Adaptación transcultural y validación del cuestionario de cultura preventiva Organizational Performance Metric / Transcultural adaptation and validation of the Organizational Performance Metric safety culture questionnaire

OBJETIVO: Los Indicadores Positivos de Esfuerzo Preventivo (IPEP) reflejan aspectos centrales de la cultura preventiva; existen evidencias respecto a la validez predictiva de algunos de estos respecto a los accidentes de trabajo. Éste es el caso del Organizational Performance Metric (OPM) desarrollado por el Institute for Work and Health (IWH) de Canadá, cuestionario en inglés, corto y ampliamente validado internacionalmente. El objetivo es obtener una versión adaptada transculturalmente de la herramienta OPM, traducida al castellano y analizar su fiabilidad estadística, validez y consistencia interna. MÉTODO: Tras un proceso de traducción y retro traducción con un panel de expertos, se cumplimentaron en Navarra, España, 478 cuestionarios. Se calculó el estadístico alfa de Cronbach, las correlaciones bivariadas, el índice de correlación intraclase (ICC) y un análisis factorial exploratorio a los ocho ítems que lo forman. RESULTADOS: el análisis muestra una alta fiabilidad (alfa de Cronbach=0,863) y validez interna (ICC = 0,842) de la herramienta. El análisis factorial confirma un único factor latente entre los ocho ítems del cuestionario. CONCLUSIONES: El cuestionario obtenido (OPM-Esp) constituye un instrumento válido como indicador positivo de esfuerzo preventivo para las empresas españolas. Su reducido tamaño y fácil aplicación lo hacen especialmente útil en el ámbito laboral. Su predictibilidad respecto a los accidentes de trabajo deberá valorarse para el entorno español

OBJECTIVE: Safety positive performance indicators (PPI) reflect key aspects of safety culture; some of them also have predictive validity for occupational injuries. This is the case of the Organizational Performance Metric (OPM), developed by the Canadian Institute for Work & Health (IWH), a short, widely validated international English language questionnaire. The objective of this study was to obtain a transculturally adapted Spanish language version of the OPM, and to analyze its statistical reliability, validity and internal consistency. METHOD: After a translation and back translation process was performed by an expert panel, 478 questionnaires were completed in Navarra, Spain. We calculated the Cronbach alpha coefficient, bivariate correlations and the intra-class correlation coefficient (ICC) and performed exploratory factorial analysis of all eight items. RESULTS: Data show the new tool has high reliability (Cronbach alpha = 0.863) and internal validity (ICC = 0.842). The factorial analysis confirmed a single latent factor among the eight items of the questionnaire. CONCLUSIONS: the adapted questionnaire (OPM-Esp) constitutes a valid instrument for use as an indicator of safety performance in Spanish companies. Its brevity and simplicity make it especially useful in the work environment. Its ability to predict occupational injuries should be tested in the Spanish context

[Transcultural adaptation and validation of the Organizational Performance Metric safety culture questionnaire]. / Adaptación transcultural y validación del cuestionario de cultura preventiva Organizational Performance Metric.

OBJECTIVE: Safety positive performance indicators (PPI) reflect key aspects of safety culture; some of them also have predictive validity for occupational injuries. This is the case of the Organizational Performance Metric (OPM), developed by the Canadian Institute for Work & Health (IWH), a short, widely validated international English language questionnaire. The objective of this study was to obtain a transculturally adapted Spanish language version ofthe OPM, and to analyze its statistical reliability, validity and internal consistency. METHOD: After a translation and back translation process was performed by an expert panel, 478 questionnaires were completed in Navarra, Spain. We calculated the Cronbach alpha coefficient, bivariate correlations and the intra-class correlation coefficient (ICC) and performed exploratory factorial analysis of all eight items. RESULTS: Data show the new tool has high reliability (Cronbach alpha==0.863) and internal validity (ICC=0.842). The factorial analysis confirmed a single latent factor among the eight items of the questionnaire. CONCLUSIONS: the adapted questionnaire (OPM-Esp) constitutes a valid instrument for use as an indicator of safety performance in Spanish companies. Its brevity and simplicity make it especially useful in the work environment. Its ability to predict occupational injuries should be tested in the Spanish context.

