Resumen Objetivo Estimar las relaciones prospectivas entre la exposición a las dimensiones de riesgos psicosociales incluidas en el COPSOQ-Istas21 y el deterioro de la salud general, la salud mental y los problemas del sueño entre personas trabajadoras residentes en España. Método Cohorte cuya línea base corresponde a la Encuesta de Riesgos Psicosociales de 2016, con una nueva medición al cabo de 1 año. Resultados Las dimensiones de capital social y de relaciones interpersonales y liderazgo, así como el conflicto trabajo-vida, se relacionaron con todas las variables de salud. Las de organización y contenido del trabajo lo hicieron especialmente con la salud mental, las exigencias cuantitativas con la salud general y las emocionales con la salud mental. Las dimensiones relacionadas con la inseguridad laboral no mostraron relación con la salud. Conclusiones Los resultados obtenidos refuerzan el papel del COPSOQ-Istas21 como un instrumento útil para la evaluación y la prevención de los riesgos psicosociales en el trabajo.

Abstract Objective To estimate the prospective relationships between exposure to psychosocial risks dimensions included in the COPSOQ-Istas21 and the deterioration of general and mental health and sleep problems among workers residing in Spain. Method Social capital and interpersonal relations and leadership dimensions, as well as work-Cohort whose baseline corresponds to the 2016 Psychosocial Risks Survey with a new measurement after one year. Results life conflict, were related to all health variables. Dimensions of work organization and job contents did it especially with the mental health, the quantitative demands with the general health and the emotional ones with the mental health. The dimensions related to job insecurity did not show relationships with health. Conclusions The results obtained reinforce the role of the COPSOQ-Istas21 as a useful instrument for the evaluation and prevention of psychosocial risks at work.

Abstract Objective To estimate the prospective relationships between exposure to psychosocial risks dimensions included in the COPSOQ-Istas21 and the deterioration of general and mental health and sleep problems among workers residing in Spain. Method Social capital and interpersonal relations and leadership dimensions, as well as work-Cohort whose baseline corresponds to the 2016 Psychosocial Risks Survey with a new measurement after one year. Results life conflict, were related to all health variables. Dimensions of work organization and job contents did it especially with the mental health, the quantitative demands with the general health and the emotional ones with the mental health. The dimensions related to job insecurity did not show relationships with health. Conclusions The results obtained reinforce the role of the COPSOQ-Istas21 as a useful instrument for the evaluation and prevention of psychosocial risks at work.

Resumen Objetivo Estimar las relaciones prospectivas entre la exposición a las dimensiones de riesgos psicosociales incluidas en el COPSOQ-Istas21 y el deterioro de la salud general, la salud mental y los problemas del sueño entre personas trabajadoras residentes en España. Método Cohorte cuya línea base corresponde a la Encuesta de Riesgos Psicosociales de 2016, con una nueva medición al cabo de 1 año. Resultados Las dimensiones de capital social y de relaciones interpersonales y liderazgo, así como el conflicto trabajo-vida, se relacionaron con todas las variables de salud. Las de organización y contenido del trabajo lo hicieron especialmente con la salud mental, las exigencias cuantitativas con la salud general y las emocionales con la salud mental. Las dimensiones relacionadas con la inseguridad laboral no mostraron relación con la salud. Conclusiones Los resultados obtenidos refuerzan el papel del COPSOQ-Istas21 como un instrumento útil para la evaluación y la prevención de los riesgos psicosociales en el trabajo.

ABSTRACT Objective To estimate the association between socio-economic life course and body mass index (BMI), waist circumference (WC) and general and abdominal obesity in adults. Methods A cross-sectional analysis of a population-based cohort study of 1,222 adults (aged 22-63) from Florianopolis, southern Brazil. The socio-economic life course was analysed using the educational level of participants and their parents. Height, weight and WC were measured by specially trained staff. Linear and logistic regressions were used with adjustment for confounding factors, and data were stratified according to sex. Results Mean BMI and WC were about 2 kg/m2 (95% CI: −3.3 to −0.7) and 6 cm (95% CI: −9.7 to −2.9) lower in women with a high socio-economic position, while the association was reversed in men with a high socio-economic position, with WC being about 4 cm higher (95% CI: 0.1 to 7.5). In addition, women who had always been in a high socio-economic position were less likely to have abdominal obesity (OR: 0.38; 95% CI: 0.20 to 0.76) while no such association was found in men Conclusion Socio-economic life course influences BMI, WC and obesity, with differences between males and females, thereby indicating that public policies that contemplate a socio-economic life course approach can be effective for controlling obesity

