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1.
J. Health NPEPS ; 6(1)jun. 2021.
Artículo en Portugués | LILACS | ID: biblio-1147344

RESUMEN

Objetivo: analisar a letalidade da COVID-19 por sexo e idade entre os profissionais de saúde do Estado Pará, Brasil. Método: estudo epidemiológico e observacional, com utilização de dados secundários públicos sobre casos e óbitos acumulados por COVID-19 e dados demográficos, entre março e outubro de 2020. O número de casos e óbitos por COVID-19 ocorridos entre profissionais de saúde foram comparados em relação à idade e ao sexo pelo teste qui-quadrado, seguido por regressão logística pelo método Backward Stepwise de Wald. Resultados: entre os 15.332 casos confirmados de COVID-19, 70,3% eram do sexo feminino e 61,3% com idade entre 30 a 49 anos (39,2±11,6 anos). Registraram-se 97 óbitos, com uma taxa de letalidade de 0,6%. A probabilidade de óbito foi 52,8 vezes (20,7-134,5) e 4,0 vezes (2,5-6,2) maior entre jovens e homens quando comparados às demais notificações. Conclusão: a taxa de letalidade entre os profissionais de saúde é alta, especialmente entre homens jovens. Este é um alerta sobre os impactos da doença entre os trabalhadores da saúde e suscita ao poder público, especificamente ao setor saúde melhores condições de trabalho e políticas de saúde do trabalhador.(AU)


Objective: to analyze the lethality of COVID-19 by sex and age among health professionals in the state of Pará, Brazil. Method: epidemiological and observational study, using public secondary data on cases and deaths accumulated by COVID-19 and demographic data, between March and October 2020. The number of cases and deaths by COVID-19 that occurred among health professionals were compared in relation to age and sex using the chi-square test, followed by logistic regression using Wald's Backward Stepwise method. Results: among the 15,332 confirmed cases of COVID-19, 70.3% were female and 61.3% aged between 30 and 49 years (39.2 ± 11.6 years). 97 deaths were recorded, with a fatality rate of 0.6%. The probability of death was 52.8 times (20.7-134.5) and 4.0 times (2.5-6.2) higher among young men and men when compared to other reports. Conclusion: the lethality rate among health professionals is high, especially among young men. This is an alert about the impacts of the disease among health workers and raises the public authorities, specifically the health sector, better working conditions and worker health policies.(AU)


Objetivo: analizar la letalidad de COVID-19 por sexo y edad en profesionales de la salud en el estado de Pará, Brasil. Método: estudio epidemiológico y observacional, utilizando datos secundarios públicos sobre casos y defunciones acumulados por COVID-19 y datos demográficos, entre marzo y octubre de 2020. Se comparó el número de casos y defunciones por COVID-19 ocurridos entre profesionales de la salud en relación con edad y sexo usando la prueba de chi-cuadrado, seguida de regresión logística usando el método de Wald Backward Stepwise. Resultados: entre los 15.332 casos confirmados de COVID-19, el 70,3% eran mujeres y el 61,3% tenían entre 30 y 49 años (39,2 ± 11,6 años). Se registraron 97 muertes, con una tasa de letalidad del 0,6%. La probabilidad de muerte fue 52,8 veces (20,7-134,5) y 4,0 veces (2,5-6,2) más grande entre hombres y jóvenes en comparación con otros informes. Conclusión: la tasa de letalidad entre los profesionales de la salud es alta, especialmente entre los hombres jóvenes. Se trata de una alerta sobre los impactos de la enfermedad entre los trabajadores de la salud y plantea a las autoridades públicas, específicamente al sector salud, mejores condiciones laborales y políticas de salud laboral.(AU)


Asunto(s)
Humanos , Salud Laboral , Personal de Salud/estadística & datos numéricos , Infecciones por Coronavirus/mortalidad , Política de Salud , Brasil , Estudios Epidemiológicos
2.
Artículo en Inglés | MEDLINE | ID: mdl-33799465