OBJETIVO: Los Indicadores Positivos de Esfuerzo Preventivo (IPEP) reflejan aspectos centrales de la cultura preventiva; existen evidencias respecto a la validez predictiva de algunos de estos respecto a los accidentes de trabajo. Éste es el caso del Organizational Performance Metric (OPM) desarrollado por el Institute for Work & Health (IWH) de Canadá, cuestionario en inglés, corto y ampliamente validado internacionalmente. El objetivo es obtener una versión adaptada transculturalmente de la herramienta OPM, traducida al castellano y analizar su fiabilidad estadística, validez y consistencia interna. MÉTODO: Tras un proceso de traducción y retro traducción con un panel de expertos, se cumplimentaron en Navarra, España, 478 cuestionarios. Se calculó el estadístico alfa de Cronbach, las correlaciones bivariadas, el índice de correlación intraclase (ICC) y un análisis factorial exploratorio a los ocho ítems que lo forman. RESULTADOS: el análisis muestra una alta fiabilidad (alfa de Cronbach=0,863) y validez interna(ICC=0,842) de la herramienta. El análisis factorial confirma un único factor latente entre los ocho ítems del cuestionario. CONCLUSIONES: El cuestionario obtenido (OPM-Esp) constituye un instrumento válido como indicador positivo de esfuerzo preventivo para las empresas españolas. Su reducido tamaño y fácil aplicación lo hacen especialmente útil en el ámbito laboral. Su predictibilidad respecto a los accidentes de trabajo deberá valorarse para el entorno español.

Indoor radon in Spanish workplaces. A pilot study before the introduction of the European Directive 2013/59/Euratom / Radón interior en puestos de trabajo en España. Un estudio piloto antes de la introducción de la Directiva Europea 2013/59/Euratom

Objective: To explore whether there is a possible problem regarding indoor radon concentration surpassing the new European Directive 2013/59/Euratom threshold in Spanish workplaces. We also aim to find out whether radon concentration might be associated with certain characteristics of workplaces. Method: We performed a cross-sectional study to measure indoor radon concentrations in Spanish workplaces including five different sectors (education, public administration, the health sector, the tourist sector and the private sector). To be measured, the workplace should be occupied permanently by at least one worker. Alpha-track type radon detectors were placed for at least three months and read at the Galician Radon Laboratory at the University of Santiago de Compostela. A descriptive analysis was performed on radon distribution by sector, building characteristics and number of workers affected. Results: We faced enormous difficulties in finding volunteers for this study. Galicia and Madrid had the highest number of measurements. Of a total of 248 measurements, 27% had concentrations above 300 Bq/m3. Median radon concentration was 251 Bq/m3 in Galicia, followed by Madrid, with 61.5 Bq/m3. Forty-six percent of the workplaces measured in Galicia had radon concentrations higher than 300 Bq/m3 followed by 10.6% in Madrid. Nineteen percent of all workers were exposed to more than 300 Bq/m3 and 6.3% were exposed to radon concentrations higher than 500 Bq/m3. Conclusion: Indoor radon exposure might be a relevant problem in Spanish workplaces and the number of affected workers could be high. The prevalence of workers exposed to high radon concentrations probably depends on the geographical area

Objetivo: Explorar si podría existir un problema en cuanto a la concentración de radón en los puestos de trabajo en España por superación del umbral propuesto por la nueva Directiva Europea 2013/59/Euratom. También se pretende conocer si la concentración de radón puede estar asociada a las características de los puestos de trabajo. Método: Estudio transversal en seis regiones y diferentes sectores (educación, administración pública, sanitario, turístico y privado). El puesto de trabajo medido debía ser ocupado de manera permanente por al menos un trabajador. Los detectores de radón de tipo alfa-track estuvieron colocados al menos 3 meses y fueron revelados en el Laboratorio de Radón de Galicia, de la Universidad de Santiago de Compostela. Se realizó un análisis descriptivo de la concentración de radón por sector, por características de los edificios y por número de trabajadores afectados. Resultados: Hubo dificultades para encontrar voluntarios para este estudio. Galicia y Madrid tuvieron el mayor número de mediciones. Se midieron 248 lugares de trabajo, con el 27% por encima de los 300 Bq/m3. La concentración mediana fue de 251 Bq/m3 en Galicia, seguida de Madrid con 61,5 Bq/m3. El 46% de los puestos de trabajo en Galicia tenían concentraciones mayores de 300 Bq/m3, y el 10,6% en Madrid. El 19% de los trabajadores estuvieron expuestos a más de 300 Bq/m3 y el 6,3% a más de 500 Bq/m3. Conclusión: La exposición a radón podría ser un problema de salud relevante en los lugares de trabajo en España. El número de trabajadores expuestos parece elevado. La prevalencia de trabajadores afectados depende del área geográfica

Indoor radon in Spanish workplaces. A pilot study before the introduction of the European Directive 2013/59/Euratom.

