D. Gimeno

Return to Work Expectations of Workers on Long-Term Non-Work-Related Sick Leave

Introduction Despite suggestions that worker perception might be the best predictor of return to work (RTW), there still is limited research on time to RTW in workers with lengthy non-work-related sick leave. Methods Prospective cohort study of 663 workers with a current long-term non-work-related sick leave episode recruited during the first medical visit in a mutua (Spanish health insurance company) and followed until their sick leave episode ended. Workers completed a baseline questionnaire regarding their perceptions of sick leave episode and expectations of RTW (i.e., health status, work ability, expectations and time required to RTW, self-efficacy and self-perceived connection between health and job). Time to RTW was established based on the mutua’s register. Cox regression models were used to examine the associations of worker perception and expectation of RTW with time to RTW within the study population as a whole as well as in three diagnostic subgroups (i.e., musculoskeletal disorders, mental disorders and other physical conditions). Results As a whole, time to RTW was longer for workers reporting poor health [hazard ratio (HR)xa0=xa00.71, 95%CI 0.59–0.85], extremely reduced work ability (HRxa0=xa00.69, 95%CI 0.53–0.88), a longer period of time required to RTW (HRxa0=xa00.36, 95%CI 0.25–0.52) and lack of expectation of returning to the same job (HRxa0=xa00.13, 95%CI 0.06–0.31). Workers with musculoskeletal and other physical conditions showed a similar pattern to whole study population, while workers with mental disorders did not. Conclusion Self-required time and RTW expectations are important prognostic factors in sick listed workers by all types of health conditions certified as non-work-related. Questioning the workers on their perceptions and expectations of RTW during medical visits could help health care professionals to identify individuals at risk of long-term sickness absence and facilitate triage and management of the patient.

Descripción de los factores de riesgo psicosocial en cuatro empresas

Objetivo: Describir la distribucion de las puntuaciones de los factores de riesgo psicosocial de origen laboral en cuatro empresas segun caracteristicas personales y laborales de los trabajadores. Metodos: Estudio transversal con una muestra de 890 trabajadores que participaron voluntariamente en cuatro empresas, con una tasa de respuesta conjunta del 34,5%. Los factores de riesgo psicosocial se midieron mediante un cuestionario autoadministrado que valoro la presencia de demanda, control y apoyo social, segun la percepcion del trabajador. El analisis estadistico se baso en el calculo de la mediana y medidas de la dispersion de los factores de riesgo psicosocial para cada una de las empresas por separado, ademas de la descripcion de su distribucion segun variables personales y laborales. Resultados: La puntuacion mediana para el apoyo social fue practicamente igual a 5 en todas las empresas observandose una mayor variabilidad en la demanda psicologica (entre 13 y 16) y en el control (entre 20 y 26). Al comparar respecto a variables sociolaborales, observamos valores similares en el caso del apoyo social, pero no respecto al control y la demanda, que mostraron una mayor variacion por sexo (varones), edad (menores de 40 anos) y ocupacion (administrativos). Conclusion: Aunque la baja tasa de respuesta puede limitar la validez de estos resultados, este es el primer estudio que valora la distribucion de las puntuaciones de los factores de riesgo psicosocial en cuatro empresas diferentes en Espana, evidenciando la variabilidad entre las empresas para diferentes grupos de trabajadores. Este trabajo puede ser util para realizar futuros estudios que exploren la factibilidad de definir valores de referencia utiles para la accion preventiva.

External Validation of Psychological Job Demands in a Bus Driver Sample

External Validation of Psychological Job Demands in a Bus Driver Sample: David Gimeno, et al. Occupational Health Research Unit. Department of Health and Experimental Sciences, Universitat Pompeu Fabra, Spain—Psychosocial risk factors have been considered as characteristics of the work environment rather than an individual issue, but their presence in the workplace is usually measured by self‐reported questionnaires, based on worker attitudes. The objective of the study was to compare a self‐reported measure of psychological job demands in a bus driver sample with selected indicators of bus company activity, as external ‘objective’ indicators, in order to assess its external validity. The final sample included 713 drivers in 41 routes. Self‐reported measures of psychosocial work risk factors were obtained by the Job Content Questionnaire (JCQ). Four external indicators were available for each route: passengers, break times, bus incidents, and regulating actions. Spearmans correlation coefficient was estimated to assess the validity. Correlation coefficients showed that self‐reported psychological demands were statistically significant correlated (p<0.05) with two external indicators: bus incidents (rho=0.397), and regulating actions (rho=0.475). Self‐reported psychosocial risk factors have been compared with independent external indicators of the psychosocial work environment, trying to avoid any subjects perception. According to our results, psychological demands measured by the JCQ seem to reflect the actual psychosocial work environment. Other studies are necessary to confirm these results and to assess job control and job social support. This would be another step in improving our knowledge of the quality of measurement of psychosocial risk factors.

Trastornos afectivos en la población laboral: ¿un problema emergente en salud laboral?