RESUMEN Objetivo Estimar la asociación entre trayectoria socioeconómica e índice de masa corporal (IMC), circunferencia de la cintura (CC) y obesidad general y abdominal en adultos. Métodos Análisis transversal de un estudio de cohortes de base poblacional en 1222 adultos (22-63 an˜ os de edad) en Florianópolis, sur de Brasil. La trayectoria socioeconómica fue analizada mediante el nivel educativo de los padres y los propios participantes. La medición de altura, peso y CC fue realizada por personal especialmente entrenado. Se usaron modelos de regresión lineal y logística ajustando factores confusores y estratificando por sexo. Resultados El promedio de IMC y CC fue de 2 kg/m2 (intervalo de confianza del [IC95%]: −3,3 a −0,7) y 6 cm (IC95%: −9,7 a −2,9), menor en las mujeres con mejor posición socioeconómica. Dicha asociación fue la contraria en el caso de los hombres, en los que el promedio de CC fue 4 cm mayor (IC95%: 0,1 a 7,5). Las mujeres que siempre permanecieron en mejor posición socioeconómica fueron menos propensas a tener obesidad abdominal (odds ratio: 0,38; IC95%: 0,20 a 0,76), mientras que en los hombres no se observó dicha asociación. Conclusiones La trayectoria socioeconómica se asocia al IMC, la CC y la obesidad, con diferencias entre sexos, indicando que la aplicación de políticas públicas que contemplen la trayectoria socioeconómica puede ser efectiva para el control de la obesidad.

RESUMEN Objetivo Estimar la asociación entre trayectoria socioeconómica e índice de masa corporal (IMC), circunferencia de la cintura (CC) y obesidad general y abdominal en adultos. Métodos Análisis transversal de un estudio de cohortes de base poblacional en 1222 adultos (22-63 an˜ os de edad) en Florianópolis, sur de Brasil. La trayectoria socioeconómica fue analizada mediante el nivel educativo de los padres y los propios participantes. La medición de altura, peso y CC fue realizada por personal especialmente entrenado. Se usaron modelos de regresión lineal y logística ajustando factores confusores y estratificando por sexo. Resultados El promedio de IMC y CC fue de 2 kg/m2 (intervalo de confianza del [IC95%]: −3,3 a −0,7) y 6 cm (IC95%: −9,7 a −2,9), menor en las mujeres con mejor posición socioeconómica. Dicha asociación fue la contraria en el caso de los hombres, en los que el promedio de CC fue 4 cm mayor (IC95%: 0,1 a 7,5). Las mujeres que siempre permanecieron en mejor posición socioeconómica fueron menos propensas a tener obesidad abdominal (odds ratio: 0,38; IC95%: 0,20 a 0,76), mientras que en los hombres no se observó dicha asociación. Conclusiones La trayectoria socioeconómica se asocia al IMC, la CC y la obesidad, con diferencias entre sexos, indicando que la aplicación de políticas públicas que contemplen la trayectoria socioeconómica puede ser efectiva para el control de la obesidad.

ABSTRACT Objective To estimate the association between socio-economic life course and body mass index (BMI), waist circumference (WC) and general and abdominal obesity in adults. Methods A cross-sectional analysis of a population-based cohort study of 1,222 adults (aged 22-63) from Florianopolis, southern Brazil. The socio-economic life course was analysed using the educational level of participants and their parents. Height, weight and WC were measured by specially trained staff. Linear and logistic regressions were used with adjustment for confounding factors, and data were stratified according to sex. Results Mean BMI and WC were about 2 kg/m2 (95% CI: −3.3 to −0.7) and 6 cm (95% CI: −9.7 to −2.9) lower in women with a high socio-economic position, while the association was reversed in men with a high socio-economic position, with WC being about 4 cm higher (95% CI: 0.1 to 7.5). In addition, women who had always been in a high socio-economic position were less likely to have abdominal obesity (OR: 0.38; 95% CI: 0.20 to 0.76) while no such association was found in men Conclusion Socio-economic life course influences BMI, WC and obesity, with differences between males and females, thereby indicating that public policies that contemplate a socio-economic life course approach can be effective for controlling obesity