OBJECTIVE: To explore whether there is a possible problem regarding indoor radon concentration surpassing the new European Directive 2013/59/Euratom threshold in Spanish workplaces. We also aim to find out whether radon concentration might be associated with certain characteristics of workplaces. METHOD: We performed a cross-sectional study to measure indoor radon concentrations in Spanish workplaces including five different sectors (education, public administration, the health sector, the tourist sector and the private sector). To be measured, the workplace should be occupied permanently by at least one worker. Alpha-track type radon detectors were placed for at least three months and read at the Galician Radon Laboratory at the University of Santiago de Compostela. A descriptive analysis was performed on radon distribution by sector, building characteristics and number of workers affected. RESULTS: We faced enormous difficulties in finding volunteers for this study. Galicia and Madrid had the highest number of measurements. Of a total of 248 measurements, 27% had concentrations above 300 Bq/m3. Median radon concentration was 251 Bq/m3 in Galicia, followed by Madrid, with 61.5 Bq/m3. Forty-six percent of the workplaces measured in Galicia had radon concentrations higher than 300 Bq/m3 followed by 10.6% in Madrid. Nineteen percent of all workers were exposed to more than 300 Bq/m3 and 6.3% were exposed to radon concentrations higher than 500 Bq/m3. CONCLUSION: Indoor radon exposure might be a relevant problem in Spanish workplaces and the number of affected workers could be high. The prevalence of workers exposed to high radon concentrations probably depends on the geographical area.

Condiciones de trabajo y salud de los trabajadores inmigrantesen España. Revisión bibliográfica / No disponible

Fundamentos: La relación entre inmigración, trabajo y salud constituye uno de los retos más importantes en salud laboral y más concretamente en España por el importante incremento de proporción inmigrante acontecido en el mercado laboral. El objetivo de esta investigación es conocer la relación entre las condiciones de trabajo y sus efectos en la salud de trabajadores inmigrantes en España. Métodos: Revisión bibliográfica de artículos científicos originales en español e inglés en Medline y Medes (1998-2012). Se revisaron los textos completos de los artículos incluidos. Resultados: Se incluyeron 20 estudios, 13 con metodología de investigación cuantitativa y 7 cualitativa. Los temas tratados abordaban problemas específicos de salud relacionados con el trabajo (principalmente lesiones por accidente de trabajo), incapacidad laboral y diferencias en condiciones de trabajo y empleo. Los hallazgos de los estudios mostraron mayor incidencia de lesiones por accidentes de trabajo, menores tasas de incapacidad laboral, mayor prevalencia de presentismo laboral, exposición a factores psicosociales y precariedad laboral en la población inmigrante. Conclusiones: A pesar de la singularidad del proceso demográfico migratorio, los problemas de salud y determinantes identificados no difieren de los referenciados en otros países, en otros contextos y en otros momentos (AU)

No disponible

The Impact of Education and Socioeconomic and Occupational Conditions on Self-Perceived and Mental Health Inequalities Among Immigrants and Native Workers in Spain.

There is limited evidence on the influence of social determinants on the self-perceived and mental health of immigrants settled at least 8 years in Spain. The aim of this study was to examine differences between workers related to migrant-status, self-perceived and mental health, and to assess their relationship to occupational conditions, educational level and occupational social class, stratified by sex. Using data from the Spanish National Health Survey of 2011/12, we computed prevalence, odds ratios and explicative fractions. Mental (OR 2.02; CI 1.39-2.93) and self-perceived health (OR 2.64; CI 1.77-3.93) were poorer for immigrant women compared to natives. Occupational social class variable contributes 25% to self-perceived health OR in immigrant women. Settled immigrant women workers are a vulnerable group in Spain.

Condiciones de trabajo y salud de los trabajadores inmigrantes en España. Revisión bibliográfica / Scoping review about working conditions and health of immigrant workers in Spain

Fundamentos: La relación entre inmigración, trabajo y salud constituye uno de los retos más importantes en salud laboral y más concretamente en España por el importante incremento de proporción inmigrante acontecido en el mercado laboral. El objetivo de esta investigación es conocer la relación entre las condiciones de trabajo y sus efectos en la salud de trabajadores inmigrantes en España. Métodos: Revisión bibliográfica de artículos científicos originales en español e inglés Medline y Medes (1998-2012). Se revisaron los textos completos de los artículos incluidos. Resultados: Se incluyeron 20 estudios, 13 con metodología de investigación cuantitativa y 7 cualitativa. Los temas tratados abordaban problemas específicos de salud relacionados con el trabajo (principalmente lesiones por accidente de trabajo), incapacidad laboral y diferencias en condiciones de trabajo y empleo. Los hallazgos de los estudios mostraron mayor incidencia de lesiones por accidentes de trabajo, menores tasas de incapacidad laboral, mayor prevalencia de presentismo laboral, exposición a factores psicosociales y precariedad laboral en la población inmigrante. Conclusiones: A pesar de la singularidad del proceso demográfico migratorio, los problemas de salud y determinantes identificados no difieren de los referenciados en otros países, en otros contextos y en otros momentos (AU)

