José Miguel Martinez | Universitat Politecnica de Catalunya (original) (raw)
Papers by José Miguel Martinez
The European Journal of Public Health, 2014
DOAJ (DOAJ: Directory of Open Access Journals), 2014
Los autores declaran no tener conflictos de intereses. RESUMEN Fundamentos: La incapacidad labora... more Los autores declaran no tener conflictos de intereses. RESUMEN Fundamentos: La incapacidad laboral permanente (IP) supone una importante carga social y económica. El objetivo de este estudio fue estimar la carga de enfermedad debida a la IP en España. Métodos: A partir de la Muestra Continua de Vidas Laborales (MCVL) se imputó como diagnóstico de la IP (2009-2012) el de la incapacidad temporal (IT) iniciada en 2009 en los individuos que cumplieron dos criterios: larga duración de la IT y corta duración del período entre la IT y la IP. Para los casos con diagnóstico imputado se calculó la carga de enfermedad por IP a partir de los años potenciales de vida laboral perdidos (APVLP), definidos como la diferencia entre la edad de jubilación (65 años) y la edad de inicio de la IP. Resultados: Según la MCVL, 163.135 (13,6%) personas sufrieron de IT en 2009, de las cuáles a 4.738 (0,39%) se le reconoció una IP entre 2009-2012. Se pudo establecer el diagnóstico de IP en 3.073 (64,9%) casos. Las causas más frecuentes de IP fueron los trastornos musculo-esqueléticos (27,4%) y mentales (11,6%) que, asimismo, produjeron mayor cantidad de APVLP por IP: 11.086 (26,5%) y 7.052 (16,9%), respectivamente. Los trastornos mentales destacaron por producir IP a edades más jóvenes (mediana=49 años). Conclusiones: Los trastornos mentales y los musculo-esqueléticos representaron la mayor carga de enfermedad en individuos en situación de IP. Palabras clave: Costo de enfermedad. Seguro por discapacidad. Seguridad Social. Ausencia por enfermedad. Sistema de registros.
DOAJ (DOAJ: Directory of Open Access Journals), 2014
Incapacidad y aptitud laboral. Nuevas sinergias entre medicina evaluadora y medicina laboral. His... more Incapacidad y aptitud laboral. Nuevas sinergias entre medicina evaluadora y medicina laboral. Historia clínica laboral única. La capacidad laboral, un continuo evolutivo
Gaceta sanitaria, Jul 1, 2014
La utilización de datos administrativos es práctica habitual en la investigación en salud pública... more La utilización de datos administrativos es práctica habitual en la investigación en salud pública. El objetivo de este trabajo es describir la Muestra continua de vidas laborales (MCVL) y su utilidad en la investigación en salud. La MCVL está construida sobre registros que generan todos los contactos con la Seguridad Social (laborales, incapacidades, etc.), más datos fiscales (percepciones dinerarias, ingresos, etc.) y del padrón (nivel educativo, país de nacimiento, etc.), sin que sea posible la identificación individual. La MCVL se inició en 2004 con el 4% (1,1 millón de personas) del total de población cotizante o perceptora de la Seguridad Social. Los datos de las personas que forman parte de la MCVL son actualizados anualmente, y se sustituyen las bajas producidas. Este diseño continuo permite generar una cohorte con información de la vida laboral y económica, y valorar su asociación con la incapacidad laboral. El supuesto de conexión con la historia clínica posibilitaría el análisis de otros resultados de salud.
International variation in absence from work attributed to musculoskeletal illness: findings from... more International variation in absence from work attributed to musculoskeletal illness: findings from the CUPID study
PLOS ONE, 2016
Somatising tendency, defined as a predisposition to worry about common somatic symptoms, is impor... more Somatising tendency, defined as a predisposition to worry about common somatic symptoms, is importantly associated with various aspects of health and health-related behaviour, including musculoskeletal pain and associated disability. To explore its epidemiological characteristics, and how it can be specified most efficiently, we analysed data from an international longitudinal study. A baseline questionnaire, which included questions from the Brief Symptom Inventory about seven common symptoms, was completed by 12,072 participants aged 20-59 from 46 occupational groups in 18 countries (response rate 70%). The seven symptoms were all mutually associated (odds ratios for pairwise associations 3.4 to 9.3), and each contributed to a measure of somatising tendency that exhibited an exposureresponse relationship both with multi-site pain (prevalence rate ratios up to six), and also with sickness absence for non-musculoskeletal reasons. In most participants, the level of somatising tendency was little changed when reassessed after a mean interval of 14 months (75% having a change of 0 or 1 in their symptom count), although the specific symptoms reported at follow-up often differed from those at baseline. Somatising tendency was more common in women than men, especially at older ages, and varied markedly across the 46 occupational groups studied, with higher rates in South and Central America. It was weakly associated with smoking, but not with level of education. Our study supports the use of questions from the Brief Symptom Inventory as a method for measuring somatising tendency, and suggests that in adults of working age, it is a fairly stable trait.