RESUMEN

Due to the coronavirus disease 2019 (COVID-19) pandemic, outpatient caregivers are exposed to new serious health threats at work. To protect their health, effective occupational health and safety measures (OHSM) are necessary. Outpatient caregivers (n = 15) participated in semi-structured telephone interviews in May/June 2020 (1) to examine the pandemic-related OHSM that have been implemented in their outpatient care services, as well as (2) to identify their corresponding unmet needs. Interviews were recorded, transcribed and analysed by using qualitative content analysis in accordance with Mayring. Available OHSM in outpatient care services described by outpatient caregivers mainly included personal protective equipment (PPE) and surface disinfection means after an initial shortage in the first peak of the pandemic. Further OHSM implied social distancing, increased hygiene regulations and the provision of pandemic-related information by the employer, as well as the possibility to consult a company doctor. Our study revealed that OHSM were largely adapted to the health threats posed by COVID-19, however an optimum has not yet been achieved. There is still a need for improvement in the qualitative and quantitative supply of PPE, as well as on the organisational level, e.g., with regard to the development of pandemic plans or in work organisation.


Asunto(s)
Salud Laboral , Atención Ambulatoria , Humanos , Pandemias/prevención & control , Equipo de Protección Personal
3.
Revista Digital de Postgrado ; 10(1): 255, abr. 2021. ilus
Artículo en Español | LILACS, LIVECS | ID: biblio-1147589

RESUMEN

A principios del nuevo milenio surgió el concepto del "Trauma urbano moderno", sustentando en la experiencia de varios conflagraciones en zonas densamente pobladas. Fue definido como un conflicto violento, cerrado, con heridas destructivas y de difícil acceso para su evacuación. Su manejo incluyo el cuestionamiento de viejos dogmas y la incorporación de nuevas estrategias. El motín del reten "La Planta", el incremento en las detonaciones por granadas fragmentarias y los graves enfrentamientos entre bandas delictivas o contra cuerpos de seguridad, en diversas zonas de Caracas indican el establecimiento de una modalidad mas agresiva de violencia. Los cirujanos capitalinos se enfrentan con más frecuencia a lesiones severas y múltiples. El personal medico requiere la adecuada comprensión y preparación para afrontar este nuevo tipo de heridas. La reciente enfermedad Covid 19 representa un desafió agregado en el abordaje de los pacientes con traumatismos(AU)


The experience in many combats in densely populated urban areas, determined the new concept of "Modern urban warfare" in the beginning of the new millennium. This definition is a warfare violent, close-quarter, with destructive injuries and the delayed of evacuation. New innovations were incorporate. The revolt in the "La Planta" prison, the increase of grenades explosions and engagement between criminal organized, in many zones of Caracas, illustrated this new definition. The venezuelans surgeons attended many severe and multiple injuries. The surgical personal need understand this new kind of injuries. The new disease Covid 19 represents a challenge in the attention of these patients(AU)


Asunto(s)
Humanos , Masculino , Femenino , Población Urbana , Violencia , Heridas y Traumatismos , Mortalidad , Personal de Salud , Violencia con Armas , Prisiones , Adaptación Psicológica , Salud Laboral , Infecciones por Coronavirus
4.
Nephrol Nurs J ; 48(1): 49-55, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33683843

RESUMEN

This article describes the impact of a 12-week workplace wellness program on staff (n = 14) of an outpatient hemodialysis center. The program focused on decreasing dietary sodium and increasing habitual physical activity. The average systolic and diastolic blood pressure of participants decreased by 16.9±21.6 mmHg (p < 0.05) and 4.1±14.0 mmHg (p < 0.05), and body weight decreased by 2.7±1.9kg (p < 0.05). The mean step count at baseline was 7,052±3,278 but increased to 10,388±2,882 (p < 0.05) during a walking challenge. There was a reduction in self-reported barriers to making healthy nutritional changes (p < 0.05) and engaging in habitual physical activity (p < 0.05). Our pilot findings suggest that workplace wellness programs in hemodialysis centers are feasible and effective.