Background:The relationship between immigration, work, and health is one of the most important challenges in occupational health at current, particularly in Spain, by the significant increase in the migrant workers in the labor market occurred. This investigation aims to know the relationship betwen working conditions and their effects on migrant workers. Methods: Scoping review of scientific papers on this topic at the Medline and Medes databases in Spanish and English (1998-2012). The articles included were full text reviewed. Results: 20 studies were included, 13 with quantitative methodology and 7 qualitative. The topics address specific health problems related to work (primarily occupational accidents), disability, and differences in working conditions and employment. The findings of the studies show a higher incidence of injury accidents, lower rates of disability, higher prevalence of work presenteeism, exposure to psychosocial factors, and precariousness. Conclusion: Despite the uniqueness of the demographic process migration happened in Spain, health problems and determinants identified no different from those referenced in other countries, in other contexts and in other times (AU)

[Scoping review about working conditions and health of immigrant workers in Spain]. / Condiciones de trabajo y salud de los trabajadores inmigrantes en España: revisión bibliográfica.

BACKGROUND: The relationship between immigration, work, and health is one of the most important challenges in occupational health at current, particularly in Spain, by the significant increase in the migrant workers in the labor market occurred. This investigation aims to know the relationship betwen working conditions and their effects on migrant workers. METHODS: Scoping review of scientific papers on this topic at the Medline and Medes databases in Spanish and English (1998-2012). The articles included were full text reviewed. RESULTS: 20 studies were included, 13 with quantitative methodology and 7 qualitative. The topics address specific health problems related to work (primarily occupational accidents), disability, and differences in working conditions and employment. The findings of the studies show a higher incidence of injury accidents, lower rates of disability, higher prevalence of work presenteeism, exposure to psychosocial factors, and precariousness. CONCLUSION: Despite the uniqueness of the demographic process migration happened in Spain, health problems and determinants identified no different from those referenced in other countries, in other contexts and in other times.

Percepción de las trabajadoras inmigrantes del servicio doméstico sobre los efectos de la regulación del sector en España / Perceptions of female immigrant domestic workers on the effects of the sector regulation in Spain

Objetivo: Explorar las percepciones de las mujeres inmigrantes trabajadoras del servicio doméstico sobre la puesta en vigor en España del Real Decreto 1620/2011, que regula la relación laboral del servicio del hogar familiar, y su efecto en sus condiciones de empleo. Métodos Estudio exploratorio mediante análisis de contenido cualitativo. Se realizaron tres grupos de discusión con mujeres inmigrantes (colombianas, ecuatorianas y marroquíes).Resultados A pesar de valorar positivamente los beneficios teóricos de la nueva normativa, las mujeres inmigrantes han identificado barreras legales y económicas para conseguir un contrato, ser dadas de alta en la seguridad social y que las personas empleadoras asuman su coste, en especial en el caso de las trabajadoras contratadas por horas. Estas dificultades influyen en la posibilidad de legalizar su situación. La confluencia con la crisis económica ha emergido como un problema que dificulta su cumplimiento. Conclusiones Aunque el nuevo régimen ha favorecido la creación de puestos de trabajo con mayores derechos laborales en el sector, las mujeres inmigrantes perciben que su puesta en marcha en el actual contexto de crisis económica no ha contribuido a mejorar sus condiciones de empleo (AU)

Objective: To examine the perceptions of female immigrant domestic workers of the effect of Royal Decree 1620/2011, which regulates the relationship of domestic workers in the family home and their employment conditions in Spain. Methods An exploratory study was performed using qualitative content analysis of three focus group discussions with immigrant women from Colombia, Ecuador and Morocco. Results Immigrant women positively assessed the theoretical benefits of the new regulation, but identified legal and economic barriers to obtaining a contract and being registered in the social security system by their employers, and to employers accepting the cost of these measures, especially for workers hired by the hour. These difficulties affected their possibilities of legalizing their status. The economic crisis posed a serious challenge to compliance with the new regulation. Conclusions Although the new regime encourages job creation with stronger working rights for these workers, immigrant women perceived that its implementation has been hampered by the current financial crisis and has not, therefore, improved their employment conditions (AU)

[Perceptions of female immigrant domestic workers on the effects of the sector regulation in Spain]. / Percepción de las trabajadoras inmigrantes del servicio doméstico sobre los efectos de la regulación del sector en España.