Pain, Jan 5, 2016
To inform case-definition for neck/shoulder pain in epidemiological research, we compared levels ... more To inform case-definition for neck/shoulder pain in epidemiological research, we compared levels of disability, patterns of association and prognosis for pain that was limited to the neck or shoulders (LNSP) and more generalised musculoskeletal pain that involved the neck or shoulder(s) (GPNS). Baseline data on musculoskeletal pain, disability and potential correlates were collected by questionnaire from 12,195 workers in 47 occupational groups (mostly office workers, nurses, and manual workers) in 18 countries (response rate = 70%). Continuing pain after a mean interval of 14 months was ascertained through a follow-up questionnaire in 9,150 workers from 45 occupational groups. Associations with personal and occupational factors were assessed by Poisson regression and summarised by prevalence rate ratios (PRRs). The one-month prevalence of GPNS at baseline was much greater than that of LNSP (35.1% vs. 5.6%), and it tended to be more troublesome and disabling. Unlike LNSP, the preval...
Work, 2016
BACKGROUND: Only few longitudinal studies have explored separately predictors of pain incidence a... more BACKGROUND: Only few longitudinal studies have explored separately predictors of pain incidence and persistence. OBJECTIVE: To investigate whether biological, lifestyle, occupational and psychological risk factors for the development of new episodes of upper limb pain (ULP) differ from those for its persistence. METHODS: Spanish nurses and office workers (1105) were asked at baseline about biological, lifestyle, occupational and psychological risk factors and pain in the past month at six anatomical sites in the upper limb (left and right shoulder, elbow and wrist/hand). At follow up, 12 months later, pain in the past month was again ascertained. Analysis was based on anatomical sites clustered by person. Associations were assessed by multilevel logistic regression models. RESULTS: Nine hundred and seventy-one participants (87.9%) completed follow-up. Job dissatisfaction and older age carried higher risk of new ULP. Somatising tendency (OR 2.2, 95%CI 1.6-3.1) was the strongest predictor of new ULP, with a risk estimate which differed significantly from that for the same exposure and persistence of ULP. Having adverse beliefs about the work-relatedness of ULP carried a significantly reduced risk for persistence of ULP. CONCLUSION: Our study provides only limited evidence that risk factors predicting new ULP differ from those predicting its persistence.
BMC public health, Jan 24, 2015
Informal employment is assumed to be an important but seldom studied social determinant of health... more Informal employment is assumed to be an important but seldom studied social determinant of health, affecting a large number of workers around the world. Although informal employment arrangements constitute a permanent, structural pillar of many labor markets in low- and middle-income countries, studies about its relationship with health status are still scarce. In Central America more than 60 % of non-agricultural workers have informal employment. Therefore, we aimed to assess differences in self-perceived and mental health status of Central Americans with different patterns of informal and formal employment. Employment profiles were created by combining employment relations (employees, self-employed, employers), social security coverage (yes/no) and type of contract -only for employees- (written, oral, none), in a cross-sectional study of 8,823 non-agricultural workers based on the I Central American Survey of Working Conditions and Health of 2011. Using logistic regression models,...
Revista Española de Salud Pública, 2009
La incapacidad temporal por contingencia común es un importante problema de salud pública con gra... more La incapacidad temporal por contingencia común es un importante problema de salud pública con grandes repercusiones socioeconómicas, que no se distribuye territorialmente de forma homogénea. El objetivo de este trabajo es comparar las diferencias en los costes de la incapacidad temporal por contingencia común entre las provincias de Barcelona y Madrid. Métodos: Estudio descriptivo basado en casos incidentes de incapacidad temporal por contingencia común de más de 15 días de duración seguidos hasta su finalización en una cohorte retrospectiva en el año 2006. La población de estudio fueron los trabajadores de las empresas afiliadas a una Mutua de Accidentes de Trabajo y Enfermedades Profesionales para la gestión de dicha incapacidad ubicados en las provincias de Barcelona y Madrid. Se comparó la incidencia, duración y base reguladora diaria entre Barcelona y Madrid, ajustando por sexo, edad y sector económico mediante modelos estadísticos que tuvieron en cuenta la repetición de episodios en un mismo individuo. Resultados: Se identificaron 24.527 episodios de incapacidad temporal por contingencia común, siendo el 62% de Barcelona. El coste medio por episodio fue un 33% más elevado en la provincia de Barcelona (2.589 t vs. 1.941 t). Los episodios ocurridos en la provincia de Barcelona, respecto a Madrid, presentaron una incidencia un 22% superior (1,22, IC95%:1,10-1,36) y la base reguladora media por episodio fue 7,8 t superior (IC95%:7,20-8,40). Respecto a la duración de los procesos la razón de tiempos fue de 1,03 (IC95%: 1,01-1,05). Conclusiones: Se observó una mayor incidencia y base reguladora diaria en la provincia de Barcelona respecto a la de Madrid que podría explicar su mayor coste. Palabras claves: Absentismo. Incapacidad laboral. Coste del absentismo. Salud laboral.