Fundamento Conocer la prevalencia de trastornos afectivos en poblacion ocupada. Sujetos Y METodo Trabajadores de cuatro empresas: construccion (A), componentes automovilisticos (B), componentes electricos y electronicos (C) y servicios administrativos (D). El diseno fue transversal mediante el cuestionario GHQ-28. Resultados La prevalencia oscilo entre el 8,4 (A) y el 24,0% (D). El sexo, la edad, el nivel educativo y la ocupacion presentaron diferencias significativas en algunas empresas. ConclusioN Los resultados indican una prevalencia elevada de trastornos afectivos, que podria aumentar en la medida que haya mas empresas de servicios.

Análisis de los mecanismos de producción de las lesiones leves por accidentes de trabajo en la construcción en España

Objetivos: La construccion es la actividad economica que registro mayor numero de lesiones por accidentes de trabajo (LAT) con baja en jornada en Espana (25,6%), de las cuales el 98,5% eran leves con casi 5 millones de dias perdidos en 2000. Esto ocurre despues de adoptarse numerosas normas preventivas en los ultimos anos. El objetivo fue identificar los mecanismos especificos de LAT leves en la construccion. Metodos: El total de LAT leves en la construccion fue 235.853 durante el ano 2000. De ellas se seleccionaron las ocurridas en la «construccion general de inmuebles y obras de ingenieria civil» (n = 155.044), tanto en el conjunto de trabajadores como en albaniles y peones de la construccion. Como actividad de referencia se selecciono la «actividad financiera y de seguros» (n = 2.019). Las LAT por afeccion no traumatica (infarto, etc.) fueron el grupo control (n = 167), asumiendo que el riesgo de LAT no traumatica era independiente de la actividad economica. La odds ratio (OR) se ajusto por edad, sexo, antiguedad en la empresa, tipo de contrato y tamano de la empresa, mediante modelos de regresion logistica no condicional. Resultados: Los mecanismos de produccion mas especificos de LAT en la construccion, respecto a los de las finanzas y seguros, fueron, para el conjunto de trabajadores, la proyeccion de particulas (OR = 33,0; IC del 95%, 15,3-70,8) y los golpes por objetos (OR = 18,2; IC del 95%, 9,7-34,1). Los mismos que tambien se identificaron en albaniles y peones. Conclusiones: Las actividades orientadas a prevenir las LAT leves en la construccion deben tener en cuenta estos mecanismos de produccion, especialmente la proyeccion de particulas, a pesar de que su frecuencia respecto a otros mecanismos de produccion sea baja. Los estudios de casos y controles constituyen una alternativa util para el analisis de las LAT.

Analysis of the mechanisms of minor occupational injuries in the construction industry in Spain

OBJECTIVESnThe construction industry produces the highest number of occupational injuries in Spain (25.6%). Of these, 98.5% were minor injuries with 5 million workdays lost in 2000. This occurred even after the recent introduction of numerous health and occupational safety regulations. The objective of the present study was to identify the specific mechanisms of minor occupational injuries in the construction sector.nnnMETHODSnIn 2000, there were 235,853 minor occupational injuries in the construction industry. From these, injuries in general construction and civil engineering were selected (n = 155,044). These injuries affected both the total number of workers in the sector as well as bricklayers and unskilled construction workers. Insurance and financial activities (n = 2,019) were selected as a reference economic sector. Minor occupational injuries due to nontraumatic processes (heart attack, etc.) were taken as a control group (n = 167), assuming that the risk of nontraumatic processes was independent of economic activities. Odds ratios (OR) were adjusted by age, sex, years of work experience, type of employment and company size through nonconditional logistic regression models.nnnRESULTSnThe mechanisms with the highest risk of minor occupational lesions in construction workers as a group compared with employees in the financial sector were projection of fragments (OR = 33.0; 95% CI, 15.3-70.8) and being struck by objects (OR = 18.2; CI 95%, 9.7-34.1). These were also the most specific mechanisms of injury in the subgroup of bricklayers and unskilled construction workers.nnnCONCLUSIONSnActivities aimed at preventing minor occupational injuries in the construction sector should be orientated towards these mechanisms, especially projection of fragments despite the low frequency of this mechanism compared with that of other mechanisms. Case-control design is a useful alternative approach for research into occupational injuries.

Description of psychosocial risk factors in four companies

OBJECTIVEnTo describe the distribution of work-related psychosocial risk factor scores in four companies according to the personal and occupational characteristics of the workers.nnnMETHODSnCross-sectional study of a sample of 890 workers in four companies who participated in this study voluntarily. The overall response rate was 34.5%. A self-administrated questionnaire was used to measure the presence of demand, control and social support according to the workers perceptions. Statistical analyses were performed using median and dispersion measures of psychosocial risk factors for each company separately, as well as description of their distribution according to personal and occupational variables.nnnRESULTSnThe median score for social support was almost always equal to 5 for all four companies. However, there was greater variability in psychological demand (between 13 and 16), and for control (between 20 and 26). Comparison of the scores for social and occupational variables revealed similar values for social support but not for control and demand, which showed greater variation according to sex (men), age group (less than 40 years) and occupation (clerks).nnnCONCLUSIONSnAlthough the low response rate could limit the validity of our results, this is the first study to value the distribution of work-related psychosocial risk factor scores in four companies in Spain. Variability among companies for different groups of workers was found. This study could be useful for future studies exploring the feasibility of defining reference values for use in preventive measures.