RESUMO OBJETIVO Testar se há associação entre posição socioeconômica da infância e medidas de índice de massa corporal, circunferência da cintura e presença de obesidade geral e abdominal na vida adulta. MÉTODOS Análise transversal em estudo de coorte de base populacional, incluindo amostra de adultos (22–63 anos) residentes em Florianópolis, Sul do Brasil. A posição socioeconômica da infância foi analisada por meio da escolaridade dos pais e mães dos participantes. Estatura, peso e circunferência da cintura foram aferidos por entrevistadores previamente treinados. Foram empregadas regressões linear e logística com ajuste para fatores de confusão, e estratificação dos dados segundo sexo. RESULTADOS Dos 1.222 adultos avaliados, 20,4% (IC95% 18,1–22,8) apresentaram obesidade geral e 24,8% (IC95% 22,4–27,4), obesidade abdominal. As médias de índice de massa corporal e circunferência da cintura entre mulheres foram, respectivamente, 1,2 kg/m2 (IC95% -2,3– -0,04) e 2,8 cm (IC95% -5,3– -0,2) menores entre aquelas de maior posição socioeconômica na infância. Entre os homens, a circunferência da cintura foi 3,9 cm (IC95% 1,0–6,8) maior nos indivíduos de maior posição socioeconômica na infância. Em relação à obesidade, mulheres de maior posição socioeconômica na infância tiveram menores chances de obesidade abdominal (OR = 0,56; IC95% 0,34–0,90), não tendo sido observada tal associação entre os homens. CONCLUSÕES A posição socioeconômica na infância tem influência sobre índice de massa corporal, circunferência da cintura e obesidade em adultos, com diferença na direção da associação conforme o sexo. A maior posição socioeconômica entre os homens e a menor posição socioeconômica entre as mulheres estiveram associadas aos maiores indicadores de adiposidade.

ABSTRACT OBJECTIVE To test whether there is an association between socioeconomic status in childhood and measures of body mass index, waist circumference and the presence of overall and abdominal obesity in adult life. METHODS A cross-sectional analysis of a population-based cohort study, including a sample of adults (22–63 years old) living in Florianópolis, Southern Brazil. The socioeconomic status in childhood was analyzed through the education level of the participant’s parents. Height, weight and waist circumference were measured by previously trained interviewers. Linear and logistic regressions with adjustment for confounding factors and stratification of data according to gender were used. RESULTS Of the 1,222 adults evaluated, 20.4% (95%CI 18.1–22.8) presented overall obesity and 24.8% (95%CI 22.4–27.4), abdominal obesity. The body mass index and waist circumference averages among women were, respectively, 1.2 kg/m2 (95%CI -2.3– -0.04) and 2.8 cm (95%CI -5.3– -0.2) lower among those with higher socioeconomic status in childhood. Among men, waist circumference was 3.9 cm (95%CI 1.0–6.8) higher in individuals with higher socioeconomic status in childhood. Regarding obesity, women of higher socioeconomic status in childhood had lower odds of abdominal obesity (OR = 0.56, 95%CI 0.34–0.90), and no such association was observed among men. CONCLUSIONS The socioeconomic status in childhood influences body mass index, waist circumference and obesity in adults, with a difference in the direction of association according to gender. The higher socioeconomic status among men and the lower socioeconomic status among women were associated with higher adiposity indicators.