![Research paper thumbnail of [Incidence of permanent disability in a cohort of social security-affiliated workers (2004-2007)]](https://attachments.academia-assets.com/110923888/thumbnails/1.jpg)
](Gaceta sanitaria / S.E.S.P.A.S
To describe the incidence of permanent disability, both work-related and non-work-related, by sev... more To describe the incidence of permanent disability, both work-related and non-work-related, by several socioeconomic and geographical variables. We performed a retrospective study of a cohort of 768,454 workers covered by the General Social Security Regimen, followed-up from 2004 to 2007. This study was based on the Continuous Working Life Survey. In the 4 years of follow-up, 7,749 cases in 1,937,921 workers-years were identified. Incidence rates and crude and adjusted rate ratios were estimated by Poisson regression models. The incidence of non-work-related permanent disability was 10 times greater than that of work-related disability (36.3 versus 3.7 per 10,000 workers-years). The incidences for both non-work-related and work-related disability were higher in men and increased with age and lower education level. For non-work-related permanent disability, the region with the highest incidence was Asturias and that with the lowest was Madrid (56.7 vs. 23.3). For work-related permanen...
Gaceta Sanitaria, 2009
Dadas las diferencias observadas en estudios previos de la incidencia de lesiones por accidente d... more Dadas las diferencias observadas en estudios previos de la incidencia de lesiones por accidente de trabajo (LAT) por Comunidades Autó nomas (CC.AA.), en este estudio hemos evaluado la hipó tesis de homogeneidad de la incidencia de las LAT para tipos específicos de accidentes y en determinadas actividades, entre 1994 y 2004. Métodos: Las LAT analizadas fueron no mortales con baja, de tipo mecá nico y sobreesfuerzo, ocurridas en jornada en centro para empresas manufactureras y de la construcció n. Se calculó el riesgo relativo ajustado por sexo, edad y tipo de contrato en cada una de las CC.AA. mediante la razó n de LAT estandarizada, tomando como referencia las tasas de Españ a, y estratificando segú n duració n de la baja (menos de 16 días y má s de 15 días). Resultados: El riesgo relativo ajustado de LAT segú n los diferentes tipos de accidentes analizados presenta una distribució n heterogé nea entre CC.AA. Murcia, Navarra, Baleares y País Vasco se encuentran generalmente entre las comunidades con riesgos má s elevados, mientras que Castilla-Leó n y Extremadura son las que tienen principalmente menores riesgos de sufrir una LAT. Conclusiones: La heterogeneidad en la incidencia de LAT entre CC.AA. persiste despué s de seleccionar una serie de formas de accidente específicas y ajustar por sexo, edad y tipo de contrato. Por ello sugerimos que, ademá s de seguir analizando las condiciones de trabajo como explicació n de esta heterogeneidad, se tengan en cuenta otras variables socioeconó micas al comparar las incidencias de LAT entre CC.AA.
Occupational and environmental medicine, 2014
To analyse the relationship between mental health and non-agricultural informal employment in Cen... more To analyse the relationship between mental health and non-agricultural informal employment in Central America; and to examine whether patterns of association differ by gender Cross-sectional study of 8904 non-agricultural workers (48% women) based on the I Central American Survey of Working Conditions and Health of 2011. Employment profiles were created combining formal and informal characteristics: labour relationship (permanent employees, temporary employees, self-employed, employers), social security coverage (yes, no), type of contract for employees (written, oral or no contract), company size for employers (≤5, >5 workers). Using logistic regression models, odds ratios (OR) of poor mental health (measured by GHQ12 questionnaire) and 95% confidence intervals (95% CI) were calculated by sex, adjusting for country and age, with employment profiles as independent variable. The reference group was permanent employees covered by social security with a written contract. Around 37% ...
Revista española de salud pública
Permanent disability (PD) is a major social and economic burden. The aim of this study was to det... more Permanent disability (PD) is a major social and economic burden. The aim of this study was to determine the burden of disease due to PD. Using data from the Continuous Working Life Sample (CWLS) -a random sample consisting of 4% of the active members affiliated to the Social Security (SS) System in Spain (1.1 million members) which data come from administrative registries from the SS- the diagnosis of PD (2009-2012) was established from the information on the temporary sickness absence (TSA) episodes from 2009. The diagnoses were imputed if two criteria were fulfilled: long duration of TSA and short period of time between the TSA episode and PD. The burden of disease was estimated for cases with an established diagnosis of PD by using the potential years of working life lost (PYWLL), estimated as the difference between the legal retirement age (65 years) and the age at the start of a PD. In the CWLS, 163,135 (13.6%9 individuals suffered a TSA episode in 2009, out of which 4,738 were...
