Conductas de riesgo para la salud según la ocupación en población empleada en España / Health risk behaviors by occupation in working population in Spain

Objetivo: Analizar las variaciones en las prevalencias de diferentes conductas de riesgo para la salud, según la ocupación, en la población empleada en España. Método: Estudio transversal con datos de la Encuesta Nacional de Salud española de 2017. El análisis incluye adultos de 18-65 años con empleo en el momento de la encuesta. Las conductas de riesgo para la salud son obesidad, inactividad física en el tiempo libre, consumo de tabaco y consumo excesivo de alcohol. La variable explicativa principal es la ocupación, utilizando la Clasificación Nacional de Ocupaciones de 2011. Se incluyen las siguientes características sociodemográficas: sexo, edad, país de nacimiento y nivel educativo. Se han calculado las prevalencias (P) de las conductas de riesgo, así como las odds ratios crudas y ajustadas (ORa). Resultados: Las cifras más altas de obesidad se observan en operadores de instalaciones y maquinaria, y en montadores (P: 20,0%; ORa: 1,26; intervalo de confianza aproximado del 95% [IC95%A]: 1,04-1,52). El mayor nivel de inactividad física durante el tiempo libre aparece en ocupaciones elementales (P: 83,4%; ORa: 1,70; IC95%A: 1,45-1,99). El consumo de tabaco es más alto en operadores de instalaciones y maquinaria, y en montadores (P=37,4%; ORa: 1,22; IC95%A: 1,05-1,43). El consumo excesivo de alcohol aparece en mayor medida en trabajadores cualificados en el sector agrícola, ganadero, forestal y pesquero (P: 3,9%. ORa: 1,51; IC95%A: 0,83-2,75). Conclusiones: Los resultados indican una mayor relación entre las conductas de riesgo para salud y las ocupaciones manuales o de menor cualificación. (AU)

Objective: This study aims to analyze the variations in the prevalence of different health risk behaviors according to occupation in working population in Spain. Method: Cross-sectional study with data from the Spanish National Health Survey of 2017. The analysis includes adults between 18 and 65 years with employment at the time of the survey. Health risk behaviors are obesity, physical inactivity in free time, tobacco consumption and excessive alcohol consumption. The primary explanatory variable is the occupation, using the National Classification of Occupations of 2011. Sociodemographic characteristics are gender, age, country of birth and educational level. The prevalences (P) of risk behaviors have been calculated, as well as the odd and adjusted odds ratios (aOR). Results: The highest figures of obesity are observed in operators of installations and machinery and assemblers (P: 20.0%; ORa: 1.26; A95%CI: 1.04-1.52). The higher level of physical inactivity during free time appears in elementary occupations (P: 83.4%; ORa: 1.70; A95%CI: 1.45-1.99). Tobacco consumption is higher in operators of installations and machinery and assemblies (P: 37.4%; ORa: 1.22; A95%CI: 1.05-1.43). Excessive alcohol consumption appears to a greater extent on skilled workers in the agricultural sector, livestock, forestry and fisheries (P: 3.9%; ORa: 1.51; A95%CI: 0.83-2.75). Conclusions: The results indicate a greater relationship between risk behaviors for health and manual or lower-skilled occupations. (AU)

[Health risk behaviors by occupation in working population in Spain]. / Conductas de riesgo para la salud según la ocupación en población empleada en España.

OBJECTIVE: This study aims to analyze the variations in the prevalence of different health risk behaviors according to occupation in working population in Spain. METHOD: Cross-sectional study with data from the Spanish National Health Survey of 2017. The analysis includes adults between 18 and 65 years with employment at the time of the survey. Health risk behaviors are obesity, physical inactivity in free time, tobacco consumption and excessive alcohol consumption. The primary explanatory variable is the occupation, using the National Classification of Occupations of 2011. Sociodemographic characteristics are gender, age, country of birth and educational level. The prevalences (P) of risk behaviors have been calculated, as well as the odd and adjusted odds ratios (aOR). RESULTS: The highest figures of obesity are observed in operators of installations and machinery and assemblers (P: 20.0%; ORa: 1.26; A95%CI: 1.04-1.52). The higher level of physical inactivity during free time appears in elementary occupations (P: 83.4%; ORa: 1.70; A95%CI: 1.45-1.99). Tobacco consumption is higher in operators of installations and machinery and assemblies (P: 37.4%; ORa: 1.22; A95%CI: 1.05-1.43). Excessive alcohol consumption appears to a greater extent on skilled workers in the agricultural sector, livestock, forestry and fisheries (P: 3.9%; ORa: 1.51; A95%CI: 0.83-2.75). CONCLUSIONS: The results indicate a greater relationship between risk behaviors for health and manual or lower-skilled occupations.

Changes in drug and alcohol-related mortality by educational status during the 2008-2011 economic crisis: Results from a Spanish longitudinal study.