RESUMO OBJETIVO Testar se há associação entre posição socioeconômica da infância e medidas de índice de massa corporal, circunferência da cintura e presença de obesidade geral e abdominal na vida adulta. MÉTODOS Análise transversal em estudo de coorte de base populacional, incluindo amostra de adultos (22–63 anos) residentes em Florianópolis, Sul do Brasil. A posição socioeconômica da infância foi analisada por meio da escolaridade dos pais e mães dos participantes. Estatura, peso e circunferência da cintura foram aferidos por entrevistadores previamente treinados. Foram empregadas regressões linear e logística com ajuste para fatores de confusão, e estratificação dos dados segundo sexo. RESULTADOS Dos 1.222 adultos avaliados, 20,4% (IC95% 18,1–22,8) apresentaram obesidade geral e 24,8% (IC95% 22,4–27,4), obesidade abdominal. As médias de índice de massa corporal e circunferência da cintura entre mulheres foram, respectivamente, 1,2 kg/m2 (IC95% -2,3– -0,04) e 2,8 cm (IC95% -5,3– -0,2) menores entre aquelas de maior posição socioeconômica na infância. Entre os homens, a circunferência da cintura foi 3,9 cm (IC95% 1,0–6,8) maior nos indivíduos de maior posição socioeconômica na infância. Em relação à obesidade, mulheres de maior posição socioeconômica na infância tiveram menores chances de obesidade abdominal (OR = 0,56; IC95% 0,34–0,90), não tendo sido observada tal associação entre os homens. CONCLUSÕES A posição socioeconômica na infância tem influência sobre índice de massa corporal, circunferência da cintura e obesidade em adultos, com diferença na direção da associação conforme o sexo. A maior posição socioeconômica entre os homens e a menor posição socioeconômica entre as mulheres estiveram associadas aos maiores indicadores de adiposidade.

ABSTRACT OBJECTIVE To test whether there is an association between socioeconomic status in childhood and measures of body mass index, waist circumference and the presence of overall and abdominal obesity in adult life. METHODS A cross-sectional analysis of a population-based cohort study, including a sample of adults (22–63 years old) living in Florianópolis, Southern Brazil. The socioeconomic status in childhood was analyzed through the education level of the participant’s parents. Height, weight and waist circumference were measured by previously trained interviewers. Linear and logistic regressions with adjustment for confounding factors and stratification of data according to gender were used. RESULTS Of the 1,222 adults evaluated, 20.4% (95%CI 18.1–22.8) presented overall obesity and 24.8% (95%CI 22.4–27.4), abdominal obesity. The body mass index and waist circumference averages among women were, respectively, 1.2 kg/m2 (95%CI -2.3– -0.04) and 2.8 cm (95%CI -5.3– -0.2) lower among those with higher socioeconomic status in childhood. Among men, waist circumference was 3.9 cm (95%CI 1.0–6.8) higher in individuals with higher socioeconomic status in childhood. Regarding obesity, women of higher socioeconomic status in childhood had lower odds of abdominal obesity (OR = 0.56, 95%CI 0.34–0.90), and no such association was observed among men. CONCLUSIONS The socioeconomic status in childhood influences body mass index, waist circumference and obesity in adults, with a difference in the direction of association according to gender. The higher socioeconomic status among men and the lower socioeconomic status among women were associated with higher adiposity indicators.

Abstract The presence of missing data in collected variables is common in health surveys, but the subsequent imputation thereof at the time of analysis is not. Working with imputed data may have certain benefits regarding the precision of the estimators and the unbiased identification of associations between variables. The imputation process is probably still little understood by many non-statisticians, who view this process as highly complex and with an uncertain goal. To clarify these questions, this note aims to provide a straightforward, non-exhaustive overview of the imputation process to enable public health researchers ascertain its strengths. All this in the context of dichotomous variables which are commonplace in public health. To illustrate these concepts, an example in which missing data is handled by means of simple and multiple imputation is introduced.

Resumen Que haya valores ausentes en variables registradas en encuestas de salud es habitual, pero no lo es imputarlos posteriormente cuando se realiza el análisis. Trabajar con datos imputados puede tener ventajas en términos de precisión de los estimadores y de identificación sin sesgos de la asociación entre variables. Probablemente, el proceso de imputación sigue siendo desconocido para muchos profesionales no estadísticos, que le atribuyen una alta complejidad y quizás un objetivo que no es exactamente el que persigue. Para aclarar estas cuestiones, esta nota pretende ofrecer una visión amena, no exhaustiva, del proceso de imputación, que permita conocer sus bondades para el trabajo de un salubrista. Todo ello en el marco de variables dicotómicas, habituales en salud pública. Para ilustrar los conceptos se usa un ejemplo en el cual se trabaja con datos con valores ausentes, imputados de forma simple y múltiple.