European journal of public health, Jan 3, 2014
To analyse the impact of labour market trajectory indicators on early retirement, measured by age... more To analyse the impact of labour market trajectory indicators on early retirement, measured by age at onset of permanent disability (PD). Four labour market trajectory indicators were reconstructed in 14 972 new cases of PD recognized between 2004 and 2010: (1) number of employment contracts, (2) number of unemployment periods, (3) number of periods without social security affiliation and (4) percentage of time spent in inactivity. The outcome was measured as the age at onset of PD. Median differences and 95% confidence intervals (95%CI) were compared using a median regression. Analyses were stratified by sex and adjusted for occupational category and total time elapsed between the beginning of working life and the age at onset of PD: separately for each labour market indicator, and adjusted for each other. In men, the age at the onset of PD for workers with 15 or more employment contracts decreased by 4.8 years; and for workers with five or more periods without affiliation it decrea...
Pain, 2013
To explore definitions for multisite pain, and compare associations with risk factors for differe... more To explore definitions for multisite pain, and compare associations with risk factors for different patterns of musculoskeletal pain, we analysed cross-sectional data from the Cultural and Psychosocial Influences on Disability (CUPID) study. The study sample comprised 12,410 adults aged 20-59 years from 47 occupational groups in 18 countries. A standardised questionnaire was used to collect information about pain in the past month at each of 10 anatomical sites, and about potential risk factors. Associations with pain outcomes were assessed by Poisson regression, and characterised by prevalence rate ratios (PRRs). Extensive pain, affecting 6-10 anatomical sites, was reported much more frequently than would be expected if the occurrence of pain at each site were independent (674 participants vs 41.9 expected). In comparison with pain involving only 1-3 sites, it showed much stronger associations (relative to no pain) with risk factors such as female sex (PRR 1.6 vs 1.1), older age (PRR 2.6 vs 1.1), somatising tendency (PRR 4.6 vs 1.3), and exposure to multiple physically stressing occupational activities (PRR 5.0 vs 1.4). After adjustment for number of sites with pain, these risk factors showed no additional association with a distribution of pain that was widespread according to the frequently used American College of Rheumatology criteria. Our analysis supports the classification of pain at multiple anatomical sites simply by the number of sites affected, and suggests that extensive pain differs importantly in its associations with risk factors from pain that is limited to only a small number of anatomical sites.
Revista Española de Salud Pública, 2007
PLoS ONE, 2012
Background: The CUPID (Cultural and Psychosocial Influences on Disability) study was established ... more Background: The CUPID (Cultural and Psychosocial Influences on Disability) study was established to explore the hypothesis that common musculoskeletal disorders (MSDs) and associated disability are importantly influenced by culturally determined health beliefs and expectations. This paper describes the methods of data collection and various characteristics of the study sample. Methods/Principal Findings: A standardised questionnaire covering musculoskeletal symptoms, disability and potential risk factors, was used to collect information from 47 samples of nurses, office workers, and other (mostly manual) workers in 18 countries from six continents. In addition, local investigators provided data on economic aspects of employment for each occupational group. Participation exceeded 80% in 33 of the 47 occupational groups, and after pre-specified exclusions, analysis was based on 12,426 subjects (92 to 1018 per occupational group). As expected, there was high usage of computer keyboards by office workers, while nurses had the highest prevalence of heavy manual lifting in all but one country. There was substantial heterogeneity between occupational groups in economic and psychosocial aspects of work; three-to fivefold variation in awareness of someone outside work with musculoskeletal pain; and more than tenfold variation in the prevalence of adverse health beliefs about back and arm pain, and in awareness of terms such as ''repetitive strain injury'' (RSI). Conclusions/Significance: The large differences in psychosocial risk factors (including knowledge and beliefs about MSDs) between occupational groups should allow the study hypothesis to be addressed effectively.
Pain, 2013
To compare the prevalence of disabling low back pain (DLBP) and disabling wrist/hand pain (DWHP) ... more To compare the prevalence of disabling low back pain (DLBP) and disabling wrist/hand pain (DWHP) among groups of workers carrying out similar physical activities in different cultural environments, and to explore explanations for observed differences, we conducted a cross-sectional survey in 18 countries. Standardised questionnaires were used to ascertain pain that interfered with everyday activities and exposure to possible risk factors in 12,426 participants from 47 occupational groups (mostly nurses and office workers). Associations with risk factors were assessed by Poisson regression. The 1-month prevalence of DLBP in nurses varied from 9.6% to 42.6%, and that of DWHP in office workers from 2.2% to 31.6%. Rates of disabling pain at the 2 anatomical sites covaried (r = 0.76), but DLBP tended to be relatively more common in nurses and DWHP in office workers. Established risk factors such as occupational physical activities, psychosocial aspects of work, and tendency to somatise were confirmed, and associations were found also with adverse health beliefs and group awareness of people outside work with musculoskeletal pain. However, after allowance for these risk factors, an up-to 8-fold difference in prevalence remained. Systems of compensation for work-related illness and financial support for health-related incapacity for work appeared to have little influence on the occurrence of symptoms. Our findings indicate large international variation in the prevalence of disabling forearm and back pain among occupational groups carrying out similar tasks, which is only partially explained by the personal and socioeconomic risk factors that were analysed.