Asunto(s)
Instituciones de Atención Ambulatoria , Salud Laboral , Diálisis Renal , Dieta Hiposódica , Ejercicio Físico/psicología , Humanos , Proyectos Piloto , Evaluación de Programas y Proyectos de Salud , Autoinforme
5.
Medicine (Baltimore) ; 100(9): e24830, 2021 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-33655945

RESUMEN

ABSTRACT: Low back pain (LBP) is one of the most common symptoms of work-related musculoskeletal disorders in pharmacists. This can impede the physical functions of the body and lead to incapacitation, resulting in significant social and economic burden. This study aimed to investigate the incidence and risk factors that correlate with LBP in Taiwanese pharmacists.A retrospective cohort study was conducted among all registered pharmacists aged 20 to 40 years using the National Health Insurance Research Database (2000-2013) in Taiwan. The LBP diagnosis was confirmed with one episode of hospitalization or at least three claimed outpatient visits for LBP. Data on workplace characteristics as well as comorbidities were also collected for the analyses. A Cox proportional hazard regression was used to estimate the risk factors for LBP.The incidence rate of LBP among pharmacists was 16.60% in this study. Older pharmacists (28.49%; P < .01) and those who worked at district hospitals (23.51%; P < .01) showed a higher proportion of LBP. Furthermore, after adjustment for selected potential confounding factors, female pharmacists [adjusted hazard ratio (aHR): 1.12, 95% confidence interval (95% CI): 1.01-1.24, P = .0354] and pharmacists with diabetes (aHR: 1.55; 95% CI: 1.20-2.01; P = .0008) and gout (aHR: 1.70; 95% CI: 1.37-2.09; P < .0001) had significantly higher risks of LBP.In conclusion, age was positively correlated with LBP, and the workplace was an important factor in the development of LBP in pharmacists. We suggest that pharmacists who work in district hospitals should pay more attention to the development of LBP.


Asunto(s)
Dolor de la Región Lumbar/epidemiología , Enfermedades Profesionales/epidemiología , Salud Laboral , Farmacéuticos/estadística & datos numéricos , Vigilancia de la Población/métodos , Lugar de Trabajo/normas , Adulto , Femenino , Humanos , Dolor de la Región Lumbar/diagnóstico , Dolor de la Región Lumbar/etiología , Masculino , Persona de Mediana Edad , Enfermedades Profesionales/etiología , Dimensión del Dolor , Estudios Retrospectivos , Factores de Riesgo , Encuestas y Cuestionarios , Taiwán/epidemiología , Adulto Joven
6.
Pan Afr Med J ; 38: 27, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33777295

RESUMEN

Introduction: long-distance truck drivers have been identified as a high-risk group for coronavirus disease (COVID-19) infection. Thus, the aim of this scoping review is to map out the existing evidence on the impact of long-distance truck drivers on the spread of COVID-19 and measures that countries can implement to mitigate this route of spread in the African region. Methods: we searched the PubMed database and the website of the World Health Organization (WHO) in March 2020 for eligible studies. Results: the search strategy identified 669 citations, of which six met the inclusion criteria. The most frequently reported interventions were maintaining hand hygiene, social distance, testing truck drivers, regulation of trade and transport e.g. only trucks with the food, medical supplies, fuels, agricultural supplies will be allowed to operate in interstate operations and regulating and controlling trucks carrying essential goods and services e.g. truck drivers are required to declare their final destination and are urged to stop only at designated points. Two studies from the African region reported about border closures and entry and exit screening, two studies from the US reported about the threat for public safety and risks and mitigation plans and 2 guidelines reported about harmonisation and facilitation of cross border in the context of the COVID-19 outbreak. Conclusion: this review highlights the countries response to mitigate the impact of the pandemic by implementing measures to facilitate safe cross-border trade and adopting regional harmonization of trucking regulations.


Asunto(s)
Conducción de Automóvil/estadística & datos numéricos , Exposición Profesional , África/epidemiología , Brotes de Enfermedades , Higiene de las Manos/normas , Humanos , Vehículos a Motor , Salud Laboral , Factores de Riesgo
9.
Soc Work Health Care ; 60(1): 8-29, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33657982

RESUMEN

The COVID-19 pandemic has wrought widespread devastation upon children and families across the United States, widening existing health disparities and inequities that disproportionately affect communities of color. In health care settings specifically, social work is the key workforce tasked with responding to patient and family psychosocial needs, both of which have increased substantially since the emergence of COVID-19. There is a need to understand ways in which hospital social workers' roles, responsibilities, and integration within interprofessional teams have evolved in response to these challenges. In this qualitative study, focus groups were conducted with 55 social workers employed across multiple settings in a large, urban, pediatric hospital in Spring 2020. Thematic analyses revealed salient superordinate themes related to the pandemic's impact on social work practice and social workers themselves, institutional facilitators and impediments to effective social work and interprofessional practice, and social work perspectives on future pandemic recovery efforts. Within each theme, a number of interrelated subthemes emerged elucidating nuances of telehealth adoption in the context of remote work, the salience of social determinants of health, and the critical role of social work in social justice oriented pandemic preparedness and response efforts. Implications for interprofessional practice and the profession at large are discussed.