OBJECTIVE: To examine the perceptions of female immigrant domestic workers of the effect of Royal Decree 1620/2011, which regulates the relationship of domestic workers in the family home and their employment conditions in Spain. METHODS: An exploratory study was performed using qualitative content analysis of three focus group discussions with immigrant women from Colombia, Ecuador and Morocco. RESULTS: Immigrant women positively assessed the theoretical benefits of the new regulation, but identified legal and economic barriers to obtaining a contract and being registered in the social security system by their employers, and to employers accepting the cost of these measures, especially for workers hired by the hour. These difficulties affected their possibilities of legalizing their status. The economic crisis posed a serious challenge to compliance with the new regulation. CONCLUSIONS: Although the new regime encourages job creation with stronger working rights for these workers, immigrant women perceived that its implementation has been hampered by the current financial crisis and has not, therefore, improved their employment conditions.

Differences in exposure to occupational health risks in Spanish and foreign-born workers in Spain (ITSAL Project).

Migrant workers usually show higher rates of work-related health problems than natives. However, little information is available about their exposure to occupational risks. We describe self-reported working exposure in Spanish and foreign-born workers. A cross-sectional survey was conducted as part of the ITSAL Project. Data on sociodemographic and self-reported occupational exposure in 1,841 foreign-born and 509 Spanish workers were collected through face-to-face interviews. Prevalence and adjusted odds ratios-aOR- (by age, education, type of contract) were calculated. Foreign-born men in non-services sectors and those in manual occupations perceived exposure to occupational risks with lower prevalence than Spanish workers. Foreign-born women reported higher prevalence of exposure than Spanish female workers. By occupation, foreign-born female workers were more likely than Spanish workers to report working many hours/day (aOR2.68; 95 % CI 1.06-6.78) and exposure to extreme temperatures (aOR2.19; 95 % CI 1.10-4.38). Some groups of migrant workers may need increased protection regarding some occupational exposures.

De la encuesta a la base de datos: experiencia de trabajo de campo del estudio «Inmigración, trabajo y salud» (Proyecto ITSAL) / From questionnaire to database: field work experience in the ‘Immigration, work and health survey’ (ITSAL Project)

Objetivo A pesar de la necesidad de información sobre salud de las poblaciones inmigrantes, los datos disponibles son escasos. El presente estudio describe el trabajo de campo en un estudio transversal sobre salud de los trabajadores inmigrantes en España. Método Muestra de conveniencia de trabajadores procedentes de Colombia, Ecuador, Marruecos y Rumanía, por itinerarios, en cuatro ciudades. Se calcularon los indicadores de resultados propuestos por la American Association of Public Opinion Research. Resultados Se accedió a 6504 personas, de las cuales el 71,4% cumplían criterios de inclusión, y de ellos sólo el 57,8% completó la entrevista. Las tasas de respuesta y cooperación superaron el 50%.ConclusionesLa estrategia de muestreo por itinerarios ha permitido a los encuestadores acceder a esta población. También ha sido beneficiosa la participación de encuestadores especialmente formados y con un perfil similar al de la población objetivo(AU)

Objective Despite the need for information in the area of migration and health, the available data are sparse. We describe the field work in a cross-sectional study on the health of immigrant workers in Spain. Method A convenience sample of workers from Colombia, Ecuador, Morocco and Rumania in four cities was targeted, using a block-walking approach. The outcome rates of the American Association of Public Opinion Research were estimated. Results Of 6,504 persons approached, 71.4% were eligible contacts. Of these contacts, only 57.8% completed interviews. Response and cooperation rates were above 50%.ConclusionsBlock-walking enabled surveyors to access difficult-to-reach groups. The use of specifically trained surveyors with a background similar to that of the target population increased the effectiveness of our methods (AU)

From questionnaire to database: field work experience in the 'Immigration, work and health survey' (ITSAL Project).

OBJECTIVE: Despite the need for information in the area of migration and health, the available data are sparse. We describe the field work in a cross-sectional study on the health of immigrant workers in Spain. METHOD: A convenience sample of workers from Colombia, Ecuador, Morocco and Rumania in four cities was targeted, using a block-walking approach. The outcome rates of the American Association of Public Opinion Research were estimated. RESULTS: Of 6,504 persons approached, 71.4% were eligible contacts. Of these contacts, only 57.8% completed interviews. Response and cooperation rates were above 50%. CONCLUSIONS: Block-walking enabled surveyors to access difficult-to-reach groups. The use of specifically trained surveyors with a background similar to that of the target population increased the effectiveness of our methods.