The European Journal of Public Health, 2014
DOAJ (DOAJ: Directory of Open Access Journals), 2014
Los autores declaran no tener conflictos de intereses. RESUMEN Fundamentos: La incapacidad labora... more Los autores declaran no tener conflictos de intereses. RESUMEN Fundamentos: La incapacidad laboral permanente (IP) supone una importante carga social y económica. El objetivo de este estudio fue estimar la carga de enfermedad debida a la IP en España. Métodos: A partir de la Muestra Continua de Vidas Laborales (MCVL) se imputó como diagnóstico de la IP (2009-2012) el de la incapacidad temporal (IT) iniciada en 2009 en los individuos que cumplieron dos criterios: larga duración de la IT y corta duración del período entre la IT y la IP. Para los casos con diagnóstico imputado se calculó la carga de enfermedad por IP a partir de los años potenciales de vida laboral perdidos (APVLP), definidos como la diferencia entre la edad de jubilación (65 años) y la edad de inicio de la IP. Resultados: Según la MCVL, 163.135 (13,6%) personas sufrieron de IT en 2009, de las cuáles a 4.738 (0,39%) se le reconoció una IP entre 2009-2012. Se pudo establecer el diagnóstico de IP en 3.073 (64,9%) casos. Las causas más frecuentes de IP fueron los trastornos musculo-esqueléticos (27,4%) y mentales (11,6%) que, asimismo, produjeron mayor cantidad de APVLP por IP: 11.086 (26,5%) y 7.052 (16,9%), respectivamente. Los trastornos mentales destacaron por producir IP a edades más jóvenes (mediana=49 años). Conclusiones: Los trastornos mentales y los musculo-esqueléticos representaron la mayor carga de enfermedad en individuos en situación de IP. Palabras clave: Costo de enfermedad. Seguro por discapacidad. Seguridad Social. Ausencia por enfermedad. Sistema de registros.
DOAJ (DOAJ: Directory of Open Access Journals), 2014
Incapacidad y aptitud laboral. Nuevas sinergias entre medicina evaluadora y medicina laboral. His... more Incapacidad y aptitud laboral. Nuevas sinergias entre medicina evaluadora y medicina laboral. Historia clínica laboral única. La capacidad laboral, un continuo evolutivo
Gaceta sanitaria, Jul 1, 2014
La utilización de datos administrativos es práctica habitual en la investigación en salud pública... more La utilización de datos administrativos es práctica habitual en la investigación en salud pública. El objetivo de este trabajo es describir la Muestra continua de vidas laborales (MCVL) y su utilidad en la investigación en salud. La MCVL está construida sobre registros que generan todos los contactos con la Seguridad Social (laborales, incapacidades, etc.), más datos fiscales (percepciones dinerarias, ingresos, etc.) y del padrón (nivel educativo, país de nacimiento, etc.), sin que sea posible la identificación individual. La MCVL se inició en 2004 con el 4% (1,1 millón de personas) del total de población cotizante o perceptora de la Seguridad Social. Los datos de las personas que forman parte de la MCVL son actualizados anualmente, y se sustituyen las bajas producidas. Este diseño continuo permite generar una cohorte con información de la vida laboral y económica, y valorar su asociación con la incapacidad laboral. El supuesto de conexión con la historia clínica posibilitaría el análisis de otros resultados de salud.
International variation in absence from work attributed to musculoskeletal illness: findings from... more International variation in absence from work attributed to musculoskeletal illness: findings from the CUPID study
PLOS ONE, 2016
Somatising tendency, defined as a predisposition to worry about common somatic symptoms, is impor... more Somatising tendency, defined as a predisposition to worry about common somatic symptoms, is importantly associated with various aspects of health and health-related behaviour, including musculoskeletal pain and associated disability. To explore its epidemiological characteristics, and how it can be specified most efficiently, we analysed data from an international longitudinal study. A baseline questionnaire, which included questions from the Brief Symptom Inventory about seven common symptoms, was completed by 12,072 participants aged 20-59 from 46 occupational groups in 18 countries (response rate 70%). The seven symptoms were all mutually associated (odds ratios for pairwise associations 3.4 to 9.3), and each contributed to a measure of somatising tendency that exhibited an exposureresponse relationship both with multi-site pain (prevalence rate ratios up to six), and also with sickness absence for non-musculoskeletal reasons. In most participants, the level of somatising tendency was little changed when reassessed after a mean interval of 14 months (75% having a change of 0 or 1 in their symptom count), although the specific symptoms reported at follow-up often differed from those at baseline. Somatising tendency was more common in women than men, especially at older ages, and varied markedly across the 46 occupational groups studied, with higher rates in South and Central America. It was weakly associated with smoking, but not with level of education. Our study supports the use of questions from the Brief Symptom Inventory as a method for measuring somatising tendency, and suggests that in adults of working age, it is a fairly stable trait.