Resumen Que haya valores ausentes en variables registradas en encuestas de salud es habitual, pero no lo es imputarlos posteriormente cuando se realiza el análisis. Trabajar con datos imputados puede tener ventajas en términos de precisión de los estimadores y de identificación sin sesgos de la asociación entre variables. Probablemente, el proceso de imputación sigue siendo desconocido para muchos profesionales no estadísticos, que le atribuyen una alta complejidad y quizás un objetivo que no es exactamente el que persigue. Para aclarar estas cuestiones, esta nota pretende ofrecer una visión amena, no exhaustiva, del proceso de imputación, que permita conocer sus bondades para el trabajo de un salubrista. Todo ello en el marco de variables dicotómicas, habituales en salud pública. Para ilustrar los conceptos se usa un ejemplo en el cual se trabaja con datos con valores ausentes, imputados de forma simple y múltiple.

Abstract The presence of missing data in collected variables is common in health surveys, but the subsequent imputation thereof at the time of analysis is not. Working with imputed data may have certain benefits regarding the precision of the estimators and the unbiased identification of associations between variables. The imputation process is probably still little understood by many non-statisticians, who view this process as highly complex and with an uncertain goal. To clarify these questions, this note aims to provide a straightforward, non-exhaustive overview of the imputation process to enable public health researchers ascertain its strengths. All this in the context of dichotomous variables which are commonplace in public health. To illustrate these concepts, an example in which missing data is handled by means of simple and multiple imputation is introduced.

Abstract Objective: Researchers in public health are often interested in examining the effect of several exposures on the incidence of a recurrent event. The aim of the present study is to assess how well the common-baseline hazard models perform to estimate the effect of multiple exposures on the hazard of presenting an episode of a recurrent event, in presence of event dependence and when the history of prior-episodes is unknown or is not taken into account. Methods: Through a comprehensive simulation study, using specific-baseline hazard models as the reference, we evaluate the performance of common-baseline hazard models by means of several criteria: bias, mean squared error, coverage, confidence intervals mean length and compliance with the assumption of proportional hazards. Results: Results indicate that the bias worsen as event dependence increases, leading to a considerable overestimation of the exposure effect; coverage levels and compliance with the proportional hazards assumption are low or extremely low, worsening with increasing event dependence, effects to be estimated, and sample sizes. Conclusions: Common-baseline hazard models cannot be recommended when we analyse recurrent events in the presence of event dependence. It is important to have access to the history of prior-episodes per subject, it can permit to obtain better estimations of the effects of the exposures.

Resumen Objetivo: A menudo los investigadores en salud pública están interesados en examinar el efecto de varias exposiciones en la incidencia de un evento recurrente. El objetivo de este estudio es evaluar el funcionamiento de los modelos de riesgo basal común al estimar el efecto de múltiples exposiciones sobre el riesgo de presentar un episodio de un evento recurrente, cuando existe dependencia del evento y los antecedentes de los episodios por sujeto son desconocidos o bien no se tienen en cuenta. Métodos: Mediante un estudio exhaustivo de simulación, utilizando modelos de riesgo basal específico como referencia, se evalúa el rendimiento de los modelos de riesgo basal común a través de diversos criterios: sesgo, error cuadrático medio, cobertura, longitud de los intervalos de confianza y compatibilidad con el supuesto de riesgos proporcionales. Resultados: El sesgo empeora a medida que aumenta la dependencia del evento, llevando a una sobreestimación considerable del efecto de la exposición; los niveles de cobertura y el cumplimiento del supuesto de riesgos proporcionales son bajos o muy bajos, lo que empeora con el aumento de la dependencia del evento, el efecto a estimar y el tamaño muestral. Conclusiones: El uso de modelos de riesgo basal común no puede recomendarse cuando analizamos eventos recurrentes en presencia de dependencia del evento. Es importante tener acceso a los antecedentes de episodios previos por sujeto, ya que ello puede permitir obtener mejores estimaciones de los efectos de las exposiciones.