Diferencias en los accidentes laborales en España según país de procedencia del trabajador / Differences in occupational accidents in Spain according to the worker's country of origin

OBJETIVO: Comparar los accidentes laborales en trabajadores inmigrantes y autóctonos en España. MATERIAL Y MÉTODOS: La fuente de información procede de la Encuesta Española de Condiciones de Trabajo. La nacionalidad del trabajador fue la variable explicativa principal, clasificada según el índice de desarrollo humano (IDH). La variable resultado fueron los accidentes laborales (AL). Otras variables incluidas fueron sociodemográficas y condiciones de empleo. Se calcularon prevalencias y razones de momios (RM) crudas y ajustadas (regresión logística) con sus intervalos de confianza al 95 por ciento (IC95 por ciento). RESULTADOS: La prevalencia de AL en trabajadores de países de bajo IDH fue 12.7 por ciento (mujeres: 11.1 por ciento), y en españoles 10.3 por ciento (mujeres: 8.1 por ciento). Comparado con trabajadoras autóctonas, las mujeres de países de bajo IDH presentaron mayor riesgo (RM ajustada 1.66; IC95 por ciento 1.21-2.28). Conclusión. Es necesario profundizar en el análisis causal de los AL en inmigrantes identificando los posibles factores de riesgo y reforzando las medidas preventivas para su control.

OBJECTIVE: Compare the occupational accidents between autochthonous and immigrant workers in Spain. MATERIAL AND METHODS: Data were obtained from the Spanish Survey of Working Conditions. Nationality was considered as an explicative variable, and the country of origin was regrouped according to the Human Development Index-HDI. Occupational accidents were the outcome. Other variables included were sociodemographic and employment conditions. Prevalences were calculated as well as simple and adjusted odds ratio (OR) (logistic regression) with a 95 percent confidence interval (CI 95 percent). RESULTS: The prevalence of occupational accidents was 12.7 percent (women, 11.1 percent) for workers from low HDI countries and 10.3 percent (women, 8.1 percent) for Spaniards. A higher risk of occupational accidents was observed among women from low HDI countries compared to Spaniards (adjusted OR 1.66; 95 percentCI 1.21-2.28). DISCUSSION: It is necessary to conduct a more thorough causal analysis of occupational accidents among immigrants in order to identify risk factors and strengthen prevention and control strategies.

[Differences in occupational accidents in Spain according to the worker's country of origin]. / Diferencias en los accidentes laborales en España según país de procedencia del trabajador.

OBJECTIVE: Compare the occupational accidents between autochthonous and immigrant workers in Spain. MATERIAL AND METHODS: Data were obtained from the Spanish Survey of Working Conditions. Nationality was considered as an explicative variable, and the country of origin was regrouped according to the Human Development Index-HDI. Occupational accidents were the outcome. Other variables included were sociodemographic and employment conditions. Prevalences were calculated as well as simple and adjusted odds ratio (OR) (logistic regression) with a 95% confidence interval (CI 95%). RESULTS: The prevalence of occupational accidents was 12.7% (women, 11.1%) for workers from low HDI countries and 10.3% (women, 8.1%) for Spaniards. A higher risk of occupational accidents was observed among women from low HDI countries compared to Spaniards (adjusted OR 1.66; 95%CI 1.21-2.28). DISCUSSION: It is necessary to conduct a more thorough causal analysis of occupational accidents among immigrants in order to identify risk factors and strengthen prevention and control strategies.

Immigration, work and health in Spain: the influence of legal status and employment contract on reported health indicators.

OBJECTIVE: To analyze the relationship of legal status and employment conditions with health indicators in foreign-born and Spanish-born workers in Spain. METHODS: Cross-sectional study of 1,849 foreign-born and 509 Spanish-born workers (2008-2009, ITSAL Project). Considered employment conditions: permanent, temporary and no contract (foreign-born and Spanish-born); considered legal statuses: documented and undocumented (foreign-born). Joint relationships with self-rated health (SRH) and mental health (MH) were analyzed via logistical regression. RESULTS: When compared with male permanently contracted Spanish-born workers, worse health is seen in undocumented foreign-born, time in Spain ≤3 years (SRH aOR 2.68, 95% CI 1.09-6.56; MH aOR 2.26, 95% CI 1.15-4.42); in Spanish-born, temporary contracts (SRH aOR 2.40, 95% CI 1.04-5.53); and in foreign-born, temporary contracts, time in Spain >3 years (MH: aOR 1.96, 95% CI 1.13-3.38). In females, highest self-rated health risks are in foreign-born, temporary contracts (aOR 2.36, 95% CI 1.13-4.91) and without contracts, time in Spain >3 years (aOR 4.63, 95% CI 1.95-10.97). CONCLUSIONS: Contract type is a health determinant in both foreign-born and Spanish-born workers. This study offers an uncommon exploration of undocumented migration and raises methodological issues to consider in future research.