Pain, Jan 5, 2016
To inform case-definition for neck/shoulder pain in epidemiological research, we compared levels ... more To inform case-definition for neck/shoulder pain in epidemiological research, we compared levels of disability, patterns of association and prognosis for pain that was limited to the neck or shoulders (LNSP) and more generalised musculoskeletal pain that involved the neck or shoulder(s) (GPNS). Baseline data on musculoskeletal pain, disability and potential correlates were collected by questionnaire from 12,195 workers in 47 occupational groups (mostly office workers, nurses, and manual workers) in 18 countries (response rate = 70%). Continuing pain after a mean interval of 14 months was ascertained through a follow-up questionnaire in 9,150 workers from 45 occupational groups. Associations with personal and occupational factors were assessed by Poisson regression and summarised by prevalence rate ratios (PRRs). The one-month prevalence of GPNS at baseline was much greater than that of LNSP (35.1% vs. 5.6%), and it tended to be more troublesome and disabling. Unlike LNSP, the preval...
Work, 2016
BACKGROUND: Only few longitudinal studies have explored separately predictors of pain incidence a... more BACKGROUND: Only few longitudinal studies have explored separately predictors of pain incidence and persistence. OBJECTIVE: To investigate whether biological, lifestyle, occupational and psychological risk factors for the development of new episodes of upper limb pain (ULP) differ from those for its persistence. METHODS: Spanish nurses and office workers (1105) were asked at baseline about biological, lifestyle, occupational and psychological risk factors and pain in the past month at six anatomical sites in the upper limb (left and right shoulder, elbow and wrist/hand). At follow up, 12 months later, pain in the past month was again ascertained. Analysis was based on anatomical sites clustered by person. Associations were assessed by multilevel logistic regression models. RESULTS: Nine hundred and seventy-one participants (87.9%) completed follow-up. Job dissatisfaction and older age carried higher risk of new ULP. Somatising tendency (OR 2.2, 95%CI 1.6-3.1) was the strongest predictor of new ULP, with a risk estimate which differed significantly from that for the same exposure and persistence of ULP. Having adverse beliefs about the work-relatedness of ULP carried a significantly reduced risk for persistence of ULP. CONCLUSION: Our study provides only limited evidence that risk factors predicting new ULP differ from those predicting its persistence.
BMC public health, Jan 24, 2015
Informal employment is assumed to be an important but seldom studied social determinant of health... more Informal employment is assumed to be an important but seldom studied social determinant of health, affecting a large number of workers around the world. Although informal employment arrangements constitute a permanent, structural pillar of many labor markets in low- and middle-income countries, studies about its relationship with health status are still scarce. In Central America more than 60 % of non-agricultural workers have informal employment. Therefore, we aimed to assess differences in self-perceived and mental health status of Central Americans with different patterns of informal and formal employment. Employment profiles were created by combining employment relations (employees, self-employed, employers), social security coverage (yes/no) and type of contract -only for employees- (written, oral, none), in a cross-sectional study of 8,823 non-agricultural workers based on the I Central American Survey of Working Conditions and Health of 2011. Using logistic regression models,...
Revista Española de Salud Pública, 2009
La incapacidad temporal por contingencia común es un importante problema de salud pública con gra... more La incapacidad temporal por contingencia común es un importante problema de salud pública con grandes repercusiones socioeconómicas, que no se distribuye territorialmente de forma homogénea. El objetivo de este trabajo es comparar las diferencias en los costes de la incapacidad temporal por contingencia común entre las provincias de Barcelona y Madrid. Métodos: Estudio descriptivo basado en casos incidentes de incapacidad temporal por contingencia común de más de 15 días de duración seguidos hasta su finalización en una cohorte retrospectiva en el año 2006. La población de estudio fueron los trabajadores de las empresas afiliadas a una Mutua de Accidentes de Trabajo y Enfermedades Profesionales para la gestión de dicha incapacidad ubicados en las provincias de Barcelona y Madrid. Se comparó la incidencia, duración y base reguladora diaria entre Barcelona y Madrid, ajustando por sexo, edad y sector económico mediante modelos estadísticos que tuvieron en cuenta la repetición de episodios en un mismo individuo. Resultados: Se identificaron 24.527 episodios de incapacidad temporal por contingencia común, siendo el 62% de Barcelona. El coste medio por episodio fue un 33% más elevado en la provincia de Barcelona (2.589 t vs. 1.941 t). Los episodios ocurridos en la provincia de Barcelona, respecto a Madrid, presentaron una incidencia un 22% superior (1,22, IC95%:1,10-1,36) y la base reguladora media por episodio fue 7,8 t superior (IC95%:7,20-8,40). Respecto a la duración de los procesos la razón de tiempos fue de 1,03 (IC95%: 1,01-1,05). Conclusiones: Se observó una mayor incidencia y base reguladora diaria en la provincia de Barcelona respecto a la de Madrid que podría explicar su mayor coste. Palabras claves: Absentismo. Incapacidad laboral. Coste del absentismo. Salud laboral.