Resumen Objetivo: A menudo los investigadores en salud pública están interesados en examinar el efecto de varias exposiciones en la incidencia de un evento recurrente. El objetivo de este estudio es evaluar el funcionamiento de los modelos de riesgo basal común al estimar el efecto de múltiples exposiciones sobre el riesgo de presentar un episodio de un evento recurrente, cuando existe dependencia del evento y los antecedentes de los episodios por sujeto son desconocidos o bien no se tienen en cuenta. Métodos: Mediante un estudio exhaustivo de simulación, utilizando modelos de riesgo basal específico como referencia, se evalúa el rendimiento de los modelos de riesgo basal común a través de diversos criterios: sesgo, error cuadrático medio, cobertura, longitud de los intervalos de confianza y compatibilidad con el supuesto de riesgos proporcionales. Resultados: El sesgo empeora a medida que aumenta la dependencia del evento, llevando a una sobreestimación considerable del efecto de la exposición; los niveles de cobertura y el cumplimiento del supuesto de riesgos proporcionales son bajos o muy bajos, lo que empeora con el aumento de la dependencia del evento, el efecto a estimar y el tamaño muestral. Conclusiones: El uso de modelos de riesgo basal común no puede recomendarse cuando analizamos eventos recurrentes en presencia de dependencia del evento. Es importante tener acceso a los antecedentes de episodios previos por sujeto, ya que ello puede permitir obtener mejores estimaciones de los efectos de las exposiciones.

Abstract Objective: Researchers in public health are often interested in examining the effect of several exposures on the incidence of a recurrent event. The aim of the present study is to assess how well the common-baseline hazard models perform to estimate the effect of multiple exposures on the hazard of presenting an episode of a recurrent event, in presence of event dependence and when the history of prior-episodes is unknown or is not taken into account. Methods: Through a comprehensive simulation study, using specific-baseline hazard models as the reference, we evaluate the performance of common-baseline hazard models by means of several criteria: bias, mean squared error, coverage, confidence intervals mean length and compliance with the assumption of proportional hazards. Results: Results indicate that the bias worsen as event dependence increases, leading to a considerable overestimation of the exposure effect; coverage levels and compliance with the proportional hazards assumption are low or extremely low, worsening with increasing event dependence, effects to be estimated, and sample sizes. Conclusions: Common-baseline hazard models cannot be recommended when we analyse recurrent events in the presence of event dependence. It is important to have access to the history of prior-episodes per subject, it can permit to obtain better estimations of the effects of the exposures.

Objetivo: Estimar la frecuencia de incapacidades temporales por contingencia común (ITcc) relacionadas con accidentes de trabajo (AT) previos con (ATB) o sin baja (ATSB). Métodos: Estudio longitudinal prospectivo. Se seleccionaron los trabajadores con ATB o ATSB notificados en Catalunya el último trimestre de 2009. Se hizo seguimiento durante seis meses posteriores al alta (ATB) o accidente (ATSB) según sexo y ocupación. Las fuentes de información fueron los registros oficiales de la autoridad laboral y sanitaria. Se definió "ITcc compatible con AT" si la incapacidad temporal se producía en los seis meses siguientes por el mismo grupo diagnóstico. Se calculó la frecuencia absoluta y relativa de ITcc según tiempo transcurrido y su duración (días acumulados, medidas de tendencia central y dispersión) según grupo diagnostico o área del cuerpo afectada comparándola con la del conjunto de Catalunya. Resultados: Un 2,9% de los ATB (n=627) presentó una ITcc compatible con AT con diferencias según diagnóstico, sexo y ocupación, siendo el mismo caso para el 2,1% de los ATSB (n=496). A igual diagnóstico, la duración de los ATB fue superior entre los que tuvieron después una ITcc compatible con ellos y la duración de éstas ITcc, superior al conjunto de Catalunya. Conclusiones: Parte de la infradeclaración de patología laboral corresponde a episodios reconocidos como laborales en un primer momento. La duración de la incapacidad no dependería únicamente del diagnóstico y curso clínico sino también de criterios de gestión de las Mutuas que podrían determinar que las lesiones más complicadas fueran derivadas a la asistencia pública con consecuencias personales, legales, sanitarias y económicas para todos los implicados.