Invisible work, unseen hazards: The health of women immigrant household service workers in Spain.

BACKGROUND: Household service work has been largely absent from occupational health studies. We examine the occupational hazards and health effects identified by immigrant women household service workers. METHODS: Exploratory, descriptive study of 46 documented and undocumented immigrant women in household services in Spain, using a phenomenological approach. Data were collected between September 2006 and May 2007 through focus groups and semi-structured individual interviews. Data were separated for analysis by documentation status and sorted using a mixed-generation process. In a second phase of analysis, data on psychosocial hazards were organized using the Copenhagen Psychosocial Questionnaire as a guide. RESULTS: Informants reported a number of environmental, ergonomic and psychosocial hazards and corresponding health effects. Psychosocial hazards were especially strongly present in data. Data on reported hazards were similar by documentation status and varied by several emerging categories: whether participants were primarily cleaners or carers and whether they lived in or outside of the homes of their employers. Documentation status was relevant in terms of empowerment and bargaining, but did not appear to influence work tasks or exposure to hazards directly. CONCLUSIONS: Female immigrant household service workers are exposed to a variety of health hazards that could be acted upon by improved legislation, enforcement, and preventive workplace measures, which are discussed.

Una visión de género a los protocolos de vigilancia sanitaria de la población trabajadora / Occupational health surveillance protocols in Spain: a gender perspective

Objetivo: Los protocolos para la vigilancia de la salud de la población trabajadora constituyen una herramienta básicaen la prevención de los riesgos laborales. Los recientes cambios normativos, junto al fuerte incremento del empleo remuneradoen las mujeres, plantean la necesidad de revisar su aplicabilidad a las trabajadoras. El objetivo de este artículo es evaluarestos protocolos desde una perspectiva de género.Método: Se ha analizado el diseño y el contenido de cuatro de los 19 protocolos publicados por el Ministerio de Sanidady Consumo por ocho personas expertas mediante una técnica de consenso estructurado en la que se aplicó una guía para laevaluación de la perspectiva de género basada en el Instrumento AGREE y dividida en cinco áreas generales y 14 ítems específicos.Resultados: De las cinco áreas consideradas, las mejor valoradas en los cuatro protocolos han sido alcance y objetivos,y participación, siendo las más débiles las de aplicabilidad, salud sexual y reproductiva y riesgos laborales. En los protocolosde Asma Laboral, Manipulación Manual de Cargas y Pantallas de Visualización de Datos seis de las ocho personas expertasrecomiendan su mejora desde una perspectiva del género. En el protocolo de Plaguicidas se hace la misma recomendaciónpor unanimidad de todos los expertos.Conclusión: Es necesario identificar los sesgos de género en los protocolos utilizados para la vigilancia de la salud de lapoblación trabajadora e introducir los cambios necesarios(AU)

Background: Specific occupational health surveillance protocols are essential tools for the prevention of occupationalhazards. Recent changes in legislation, coupled with a significant increase in women workforce, necessitate a review of theseprotocols with respect to their applicability to female workers. The aim of this article is to analyze existing Spanish occupationalhealth surveillance protocols from a gender perspective Methods: The design and content of four of the nineteen available protocols published by Spanish Ministry of Healthwere analyzed by eight experts through consensus techniques, using a Gender Perspective Guide based on the AGREEInstrument and evaluating each protocol in relation to five major areas and 14 individual items.Results: Of the five major areas, participation, and scope and objective obtained the best evaluations, while applicability,sexual and reproductive health, and occupational hazards yielded the poorest scores. For protocols used for OccupationalAsthma, Manual Handling of Loads and Data Computer Screens, six out of the eight experts recommended review andimprovement from a gender perspective. For the protocol regarding Pesticides, this same recommendation was supportedunanimously.Conclusions: Gender biases need to be identified, and changes recommended when necessary, in the Spanish protocolsfor occupational health surveillance(AU)

[Occupational health of immigrant workers in Spain [ITSAL Project]: key informants survey]. / Condiciones de trabajo y salud en inmigrantes (Proyecto ITSAL): entrevistas a informantes clave.