Gaceta sanitaria / S.E.S.P.A.S
To describe the incidence of permanent disability, both work-related and non-work-related, by sev... more To describe the incidence of permanent disability, both work-related and non-work-related, by several socioeconomic and geographical variables. We performed a retrospective study of a cohort of 768,454 workers covered by the General Social Security Regimen, followed-up from 2004 to 2007. This study was based on the Continuous Working Life Survey. In the 4 years of follow-up, 7,749 cases in 1,937,921 workers-years were identified. Incidence rates and crude and adjusted rate ratios were estimated by Poisson regression models. The incidence of non-work-related permanent disability was 10 times greater than that of work-related disability (36.3 versus 3.7 per 10,000 workers-years). The incidences for both non-work-related and work-related disability were higher in men and increased with age and lower education level. For non-work-related permanent disability, the region with the highest incidence was Asturias and that with the lowest was Madrid (56.7 vs. 23.3). For work-related permanen...
Gaceta Sanitaria, 2009
Dadas las diferencias observadas en estudios previos de la incidencia de lesiones por accidente d... more Dadas las diferencias observadas en estudios previos de la incidencia de lesiones por accidente de trabajo (LAT) por Comunidades Autó nomas (CC.AA.), en este estudio hemos evaluado la hipó tesis de homogeneidad de la incidencia de las LAT para tipos específicos de accidentes y en determinadas actividades, entre 1994 y 2004. Métodos: Las LAT analizadas fueron no mortales con baja, de tipo mecá nico y sobreesfuerzo, ocurridas en jornada en centro para empresas manufactureras y de la construcció n. Se calculó el riesgo relativo ajustado por sexo, edad y tipo de contrato en cada una de las CC.AA. mediante la razó n de LAT estandarizada, tomando como referencia las tasas de Españ a, y estratificando segú n duració n de la baja (menos de 16 días y má s de 15 días). Resultados: El riesgo relativo ajustado de LAT segú n los diferentes tipos de accidentes analizados presenta una distribució n heterogé nea entre CC.AA. Murcia, Navarra, Baleares y País Vasco se encuentran generalmente entre las comunidades con riesgos má s elevados, mientras que Castilla-Leó n y Extremadura son las que tienen principalmente menores riesgos de sufrir una LAT. Conclusiones: La heterogeneidad en la incidencia de LAT entre CC.AA. persiste despué s de seleccionar una serie de formas de accidente específicas y ajustar por sexo, edad y tipo de contrato. Por ello sugerimos que, ademá s de seguir analizando las condiciones de trabajo como explicació n de esta heterogeneidad, se tengan en cuenta otras variables socioeconó micas al comparar las incidencias de LAT entre CC.AA.
Occupational and environmental medicine, 2014
To analyse the relationship between mental health and non-agricultural informal employment in Cen... more To analyse the relationship between mental health and non-agricultural informal employment in Central America; and to examine whether patterns of association differ by gender Cross-sectional study of 8904 non-agricultural workers (48% women) based on the I Central American Survey of Working Conditions and Health of 2011. Employment profiles were created combining formal and informal characteristics: labour relationship (permanent employees, temporary employees, self-employed, employers), social security coverage (yes, no), type of contract for employees (written, oral or no contract), company size for employers (≤5, >5 workers). Using logistic regression models, odds ratios (OR) of poor mental health (measured by GHQ12 questionnaire) and 95% confidence intervals (95% CI) were calculated by sex, adjusting for country and age, with employment profiles as independent variable. The reference group was permanent employees covered by social security with a written contract. Around 37% ...
Revista española de salud pública
Permanent disability (PD) is a major social and economic burden. The aim of this study was to det... more Permanent disability (PD) is a major social and economic burden. The aim of this study was to determine the burden of disease due to PD. Using data from the Continuous Working Life Sample (CWLS) -a random sample consisting of 4% of the active members affiliated to the Social Security (SS) System in Spain (1.1 million members) which data come from administrative registries from the SS- the diagnosis of PD (2009-2012) was established from the information on the temporary sickness absence (TSA) episodes from 2009. The diagnoses were imputed if two criteria were fulfilled: long duration of TSA and short period of time between the TSA episode and PD. The burden of disease was estimated for cases with an established diagnosis of PD by using the potential years of working life lost (PYWLL), estimated as the difference between the legal retirement age (65 years) and the age at the start of a PD. In the CWLS, 163,135 (13.6%9 individuals suffered a TSA episode in 2009, out of which 4,738 were...