Objectiu: Estimar la freqüència d'incapacitats temporals per contingència comuna (ITcc) derivades d'accidents de treball previs amb (ATB) o sense baixa (ATSB). Mètodes: Estudi longitudinal prospectiu. Es van seleccionar els treballadors/ores amb ATB/ATSB notificats al Registre d'accidents de treball de Catalunya l'últim trimestre de 2009. Es va fer un seguiment durant els sis mesos posteriors a l'alta (ATB) o l'accident (ATSB) segons el sexe i l'ocupació. Les fonts d'informació van ser els registres oficials de l'autoritat laboral y sanitària. Es va definir "ITcc compatible amb AT" si es produïa en els sis mesos següents pel mateix grup diagnòstic. Es va calcular la freqüència absoluta i relativa d'ITcc segons el temps transcorregut i durada (dies acumulats, les mesures de tendència central i la dispersió) segons grup diagnòstic o àrea del cos afectada comparant-lo amb el conjunt de Catalunya. Resultats: Un 2,9% d'ATB (627) va presentar una ITcc compatible amb AT amb diferències segons diagnòstic, sexe i ocupació i un 2,1% d'ATSB (496). A igual diagnòstic la durada dels ATB va ser superior entre els que van presentar una ITcc compatible amb ells i la durada d'aquestes ITcc, superior al conjunt del país. Conclusions: Una part de la infradeclaració de patologia laboral correspon a episodis reconeguts com a laborals en un primer moment. La durada de la incapacitat no dependria únicament del procés (diagnòstic i curs clínic) sinó també d'altres criteris de gestió de les Mútues que comportarien que lesions més complicades serien derivades a l'assistència pública amb conseqüències personals, legals, sanitàries i de cost econòmic per a tots els implicats.

Objectives: To estimate the frequency of non-work sickness absence (ITcc) related to previous occupational injuries with (ATB) or without (ATSB) sick leave. Methods: Prospective longitudinal study. Workers with ATB or ATSB notified to the Occupational Accident Registry of Catalonia were selected in the last term of 2009. They were followed-up for six months after returning to work (ATB) or after the accident (ATSB), by sex and occupation. Official labor and health authority registries were used as information sources. An "injury-associated ITcc" was defined when the sick leave occurred in the following six months and within the same diagnosis group. The absolute and relative frequency were calculated according to time elapsed and its duration (cumulated days, measures of central trend and dispersion), by diagnosis group or affected body area, as compared to all of Catalonia. Results: 2,9% of ATB (n=627) had an injury-associated ITcc, with differences by diagnosis, sex and occupation; this was also the case for 2,1% of ATSB (n=496). With the same diagnosis, duration of ITcc was longer among those who had an associated injury, and with respect to all of Catalonia. Conclusions: Some of the under-reporting of occupational pathology corresponds to episodes initially recognized as being work-related. Duration of sickness absence depends not only on diagnosis and clinical course, but also on criteria established by the entities managing the case. This could imply that more complicated injuries are referred to the national health system, resulting in personal, legal, healthcare and economic cost consequences for all involved stakeholders.

OBJETIVO: Caracterizar o perfil do paciente atendido em ambulatório de doenças profissionais de um hospital geral e, em especial, o portador da condição patológica mais freqüente: as lesões por esforços repetitivos (LER). MÉTODOS: Foram analisadas as 565 fichas-resumo de atendimento ambulatorial em saúde do trabalhador, em 1996, em função de variáveis sociodemográficas, de características do trabalho e de diagnóstico. Foram adotados os seguintes procedimentos: descrição univariável de todas as variáveis; análise bivariada, utilizando-se o teste do qui-quadrado (chi²) para variáveis categóricas; comparação de médias ou amplitudes para variável categórica e outra quantitativa; análise multivariada por meio de modelos log-linear, com transformação logit, para detectar os grupos com maior proporção de LER. RESULTADOS: Houve predomínio no atendimento de pacientes do sexo feminino com menos de 40 anos, sendo que, nos casos de LER, esse predomínio mostrou-se mais acentuado. As ocupações agrupadas apareceram em ordem decrescente, na seqüência: administrativos, operários e prestadores de serviços, sendo 59,6% pertencentes ao ramo de atividade econômica de serviços. As LER corresponderam a 56% dos diagnósticos feitos nas primeiras consultas. CONCLUSÕES: Confirmou-se a tendência de mudança no perfil epidemiológico das demandas atendidas no ambulatório de doenças profissionais, no final da década de 80, quando emergiram as LER. Deslocaram-se para uma minoria as antigas doenças profissionais decorrentes da exposição a riscos químicos e físicos, em função daquelas relacionadas às condições ergonômicas inadequadas.