INTRODUCTION: The objective was to assess changes in drug- and alcohol-related mortality by educational attainment during the last financial crisis in Spain. METHODS: Data came from the 2001 Census Longitudinal Study. We included 22.2 million residents in Spain aged ≥35 at census date followed-up until December 2011. Outcomes were drug-related mortality (DRM) and deaths directly attributable to alcohol (DDA). Mortality risks before and during the crisis were assessed using age-standardized rates and educational inequalities by estimating age-adjusted Rate Ratios (RR) and Relative Indexes of inequality (RII) between educational groups. RESULTS: During the first four year of the crisis, DRM and DDA in men and women increased in all educational subgroups except for DRM in men with tertiary studies (-15%). The increase in mortality was larger in those with higher educational status, with women with tertiary studies experiencing the largest increases in DRM (+100%) and DDA (+114%). Mortality risks for both outcomes followed an educational gradient before and during the crisis in men and women, with those with primary studies being at higher risk. Absolute and relative measures of inequality decreased during the crisis, except for DRM in men. CONCLUSIONS: DRM and DDA follow an inverse educational gradient, with those with primary studies being at higher risk. During the last financial crisis, DRM decreased only in men with tertiary studies, with DRM and DDA increasing in all other groups. The increase was larger in those with higher educational status, reducing inequalities in all groups except of DRM in men.

The choice of screening instrument matters: the case of problematic cannabis use screening in spanish population of adolescents.

The aim of this study was to examine the feasibility of problem cannabis use screening instruments administration within wide school surveys, their psychometric properties, overlaps, and relationships with other variables. Students from 7 Spanish regions, aged 14-18, who attended secondary schools were sampled by two-stage cluster sampling (net sample 14,589). Standardized, anonymous questionnaire including DSM-IV cannabis abuse criteria, Cannabis Abuse Screening Test (CAST), and Severity of Dependence Scale (SDS) was self-completed with paper and pencil in the selected classrooms. Data was analysed using classical psychometric theory, bivariate tests, and multinomial logistic regression analysis. Not responding to instruments' items (10.5-12.3%) was associated with reporting less frequent cannabis use. The instruments overlapped partially, with 16.1% of positives being positive on all three. SDS was more likely to identify younger users with lower frequency of use who thought habitual cannabis use posed a considerable problem. CAST positivity was associated with frequent cannabis use and related problems. It is feasible to use short psychometric scales in wide school surveys, but one must carefully choose the screening instrument, as different instruments identify different groups of users. These may correspond to different types of problematic cannabis use; however, measurement bias seems to play a role too.

Comparison of two methods to assess the effect of age and sex on the risk of car crashes.

BACKGROUND: This study was designed to compare two methods (direct measurement of exposure and quasi-induced exposure) for assessing the effect of age and sex on the risk of being involved in a car crash in Spain. METHODS: Spanish crash rates (per 10,000,000 driver-km) for age and sex groups of drivers aged 18-64 years old were obtained for 2004-2007, using information from the Spanish General Traffic Office (census of reported car crashes) and the Spanish Household Survey on Alcohol and Drugs (estimate of the mean km driven for each car driver). The rate ratios estimated by direct exposure estimates were compared to those obtained with the quasi-induced exposure method, which compares the age and sex of responsible and non-responsible drivers involved in the same clean collision (in which only one of the drivers committed a driving infraction). RESULTS: Both methods detected an increased risk of involvement in a crash for the youngest (18-20 years) and the oldest drivers (60-64 years), compared to middle-aged drivers (45-49 years). However, the rate ratios obtained with the quasi-induced method for the youngest group (2.0 for men, 1.6 for women) were much lower than those obtained with crash rates (13.4 for men, 5.7 for women). Both methods detected a similar increase in the risk of involvement of male drivers compared to women in the youngest age group. This excess risk for men was maintained with increasing age up to 45-49 years when the quasi-induced method was used. However, direct comparisons of crash rates revealed an increased risk of involvement in women compared to men of the same age from 25-29 years onward. CONCLUSIONS: Both direct measurement of driving exposure and the quasi-induced exposure method detected some well-known patterns of risk associated with driver's age and sex. However, factors that could explain important differences between the two methods deserve attention, especially those related with the excess risk for the youngest drivers as well as sex-related risk.

Estimating the prevalence of drug injection using a multiplier method based on a register of new HIV diagnoses.

Knowledge of prevalence of illegal drug injection can aid the design and evaluation of services for problem drug users. In this study, prevalence of recent injectors in Spain was estimated with a multiplier method using the number of injectors in a population register of new HIV diagnoses, HIV incidence among injectors from cohort studies and HIV prevalence among injectors in a drug treatment register. Prevalence in 2008 was 38.8 (95% CI 23.8-53.8) per 100,000 population, a 2.8 times reduction compared with 2001. This method permits estimation of both prevalence and trends of drug injection. It is sustainable and routinely applicable in many countries.

