficit are known, it will be possible to do better management of the SA.

Herramientas técnicas para el control de prestaciones del sistema de seguridad social / Technical tools for the Benefit Control of the Spanish Social Security System

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[Disability leave and sick leave in Spain. 2016 legislative update]. / Discapacidad e incapacidad laboral en España. Actualización legislativa 2016.

In Spanish, the concepts of discapacidad (disability leave) and incapacidad (sick leave) jointly refer to the impairment of a person due to injuries, diseases or deficiencies that limit their activity in a social, personal or occupational field. However, this common link does not imply that both concepts are the same. Statistical data from INE (Instituto Nacional de Estadística: Statistic National Institute) show that Spain had in 2015 3.85 million persons with a disability (59.8% were women). Statistical data from 2015 from INSS (Instituto Nacional de Seguridad Social: Social Security National Institute) show high levels in the number of processes and in workers affected by temporary sick leave, with social costs to the social security system. Both concepts have been updated: about disability leave, Law 39/2006 adjusted terminology by avoiding the use of concepts with discriminating or pejorative connotation. Regarding sick leave, the Ley General de Seguridad Social (General Social Security Law)has been amended and came into effect in January, 2016. It is necessary to know and distinguish these aspects for a better administrative management, and a more oriented information to the affected patient.

Los conceptos de discapacidad e incapacidad hacen referencia conjuntamente al menoscabo de una persona por lesiones, enfermedades o deficiencias que limitan su actividad en el ámbito social, personal o laboral. Pero este nexo común no implica equiparación entre ambos. Datos estadísticos del 2015 del Instituto Nacional de Estadística (INE) muestran en España 3.85 millones de personas con alguna discapacidad, el 59.8% mujeres. Datos estadísticos del 2015 del Instituto Nacional de la Seguridad Social (INSS), tanto en número de procesos, como de trabajadores afectados por incapacidad muestran cifras elevadas, con costos sociales en prestaciones a cargo de la seguridad social. Ambos conceptos han sido objeto de actualización legislativa: en discapacidad, la Ley 39/2006 ajusta la terminología y evita el uso de conceptos con connotación peyorativa o discriminativa. En incapacidad, la Ley General de la Seguridad Social ha sido modificada y ha entrado en vigor en enero de 2016. Es necesario conocer y diferenciar estos aspectos para una mejor gestión administrativa, e información más orientada al paciente afectado.

Tromboembolismo pulmonar en Medicina del Trabajo / Pulmonary thromboembolism in occupational medicine

El médico del trabajo debe conocer los factores de riesgo y sospechar la presencia de un tromboembolismo pulmonar (TEP) ante un cuadro clínico compatible. El TEP pertenece a las enfermedades cardiovasculares que son la primera causa (40%) de mortalidad en el lugar de trabajo en España, y actualmente pueden considerarse accidente de trabajo por la evolución doctrinal en la interpretación jurisprudencial de la presunción iuris tantum. Presentamos un varón hipertenso y obeso que tras un periodo de reposo relativo, por un esguince de tobillo, presentó un TEP en su puesto de trabajo. La información que nos facilitó un pulsioxímetro portátil (92% SpO2) nos fue de gran ayuda para derivarlo urgentemente al medio hospitalario donde se confirmó el diagnóstico de presunción. Ya sea considerado posteriormente accidente de trabajo o no (en este caso no lo fue), el médico del trabajo está obligado a atender y derivar adecuadamente al trabajador afectado

Occupational physicians should be familiar with the risk factors and clinical presentation of pulmonary thromboembolism (PTE). PTE belongs to the group ofis a cardiovascular diseases, which are the main cause (40%) of death in Spanish workplaces; at present, they may be considered a work-related injury because of the doctrinal evolution in the legal interpretation of the presumption of iuris tantum. We present the case of a hypertensive and obese adult male who suffered a PTE at his workplace. The availability of a portable pulse oximeter (room air SpO2, 92%) was critical in guiding the decision to refer him urgently to the hospital, where the diagnosis was confirmed. We can conclude that, independently of whether this event is later deemed to be work-related (in this case it was not), occupational physicians must know how to correctly manage and refer affected workers

[Pulmonary thromboembolism in Occupational Medicine]. / Tromboembolismo pulmonar en Medicina del Trabajo.

Occupational physicians should be familiar with the risk factors and clinical presentation of pulmonary thromboembolism (PTE). PTE belongs to the group ofis a cardiovascular diseases, which are the main cause (40%) of death in Spanish workplaces; at present, they may be considered a work-related injury because of the doctrinal evolution in the legal interpretation of the presumption of iuris tantum. We present the case of a hypertensive and obese adult male who suffered a PTE at his workplace. The availability of a portable pulse oximeter (room air SpO2, 92%) was critical in guiding the decision to refer him urgently to the hospital, where the diagnosis was confirmed. We can conclude that, independently of whether this event is later deemed to be work-related (in this case it was not), occupational physicians must know how to correctly manage and refer affected workers.

El médico del trabajo debe conocer los factores de riesgo y sospechar la presencia de un tromboembolismo pulmonar (TEP) ante un cuadro clínico compatible. El TEP pertenece a las enfermedades cardiovasculares que son la primera causa (40%) de mortalidad en el lugar de trabajo en España, y actualmente pueden considerarse accidente de trabajo por la evolución doctrinal en la interpretación jurisprudencial de la presunción iuris tantum. Presentamos un varón hipertenso y obeso que tras un periodo de reposo relativo, por un esguince de tobillo, presentó un TEP en su puesto de trabajo. La información que nos facilitó un pulsioxímetro portátil (92% SpO2) nos fue de gran ayuda para derivarlo urgentemente al medio hospitalario donde se confirmó el diagnóstico de presunción. Ya sea considerado posteriormente accidente de trabajo o no (en este caso no lo fue), el médico del trabajo está obligado a atender y derivar adecuadamente al trabajador afectado.

Profesiograma y aptitud laboral. Medicina del Trabajo / Job profile diagram and working aptitude. Occupational Medicine

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