A glossary for the social epidemiology of work organization. Part 3: terms from labour markets

This is part 3 of a three-part glossary on the social epidemiology of work organisation. The first two parts deal with the social psychology of work and with organisations. This concluding part presents concepts related to labour markets. These concepts are drawn from economics, business and sociology. They relate both to traditional interests in these disciplines and to contemporary ideas on post-industrialisation and globalisation, particularly the growth of employment in service industries, the development of a 24-h economy, increased participation of the female labour force and the perceived needs of employers in emerging high-tech economies.These changes are of particular interest because they are linked to increasing inequality in earnings and changes in social relationships in employment. These concepts have the potential to elucidate the pathways through which health is affected by conditions of work as an underlying cause

Validación de un cuestionario para medir retrospectivamente la exposición laboral a plaguicidas

ResumenObjetivosValidar un cuestionario diseñado para medir retrospectivamente la exposición laboral a plaguicidas en un estudio de casos y controles sobre trabajadores expuestos a plaguicidas y malformaciones congénitas.MétodosSe compara la información obtenida mediante una entrevista personal con 56 agricultores con: 1) una entrevista con los empleadores de los agricultores, 2) la observación directa de los lugares de trabajo y 3) un cuestionario que cumplimentaron los agncultores durante la realización del Programa de Capacitación para Manipuladores de Plaguicidas.ResultadosLos índices de exactitud y fiabilidad fueron altos para las variables «cultivos trabajados», «períodos de tratamiento» y «utilización de protección personal», con sensibilidades entre 0,81 y 1 e índices Kappa de 0,65 a 0,80. Sin embargo, las variables «duración de los tratamientos» y «productos plaguicidas utilizados» presentaron índices de exactitud más bajos con sensibilidades entre 0,32 y 0,50.ConclusionesLos resultados sugieren que el cuestionario es un buen instrumento para la medición de algunas variables pero en otras reflejan la existencia de problemas de recuerdo. Esto hace necesario adoptar medidas que mejoren la exactitud de la medida de la exposición como la introducción en el cuestionario del tamaño del área tratada como otra variable que permita valorar la duración de la exposición y la utilización de listas de recuerdo de productos plaguicidas durante la entrevista.SummaryObjectiveThe aim of this study is to validate a questionnaire intended to assess retrospective occupational exposure to pesticides in a case control study of workers exposed to pesticides and congenital malformations.MethodsOccupational data were gathered through personal interviews to 56 agricultural workers and this information was compared to: 1) personal interviews with the workers’ foremen, 2) direct observation of working places and 3) another questionnaire self-administered previously by the workers as a part of the «Training Program for Pesticide Aplicators».ResultsAccuracy and reliability indices are high for variables such as the crops where the interviewees have been working, the time period of the treatments with pesticides and the use of personal protection during treatments (sensitivity ranges between 0.81 and 1 and Kappa index ranges between 0.65 and 0.80). However, for variables such as the duration of the treatments and the pesticides used, sensitivity values range between 0.32 and 0.50.ConclusionsThe results suggest that the questionnaire is a valid tool for measuring some items but in order to improve the quality of the exposure assessment the questionnaire was modified, including a question about size of treated areas (as a proxy variable for duration of treatments) and prompt lists were developed to make easier recall by the workers of specific pesticides used in treatments

How do types of employment relate to health indicators? Findings from the Second European Survey on Working Conditions

http://deepblue.lib.umich.edu/bitstream/2027.42/56182/1/Benavides FG, How do types of employment relate to health indicators - Findings from the Second European Survey on Working Conditions, 2000.pd

Soil: the great connector of our lives now and beyond COVID-19

Open Access Journal; Published online: 05 Nov 2020Humanity depends on the existence of healthy soils, both for the production of food and for ensuring a healthy, biodiverse environment, among other functions. COVID-19 is threatening food availability in many places of the world due to the disruption of food chains, lack of workforce, closed borders and national lockdowns. As a consequence, more emphasis is being placed on local food production, which may lead to more intensive cultivation of vulnerable areas and to soil degradation. In order to increase the resilience of populations facing this pandemic and future global crises, transitioning to a paradigm that relies more heavily on local food production on soils that are carefully tended and protected through sustainable management is necessary. To reach this goal, the Intergovernmental Technical Panel on Soils (ITPS) of the Food and Agriculture Organization of the United Nations (FAO) recommends five active strategies: improved access to land, sound land use planning, sustainable soil management, enhanced research, and investments in education and extension. The soil is the great connector of lives, the source and destination of all. It is the healer and restorer and resurrector, by which disease passes into health, age into youth, death into life. Without proper care for it we can have no community, because without proper care for it we can have no life