Metodología del estudio de cohortes del proyecto itinere sobre consumidores de heroína en tres ciudades españolas y características básicas de los participantes / Cohort Study Methodology of the ITINERE Project on Heroin Users in Three Spanish Cities and Main Characteristics of the Participants

Fundamento: Los estudios de cohortes permiten monitorizar elimpacto del uso de drogas sobre la salud, e identificar los factorescondicionantes. El objetivo de este trabajo es describir la metodologíay las características básicas de una cohorte de consumidores deheroína diseñada con este fin.Métodos: Participaron 991 jóvenes consumidores de heroína,seleccionados en la comunidad en Barcelona, Madrid y Sevilla, principalmentemediante nominación de otros participantes (39,7%) o deconsumidores o exconsumidores no participantes (44,7%). Se administróun cuestionario con ordenador y se recogió una muestra desangre en papel secante. También se registraron sus medidas antropométricas.Se remuneró a participantes y captadores. Se usaronmétodos estadísticos uni y bivariados.Resultados: Un 42,4% había cambiado alguna vez de vía principalde administración de heroína, sobre todo hacia la inyección enBarcelona y hacia la vía pulmonar en Sevilla. Un 75,8% (Barcelona),49,8% (Madrid), y 15,5% (Sevilla) se habían inyectado drogas en losúltimos 12 meses. En Madrid y Sevilla un 96%-97% consumían laheroína sólo en forma de base, y en Barcelona predominaba la heroína-clorhidrato. Frecuentemente mezclaban heroína y cocaína en lamisma dosis (generalmente cocaína-base en Madrid y Sevilla, ycocaína-clorhidrato en Barcelona). Conclusiones: Persisten importantes diferencias geográficas enla prevalencia de inyección de drogas y en los patrones de consumode heroína y cocaína, lo que podría explicar la desigual distribuciónde algunos problemas de salud. Las dificultades para reunir la muestraprevista sugieren un descenso importante de la incidencia de consumode heroína

Background: Cohort studies make it possible to monitor thehealth impact of drug use and to identify related factors. We describethe methodology and baseline characteristics of a cohort ofheroin users designed with this objective.Methods: The participants were 991 young, community-recruitedheroin users in Barcelona, Madrid and Seville. Most subjectswere named by other participants (39.7%) or by non-participatingdrug users or ex-users (44.7%). A computer-aided questionnairewas administered (self-administered with audio for questions relatedwith sex). A dried-blood spot sample was collected and anthropometricmeasurements were made. Both participants and recruitersreceived remuneration. Univariate and bivariate statistical methodswere used. Results: Some 42.4% had changed the main route of heroinadministration, mainly to injection in Barcelona and to the pulmonaryroute in Seville. About 75.8% (Barcelona), 49.8% (Madrid),and 15.5% (Seville) had injected drugs in the last 12 months. InMadrid and Seville, 96-97% used heroin in base form, while in Barcelonaheroin hydrochloride predominated. Heroin and cocainewere frequently mixed in the same dose (generally base cocaine inMadrid and Seville, and cocaine hydrochloride in Barcelona).Conclusions: Important geographic differences persist in theprevalence of drug injection and in the patterns of heroin and cocaineuse, which could explain the unequal distribution of some healthproblems. The difficulties encountered in recruiting the sample suggestthat the incidence of heroin use has declined considerably

[Cohort study methodology of the ITINERE Project on heroin users in three Spanish cities and main characteristics of the participants]. / Metodología del estudio de cohortes del proyecto ITINERE sobre consumidores de heroína en tres ciudades españolas y características básicas de los participantes.

BACKGROUND: Cohort studies make it possible to monitor the health impact of drug use and to identify related factors. We describe the methodology and baseline characteristics of a cohort of heroin users designed with this objective. METHODS: The participants were 991 young, community-recruited heroin users in Barcelona, Madrid and Seville. Most subjects were named by other participants (39.7%) or by non-participating drug users or ex-users (44.7%). A computer-aided questionnaire was administered (self-administered with audio for questions related with sex). A dried-blood spot sample was collected and anthropometric measurements were made. Both participants and recruiters received remuneration. Univariate and bivariate statistical methods were used. RESULTS: Some 42.4% had changed the main route of heroin administration, mainly to injection in Barcelona and to the pulmonary route in Seville. About 75.8% (Barcelona), 49.8% (Madrid), and 15.5% (Seville) had injected drugs in the last 12 months. In Madrid and Seville, 96-97% used heroin in base form, while in Barcelona heroin hydrochloride predominated. Heroin and cocaine were frequently mixed in the same dose (generally base cocaine in Madrid and Seville, and cocaine hydrochloride in Barcelona). CONCLUSIONS: Important geographic differences persist in the prevalence of drug injection and in the patterns of heroin and cocaine use, which could explain the unequal distribution of some health problems. The difficulties encountered in recruiting the sample suggest that the incidence of heroin use has declined considerably.

Prevalencia de infección por el virus de la inmunodeficiencia humana y de conductas de riesgo entre consumidores de drogas / Prevalence of hiv infection and risk habits in drugs users

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