Asunto(s)
/epidemiología , Servicio Social/organización & administración , Trabajadores Sociales/psicología , Grupos Focales , Procesos de Grupo , Humanos , Relaciones Interprofesionales , Salud Laboral , Pandemias , Grupo de Atención al Paciente/organización & administración , Rol Profesional , Investigación Cualitativa , Administración de la Seguridad/organización & administración , Servicio Social/normas , Factores Socioeconómicos , Telemedicina/organización & administración , Estados Unidos/epidemiología
10.
Pneumologie ; 75(3): 201-205, 2021 Mar.
Artículo en Alemán | MEDLINE | ID: mdl-33728629

RESUMEN

The S2k guideline "Diagnostics and assessment of occupational asbestos-related diseases" was updated in November 2020. This article summarizes the most important changes. There is a new reference to the risk of potentially high exposures to asbestos fibers when renovating plaster, fillers and adhesives containing asbestos.Biomarkers such as mesothelin and calretinin should currently only be used in the context of research. The "asbestos airways disease", which can only be diagnosed histologically, is included in the guideline as an early form of asbestosis. Since the UIP pattern is not characteristic of asbestosis, computed tomography cases with UIP patterns alone cannot be assigned reliably to asbestosis without the simultaneous detection of pleural plaques. With regard to the evaluation of the functional damage, attention is drawn to the importance of flow volume curve, whole-body plethysmography, diffusion capacity and exercise testing. If available, the reference values ​​according to GLI are the basis of the assessment. The guideline contains specific recommendations on prevention, medical treatment and, for the first time, on the importance of outpatient rehabilitation and training therapy. There are also references to the assessment of the new occupational disease ovarian cancer after occupational exposure to asbestos.


Asunto(s)
Asbestos , Asbestosis , Enfermedades Profesionales , Exposición Profesional , Enfermedades Pleurales , Asbestos/toxicidad , Asbestosis/diagnóstico , Humanos , Enfermedades Profesionales/diagnóstico , Exposición Profesional/efectos adversos
11.
Artículo en Chino | MEDLINE | ID: mdl-33781044

RESUMEN

To project the basis of occupational health examination quality assessment, and put forward advices for cheking: the quality and safety of occupational health examination, assessment requirements, the key points on-site, utilization of the quality assessment results. Total quality control (TQC) contains basic quality, link quality, final quality and front, middle, back of the quality in occupational health examination.


Asunto(s)
Salud Laboral , Examen Físico , Control de Calidad
12.
J Occup Health ; 63(1): e12209, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33665926

RESUMEN

OBJECTIVE: The COVID-19 pandemic has caused devastating damage to employment globally, particularly among the non-standard workforce. The objective of this study was to identify the effects of the pandemic on the employment status and lives of working students in Japan. METHODS: The Labour Force Survey (January 2019 to May 2020) was used to examine changes in students' work situations. In addition, to investigate the economic and health conditions of university students during the pandemic, the Student Lifestyle Survey was conducted in late May 2020. This survey asked students at a national university in Tokyo about recent changes in their studies, work, and lives. RESULTS: The number of working students reported in the Labour Force Survey has declined sharply since March 2020, falling by 780,000 (46%) in April. According to a survey of university students' living conditions, 37% were concerned about living expenses and tuition fees, and a higher percentage of students who were aware of financial insecurity had poor self-rated health. CONCLUSION: Nearly half of working students have lost their jobs during the pandemic in Japan, which has affected their lives, studies, and health. There is a need to monitor the impact of economic insecurity on students' studies and health over time, and to expand the safety net for disadvantaged students.