Epidemiological Differences between Localized and Nonlocalized Low Back Pain

Study Design. A cross-sectional survey with a longitudinal follow-up. Objectives. The aim of this study was to test the hypothesis that pain, which is localized to the low back, differs epidemiologically from that which occurs simultaneously or close in time to pain at other anatomical sites Summary of Background Data. Low back pain (LBP) often occurs in combination with other regional pain, with which it shares similar psychological and psychosocial risk factors. However, few previous epidemiological studies of LBP have distinguished pain that is confined to the low back from that which occurs as part of a wider distribution of pain. Methods. We analyzed data from CUPID, a cohort study that used baseline and follow-up questionnaires to collect information about musculoskeletal pain, associated disability, and potential risk factors, in 47 occupational groups (office workers, nurses, and others) from 18 countries. Results. Among 12,197 subjects at baseline, 609 (4.9%) reported localized LBP in the past month, and 3820 (31.3%) nonlocalized LBP. Nonlocalized LBP was more frequently associated with sciatica in the past month (48.1% vs. 30.0% of cases), occurred on more days in the past month and past year, was more often disabling for everyday activities (64.1% vs. 47.3% of cases), and had more frequently led to medical consultation and sickness absence from work. It was also more often persistent when participants were followed up after a mean of 14 months (65.6% vs. 54.1% of cases). In adjusted Poisson regression analyses, nonlocalized LBP was differentially associated with risk factors, particularly female sex, older age, and somatizing tendency. There were also marked differences in the relative prevalence of localized and nonlocalized LBP by occupational group. Conclusion. Future epidemiological studies should distinguish where possible between pain that is limited to the low back and LBP that occurs in association with pain at other anatomical locations

Global Retinoblastoma Presentation and Analysis by National Income Level

Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4) were female. Most patients (n = 3685 84.7%) were from low-and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 62.8%), followed by strabismus (n = 429 10.2%) and proptosis (n = 309 7.4%). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 95% CI, 12.94-24.80, and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 95% CI, 4.30-7.68). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs. © 2020 American Medical Association. All rights reserved

La profesión de salud pública y el debate de las competencias profesionales Public health professionals and professional competences debate

A pesar de sus contribuciones en el pasado, la salud pública ocupa en la actualidad una posición marginal en el sistema sanitario. Este insuficiente protagonismo se asocia con el escaso reconocimiento de la profesión y de sus profesionales. Para fortalecer la salud pública se debe profundizar en la coherencia de sus objetivos y de su base científica y metodológica, así como garantizar la competencia de sus profesionales. La falta de institucionalización de est os elementos limita la articulación de los objetivos de salud pública en una serie de prácticas eficaces. Así pues, no se han desarrollado lo que se denomina «competencias profesionales» específicas de la salud pública: el conjunto de habilidades que deben ser capaces de llevar a cabo los profesionales. El contenido profesional se debe definir a partir del análisis de las funciones y de las actividades específicas necesarias para desarrollarlas. En este trabajo se pretende estimular una reflexión, a la luz de la experiencia de otros países, que permita iniciar una nueva reconstrucción de la salud pública, mediante la cual se pueda abandonar la situación marginal actual y mejorar el desempeño de su función social.Despite its historical contribution to the improvement of health, public health occupies a marginal position in health systems. This lack of correspondence between impact and power is related in part to its scarce recognition as a profession, and in consequence to the lack of recognition of the professionals in the field. The strengthening of the public health profession requires recognising the coherence of their objectives and scientific basis, but it also requires the establishment of mechanisms to guarantee professional competence. Generally, the institutionalisation of these necessary mechanisms to articulate public health objectives into effective professional practice has been lacking. In other words, the so-called professional competencies lacked development in public health. Progress in this strategy calls for the definition of the professional content based on a functional analysis of public health. That is, an analysis of the functions that these professionals must contribute to society and of the specific activities necessary to achieve the desired outcomes. The aim of this work is to stimulate a debate along these lines taking into account the experience

Descripción de los factores de riesgo psicosocial en cuatro empresas

Objetivo: Describir la distribución de las puntuaciones de los factores de riesgo psicosocial de origen laboral en cuatro empresas según características personales y laborales de los trabajadores. Métodos: 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 valoró la presencia de demanda, control y apoyo social, según la percepción del trabajador. El análisis estadístico se basó en el cálculo de la mediana y medidas de la dispersión de los factores de riesgo psicosocial para cada una de las empresas por separado, además de la descripción de su distribución según variables personales y laborales. Resultados: La puntuación mediana para el apoyo social fue prácticamente igual a 5 en todas las empresas observándose una mayor variabilidad en la demanda psicológica (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 variación por sexo (varones), edad (menores de 40 años) y ocupación (administrativos). Conclusión: Aunque la baja tasa de respuesta puede limitar la validez de estos resultados, éste es el primer estudio que valora la distribución de las puntuaciones de los factores de riesgo psicosocial en cuatro empresas diferentes en España, evidenciando la variabilidad entre las empresas para diferentes grupos de trabajadores. Este trabajo puede ser útil para realizar futuros estudios que exploren la factibilidad de definir valores de referencia útiles para la acción preventiva