European journal of public health, Jan 3, 2014
To analyse the impact of labour market trajectory indicators on early retirement, measured by age... more To analyse the impact of labour market trajectory indicators on early retirement, measured by age at onset of permanent disability (PD). Four labour market trajectory indicators were reconstructed in 14 972 new cases of PD recognized between 2004 and 2010: (1) number of employment contracts, (2) number of unemployment periods, (3) number of periods without social security affiliation and (4) percentage of time spent in inactivity. The outcome was measured as the age at onset of PD. Median differences and 95% confidence intervals (95%CI) were compared using a median regression. Analyses were stratified by sex and adjusted for occupational category and total time elapsed between the beginning of working life and the age at onset of PD: separately for each labour market indicator, and adjusted for each other. In men, the age at the onset of PD for workers with 15 or more employment contracts decreased by 4.8 years; and for workers with five or more periods without affiliation it decrea...
Pain, 2013
To explore definitions for multisite pain, and compare associations with risk factors for differe... more To explore definitions for multisite pain, and compare associations with risk factors for different patterns of musculoskeletal pain, we analysed cross-sectional data from the Cultural and Psychosocial Influences on Disability (CUPID) study. The study sample comprised 12,410 adults aged 20-59 years from 47 occupational groups in 18 countries. A standardised questionnaire was used to collect information about pain in the past month at each of 10 anatomical sites, and about potential risk factors. Associations with pain outcomes were assessed by Poisson regression, and characterised by prevalence rate ratios (PRRs). Extensive pain, affecting 6-10 anatomical sites, was reported much more frequently than would be expected if the occurrence of pain at each site were independent (674 participants vs 41.9 expected). In comparison with pain involving only 1-3 sites, it showed much stronger associations (relative to no pain) with risk factors such as female sex (PRR 1.6 vs 1.1), older age (PRR 2.6 vs 1.1), somatising tendency (PRR 4.6 vs 1.3), and exposure to multiple physically stressing occupational activities (PRR 5.0 vs 1.4). After adjustment for number of sites with pain, these risk factors showed no additional association with a distribution of pain that was widespread according to the frequently used American College of Rheumatology criteria. Our analysis supports the classification of pain at multiple anatomical sites simply by the number of sites affected, and suggests that extensive pain differs importantly in its associations with risk factors from pain that is limited to only a small number of anatomical sites.
Revista Española de Salud Pública, 2007
PLoS ONE, 2012
Background: The CUPID (Cultural and Psychosocial Influences on Disability) study was established ... more Background: The CUPID (Cultural and Psychosocial Influences on Disability) study was established to explore the hypothesis that common musculoskeletal disorders (MSDs) and associated disability are importantly influenced by culturally determined health beliefs and expectations. This paper describes the methods of data collection and various characteristics of the study sample. Methods/Principal Findings: A standardised questionnaire covering musculoskeletal symptoms, disability and potential risk factors, was used to collect information from 47 samples of nurses, office workers, and other (mostly manual) workers in 18 countries from six continents. In addition, local investigators provided data on economic aspects of employment for each occupational group. Participation exceeded 80% in 33 of the 47 occupational groups, and after pre-specified exclusions, analysis was based on 12,426 subjects (92 to 1018 per occupational group). As expected, there was high usage of computer keyboards by office workers, while nurses had the highest prevalence of heavy manual lifting in all but one country. There was substantial heterogeneity between occupational groups in economic and psychosocial aspects of work; three-to fivefold variation in awareness of someone outside work with musculoskeletal pain; and more than tenfold variation in the prevalence of adverse health beliefs about back and arm pain, and in awareness of terms such as ''repetitive strain injury'' (RSI). Conclusions/Significance: The large differences in psychosocial risk factors (including knowledge and beliefs about MSDs) between occupational groups should allow the study hypothesis to be addressed effectively.
Pain, 2013
To compare the prevalence of disabling low back pain (DLBP) and disabling wrist/hand pain (DWHP) ... more To compare the prevalence of disabling low back pain (DLBP) and disabling wrist/hand pain (DWHP) among groups of workers carrying out similar physical activities in different cultural environments, and to explore explanations for observed differences, we conducted a cross-sectional survey in 18 countries. Standardised questionnaires were used to ascertain pain that interfered with everyday activities and exposure to possible risk factors in 12,426 participants from 47 occupational groups (mostly nurses and office workers). Associations with risk factors were assessed by Poisson regression. The 1-month prevalence of DLBP in nurses varied from 9.6% to 42.6%, and that of DWHP in office workers from 2.2% to 31.6%. Rates of disabling pain at the 2 anatomical sites covaried (r = 0.76), but DLBP tended to be relatively more common in nurses and DWHP in office workers. Established risk factors such as occupational physical activities, psychosocial aspects of work, and tendency to somatise were confirmed, and associations were found also with adverse health beliefs and group awareness of people outside work with musculoskeletal pain. However, after allowance for these risk factors, an up-to 8-fold difference in prevalence remained. Systems of compensation for work-related illness and financial support for health-related incapacity for work appeared to have little influence on the occurrence of symptoms. Our findings indicate large international variation in the prevalence of disabling forearm and back pain among occupational groups carrying out similar tasks, which is only partially explained by the personal and socioeconomic risk factors that were analysed.