Asunto(s)
/psicología , Empleo/psicología , Estilo de Vida , Salud Laboral/estadística & datos numéricos , Estudiantes/psicología , Adaptación Psicológica , Adulto , Empleo/estadística & datos numéricos , Femenino , Humanos , Japón , Masculino , Salud Mental/estadística & datos numéricos , Estudiantes/estadística & datos numéricos , Equilibrio entre Vida Personal y Laboral , Adulto Joven
14.
Artículo en Chino | MEDLINE | ID: mdl-33691376

RESUMEN

Objective: To understand the basic situation of noise hazards in wood furniture manufacturing, stone processing and special equipment manufacturing industries in Shenzhen City, and to provide basis for preventing and controlling noise hazards. Methods: In August 2019, stratified random sampling ws used to select 21 wood funiture manafacturing, 15 stone processing and 24 special equipment manufactruing as survey object. Through the methods of occupational health field investigation, noise intensity measurement and occupational health examination data collection, the noise hazards of 60 enterprises in three industries were statistically analyzed. Results: There were 154, 44 and 113 noise detection points in wood furniture manufacturing, stone processing and special equipment manufacturing enterprises, and 101, 27 and 78 out of standard points respectively, and the exceeding standard rates were 65.6% (101/154) , 61.4% (27/44) and 69.0% (78/113) , respectively. There were 1670, 172 and 856 workers exposed to noise in the three industries. Among them, 1198, 134 and 703 people had taken occupational health examination. The physical examination rates were 71.7% (1198/1670) , 77.9% (134/172) and 82.1% (703/856) , respectively. The abnormal rates were 19.1% (229/1198) , 51.5% (69/134) and 37.8% (266/703) , respectively. Conclusion: High intensity noise working environment, too long noise exposure time, incorrect wearing of personal protective equipment and neglect of occupational health examination are important reasons for hearing loss of noise exposed personnel.


Asunto(s)
Pérdida Auditiva Provocada por Ruido , Ruido en el Ambiente de Trabajo , Enfermedades Profesionales , Exposición Profesional , Salud Laboral , Humanos , Industrias , Industria Manufacturera , Ruido/efectos adversos , Ruido en el Ambiente de Trabajo/efectos adversos
15.
Artículo en Chino | MEDLINE | ID: mdl-33691377

RESUMEN

Artificial quartz stone is a new type of decorative building material, there are serious dust exposure hazards during the production and processing. Due to the lack of effective health protection for practitioners, silicosis caused by artificial quartz stone dust has been widely reported worldwide in recent years, which seriously affect the health of practitioners. This article summarizes the use status of artificial quartz stone, the exposure of practitioners and the lung tissue damage caused by dust, analyzes its pathogenic characteristics, and provides a basis for protecting the occupational population and improving occupational health.


Asunto(s)
Exposición Profesional , Silicosis , Polvo , Humanos , Pulmón , Exposición Profesional/efectos adversos , Exposición Profesional/análisis , Cuarzo/toxicidad , Dióxido de Silicio , Silicosis/etiología
16.
Artículo en Chino | MEDLINE | ID: mdl-33781046

RESUMEN

Asbestos has high fire resistance, electrical insulation and thermal insulation. It is an important fire prevention, insulation and insulation material. It is widely used in industrial production and daily life. In 1987, the international agency for research on cancer (IARC) has listed asbestos as a class I carcinogen; in 2012, IARC confirmed that all types of asbestos have carcinogenic effect. By 2019, asbestos has been banned in 66 countries and regions around the world. Asbestos exposure increases the risk of human malignant tumor. Lung cancer and mesothelioma are known asbestos induced tumors. Epidemiological studies also support that asbestos exposure is related to the incidence of malignant tumors in reproductive system, digestive system, urinary system, nasopharynx head and neck. We summarized the epidemiological studies of asbestos induced tumors in order to provide reference for further research.


Asunto(s)
Asbestos , Neoplasias Pulmonares , Mesotelioma , Exposición Profesional , Asbestos/efectos adversos , Carcinógenos/toxicidad , Humanos , Neoplasias Pulmonares/inducido químicamente , Neoplasias Pulmonares/epidemiología , Mesotelioma/inducido químicamente , Mesotelioma/epidemiología
19.
Am J Nurs ; 121(4): 50-55, 2021 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-33755630

RESUMEN

ABSTRACT: The COVID-19 pandemic has resulted in a significant increase in accommodation requests from employees seeking temporary alterations to or relief from their job demands. To maintain consistency and ensure a standard approach, Johns Hopkins Medicine established a COVID-19 Accommodation Review committee that includes experts from the occupational health, legal, and human resources departments, as well as an Americans with Disabilities Act coordinator. In this article, the authors describe the workflow and various components of their institution's accommodations review process, which has resulted in a more consistent and equitable approach to granting requests.