OBJECTIVE: To describe the characteristics, working conditions, and occupational health situation of immigrant workers in Spain through key informants. METHOD: We performed a qualitative, exploratory and descriptive study using indepth interviews carried out in 2006. Organizations and associations working with immigrant collectives in Alicante, Barcelona, Huelva, Madrid and Valencia were identified and the most representative and accessible entities in each location were selected. Fortythree interviews were performed with key informants from 34 different organisms. A narrative content analysis was performed. RESULTS: Informants described difficulties in having health problems recognized as workrelated, due to irregular and precarious employment, employers' and insurance companies' reluctance, and immigrants' lack of knowledge. Informants coincided in reporting that the occupational risks for immigrant workers did not differ from those affecting Spanish workers in the same occupations and circumstances. However, exposure to occupational risks was exacerbated in immigrants because of their greater presence in unqualified jobs and their economic need to prolong working hours. Immigrants had little knowledge of their occupational health and safetyrelated rights, although some informants detected an increase in empowerment in this area, mostly through greater participation in trade unions. CONCLUSIONS: This first step allowed us to identify some of the general factors influencing the health and safety of immigrant workers in Spain. This information will be used in a longterm, ongoing research project [Project Immigration, Work and Health (Proyecto Inmigración, Trabajo y Salud [ITSAL]), which aims to evaluate occupational health problems in inmigrants working in Spain through both qualitative and quantitative methods.

Condiciones de trabajo y salud en inmigrantes (Proyecto ITSAL): entrevistas a informantes clave / Occupational health of immigrant workers in Spain [ITSAL Project]: key informants survey

Objetivo: Caracterizar colectivos de inmigrantes trabajadores en España y conocer sus condiciones de salud laboral mediante informantes clave. Método: Estudio cualitativo exploratorio-descriptivo con entrevistas en profundidad realizado en 2006. Se identificaron organizaciones, asociaciones y colectivos relacionados con la población inmigrante en Alicante, Barcelona, Huelva, Madrid y Valencia, y se seleccionaron los más accesibles y representativos. Se entrevistó a 43 informantes clave procedentes de 34 asociaciones u organismos. Se realizó un análisis narrativo del contenido. Resultados: Se señalan dificultades para el reconocimiento de los daños a la salud derivados del trabajo por las situaciones de irregularidad y precariedad, por resistencia por parte de los contratadores o las entidades aseguradoras, y por desconocimiento de los inmigrantes. Los informantes coinciden en que los riesgos laborales en los inmigrantes no difieren de los riesgos de los trabajadores autóctonos en similares circunstancias, pero los inmigrantes padecerían exposiciones más frecuentes e intensas por el acceso mayoritario a puestos menos cualificados y por la necesidad de prolongar las jornadas de trabajo. También se destaca su desconocimiento general en relación con los derechos de protección y de salud en el trabajo, aunque algunos informantes detectan un crecimiento de su actividad reivindicativa a través de los sindicatos. Conclusiones: Este primer acercamiento ha permitido definir algunos condicionantes generales que influirán en la salud laboral de los inmigrantes. La información obtenida servirá de base para profundizar, mediante técnicas adicionales de carácter cualitativo y cuantitativo, en los problemas de salud laboral de los inmigrantes trabajadores en España dentro del marco del Proyecto Inmigración, Trabajo y Salud (ITSAL), actualmente en desarrollo (AU)

Objective: To describe the characteristics, working conditions, and occupational health situation of immigrant workers in Spain through key informants. Method: We performed a qualitative, exploratory and descriptive study using indepth interviews carried out in 2006. Organizations and associations working with immigrant collectives in Alicante, Barcelona, Huelva, Madrid and Valencia were identified and the most representative and accessible entities in each location were selected. Fortythree interviews were performed with key informants from 34 different organisms. A narrative content analysis was performed. Results: Informants described difficulties in having health problems recognized as workrelated, due to irregular and precarious employment, employers¿ and insurance companies¿ reluctance, and immigrants¿ lack of knowledge. Informants coincided in reporting that the occupational risks for immigrant workers did not differ from those affecting Spanish workers in the same occupations and circumstances. However, exposure to occupational risks was exacerbated in immigrants because of their greater presence in unqualified jobs and their economic need to prolong working hours. Immigrants had little knowledge of their occupational health and safetyrelated rights, although some informants detected an increase in empowerment in this area, mostly through greater participation in trade unions. Conclusions: This first step allowed us to identify some of the general factors influencing the health and safety of immigrant workers in Spain. This information will be used in a longterm, ongoing research project [Project Immigration, Work and Health (Proyecto Inmigración, Trabajo y Salud [ITSAL]), which aims to evaluate occupational health problems in inmigrants working in Spain through both qualitative and quantitative methods (AU)