OBJECTIVE: To assess the profile of outpatients seen at an occupational disease clinic of a general and repetitive strain injury (RSI) patients by using multivariate analyze. METHODS: The first 565 visit registries for the year 1996 were assessed regarding their social and demographics aspects, work characteristics, and diagnosis. All the variables were analyzed by univariate analysis method. Bivariate data were analyzed using Chi square test (chi²) for categorical variables, comparison of means or ranges for quantitative and categorical variables. Multivariate data were analyzed using log-linear models with logit-transformation to identify the groups with a larger proportion of RSI. RESULTS: Women sought the occupational diseases clinic more frequently than men, and there was a predominance of RSI cases. The occupation distribution was in order of priority as following: office workers, factory workers, and service workers. Of them, 56.9% were from the economic sector of services. RSI was seen in 56% of the patients diagnosed at their first visit. CONCLUSIONS: The analysis confirms the trends seen in the 80s regarding the epidemiological changes in occupational diseases, when RSI started to be identified and displaced to a secondary position the other common diseases (due to physical and chemical hazards) because of inadequacy of ergonomics.

OBJECTIVE: To assess the profile of outpatients seen at an occupational disease clinic of a general and repetitive strain injury (RSI) patients by using multivariate analyze. METHODS: The first 565 visit registries for the year 1996 were assessed regarding their social and demographics aspects, work characteristics, and diagnosis. All the variables were analyzed by univariate analysis method. Bivariate data were analyzed using Chi square test (chi²) for categorical variables, comparison of means or ranges for quantitative and categorical variables. Multivariate data were analyzed using log-linear models with logit-transformation to identify the groups with a larger proportion of RSI. RESULTS: Women sought the occupational diseases clinic more frequently than men, and there was a predominance of RSI cases. The occupation distribution was in order of priority as following: office workers, factory workers, and service workers. Of them, 56.9% were from the economic sector of services. RSI was seen in 56% of the patients diagnosed at their first visit. CONCLUSIONS: The analysis confirms the trends seen in the 80s regarding the epidemiological changes in occupational diseases, when RSI started to be identified and displaced to a secondary position the other common diseases (due to physical and chemical hazards) because of inadequacy of ergonomics.

OBJETIVO: Caracterizar o perfil do paciente atendido em ambulatório de doenças profissionais de um hospital geral e, em especial, o portador da condição patológica mais freqüente: as lesões por esforços repetitivos (LER). MÉTODOS: Foram analisadas as 565 fichas-resumo de atendimento ambulatorial em saúde do trabalhador, em 1996, em função de variáveis sociodemográficas, de características do trabalho e de diagnóstico. Foram adotados os seguintes procedimentos: descrição univariável de todas as variáveis; análise bivariada, utilizando-se o teste do qui-quadrado (chi²) para variáveis categóricas; comparação de médias ou amplitudes para variável categórica e outra quantitativa; análise multivariada por meio de modelos log-linear, com transformação logit, para detectar os grupos com maior proporção de LER. RESULTADOS: Houve predomínio no atendimento de pacientes do sexo feminino com menos de 40 anos, sendo que, nos casos de LER, esse predomínio mostrou-se mais acentuado. As ocupações agrupadas apareceram em ordem decrescente, na seqüência: administrativos, operários e prestadores de serviços, sendo 59,6% pertencentes ao ramo de atividade econômica de serviços. As LER corresponderam a 56% dos diagnósticos feitos nas primeiras consultas. CONCLUSÕES: Confirmou-se a tendência de mudança no perfil epidemiológico das demandas atendidas no ambulatório de doenças profissionais, no final da década de 80, quando emergiram as LER. Deslocaram-se para uma minoria as antigas doenças profissionais decorrentes da exposição a riscos químicos e físicos, em função daquelas relacionadas às condições ergonômicas inadequadas.