Asunto(s)
/epidemiología , Personal de Salud/organización & administración , Salud Laboral , Política Organizacional , Administración de Personal , /prevención & control , Humanos , Estados Unidos
20.
Arch. prev. riesgos labor. (Ed. impr.) ; 24(1): 20-33, ene.-mar. 2021. tab, graf
Artículo en Español | IBECS | ID: ibc-197118

RESUMEN

INTRODUCCIÓN: La promoción de la salud en el trabajo integra las iniciativas en salud y seguridad en ámbito ocupacional, con mejoras personales, incremento de productividad y menores riesgos y gastos sociales, especialmente en migraña, como enfermedad neurológica con prevalencia estimada en el 11% de la población. El objetivo de este trabajo fue conocer las condiciones preventivas de los trabajadores con migraña y las opciones de gestión preventiva en sus empresas. MÉTODO: Estudio observacional transversal realizado en 3.342 pacientes de España, Italia, Francia, Portugal, Irlanda, Reino Unido, Alemania y otros países de la UE mediante encuesta anónima en la web de la European Migraine & Headache Alliance (EMHA-web), entre septiembre de 2018 y enero de 2019. RESULTADOS: Estrés laboral y uso de PVD son los riesgos más referidos por los trabajadores con migraña. El 43.71% de trabajadores desconoce el tipo de Servicio de Prevención de su empresa, 49.06% no dispone de servicio médico; el 67.67% no ha tenido impedimentos de acceso laboral por migraña, ni despido o no renovación del contrato, pero el 42,14% tuvo algún conflicto por pérdida de productividad; el 26,54% desconoce el concepto de especial sensibilidad o no lo ha solicitado por migraña; un 55,42% no se ha sentido comprendido ni apoyado por su empresa en sus limitaciones por migraña, pero sí por los compañeros. CONCLUSIÓN: Se observa una deficiente información preventiva y escaso uso de las opciones de gestión adaptativa en las empresas para personas con migraña


INTRODUCTION: Workplace health promotion integrates initiatives in health and safety in the occupational field, with personal improvements, increased productivity and lower risks and social cost, especially with respect to migraine headaches, a neurological disorder affecting approximately 11% of the population. The objective of this study was to know the preventive resources available to workers with migraine headaches and the preventive management options in their companies. METHOD: Cross-sectional observational study of 3,342 patients from Spain, Italy, France, Portugal, Ireland, United Kingdom, Germany and other European Union countries, conducted through an anonymous survey on the web of the European Migraine & Headache Alliance (EMHA-web), from September 2018 to January 2019. RESULTS: Occupational stress (77.65%) and use of computer monitors (63.87%) are the most common risks described by workers with migraine. About. 43.71% of workers are not familiar with the type of occupational health service present in their company, 49.06% do not have a medical service; 67.67% reported no work-related limitations due to migraine, neither dismissal nor non-renewal of their contract (88.29%), but 42.14% had experienced some conflict due to decreased productivity; 26.54% were unaware of the concept of vulnerable workers or had not requested this status because of their migraine (63.8%), nor had they demanded job accommodations (67.64%) or job change (80.89%); 55.42% did not feel understood or supported by their company in their limitations due to migraine, although they did feel they were supported by their colleagues (63.07%). CONCLUSION: We found that preventive resources and information were deficient, and that there was little use of adaptive management options for workers with migraine in their companies


Asunto(s)
Humanos , Masculino , Femenino , Trastornos Migrañosos/prevención & control , Servicios de Salud del Trabajador/estadística & datos numéricos , Trastornos Migrañosos/epidemiología , Estudios Transversales , Encuestas Epidemiológicas , Salud Laboral/estadística & datos numéricos , Riesgos Laborales , Lugar de Trabajo , Europa (Continente)/epidemiología
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