The influence of information on the prevention of occupational risks and ergonomic requirements in the development of non-traumatic osteomuscular diseases of the shoulder - a pilot study.

OBJECTIVES: Shoulder pain associated with upper limb musculoskeletal disorders is an important health problem in clinical practice due to its high prevalence, frequent consultations in primary healthcare and occupational health. Preventive strategies, including information disseminated among workers, can be useful. The aim of this study is to analyze the associations between non-traumatic osteomuscular diseases of the shoulder and the workers' knowledge of the risks at the workplace and preventive measures developed there, as well as the association with ergonomic requirements. MATERIAL AND METHODS: An observational case-control study was carried out on an occupationally active population assisted during 1 year in 1 healthcare center, involving 690 participants. Data were collected through a questionnaire including sociodemographic variables, the workplace, the knowledge of prevention and ergonomic requirements. The independent effect of the variables associated with non-traumatic shoulder pathology was explored through logistic regression. RESULTS: In total, 66.7% of the participants stated that they had been informed of the occupational hazards related to their jobs. The following variables were associated with a lower probability of shoulder injuries: male gender, working hours > 9 h/day or > 40 h/week, as well as having information on the risks associated with the workplace, using personal protective equipment, the existence of an occupational risks prevention service and/or risk assessment, the knowledge of the prevention plan, periodic medical examinations, and using one arm or physical force at work. A multivariate analysis revealed that the risk increased with age and lower educational levels, forced postures, repeated gestures, monotony and temporary absences from work. Furthermore, being informed of workplace risks, and using a single arm as well as physical force were shown as independent protective factors. CONCLUSIONS: Information on both the ergonomic requirements and how to prevent occupational risks is a useful tool for the prevention of non-traumatic shoulder diseases. Preventive policies including health education interventions in the workplace could benefit other developed preventive activities. Int J Occup Med Environ Health. 2019;32(6):825-40.

Influencia de los requerimientos ergonómicos y recursos preventivos percibidos en el desarrollo de bajas laborales por patología no traumática del hombro / Influence of ergonomic requirements and perceived preventive work resources on sickness absence due to non-traumatic shoulder disorders

INTRODUCCIÓN: El hombro doloroso es un problema médico común en Atención Primaria de salud y en el ámbito laboral. Puede producir una discapacidad funcional considerable y requerir de periodos de incapacidad temporal. OBJETIVOS: Describir las características de pacientes atendidos por patología no traumática del hombro, así como estudiar la asociación entre requerimientos ergonómicos y conocimientos preventivos del puesto de trabajo y el desarrollo de bajas laborales. MATERIAL Y MÉTODO: Estudio observacional transversal en una población de 345 pacientes en edad laboral que consultaron al médico de familia por dolor en el hombro en un año, pertenecientes a un centro de salud del Departamento de Salud de Alicante-Hospital General. Se utilizó un cuestionario con preguntas sobre conocimientos en prevención de riesgos laborales, requerimientos del puesto de trabajo y haber requerido o no periodos de incapacidad temporal derivada. Se realizó un análisis descriptivo y analítico. RESULTADOS: El 39,1% de los entrevistados refirieron periodos de baja laboral, calificándose el 87% como enfermedad común. El 51% refirió no tener información sobre los riesgos asociados a sus puestos de trabajo. Los requerimientos ergonómicos más frecuentes referidos por los encuestados fueron: posturas forzadas, alzar el brazo por encima del hombro, girar cuello-columna, y movimientos repetidos. Presentaron mayor probabilidad de baja las actividades relacionadas con construcción, agricultura, ganadería y pesca, conocer la existencia de evaluación de riesgos y/o plan de prevención y los requerimientos de alzar los brazos, golpear superficies, manejar cargas pesadas, y usar fuerza física. Conocer la existencia de un plan de prevención se mostró como factor de riesgo independiente (OR 4,2 [1,1-15,9]). CONCLUSIONES: Es importante abordar preventivamente los requerimientos ergonómicos del puesto así como conseguir mayores conocimientos de las estructuras preventivas para evitar el desarrollo de bajas laborales por hombro doloroso

INTRODUCTION: Painful shoulder is a common medical problem in Primary Health Care and at the workplace. It can cause a considerable functional disability and can require periods of sick leave. OBJECTIVES: To describe the characteristics of patients treated for non-traumatic diseases of the shoulder, as well as to know the association between ergonomic requirements and preventive knowledge about the workplace in the development of sickness absence. METHODS: Cross-sectional observational study in working age population of 345 patients who consulted their general practitioner throughout the year for shoulder pain, belonging to a health center from the Health Department of the Hospital General de Alicante. A questionnaire was used with questions about knowledge in occupational risk prevention, work requirements and whether or not temporary disability periods were required. A descriptive and analytical analysis was carried out. RESULTS: 39.1% of the interviewees reported periods of sick leave, qualified in 87% as a common disorder. 51% of them reported having no information about risks associated with their jobs. The most frequent ergonomic requirements referred by the respondents were: unnatural body posture, to raise the arm over the shoulder, to turn the neck-column, and to repeat movements. The probability of temporal disability was higher in those activities related to construction, agriculture, livestock and fisheries, people with knowledge of the existence of risk assessment and / or prevention plan, and the requirements of raising the arms, hitting surfaces, handling heavy loads, and using physical strength. To have knowledge about the existence of a prevention plan was shown as an independent risk factor (OR 4.2 [1.1-15.9]). CONCLUSIONS: It is important to preventively address the ergonomic requirements of the position as well as to gain greater knowledge of preventive structures in order to prevent the development of sick leave due to shoulder pain

Detección de violencia del compañero íntimo en atención primaria de salud y sus factores asociados / Detection of intimate partner violence in primary care and related factors

Objetivo: La violencia de compañero íntimo (VCI) contra las mujeres es un importante problema de salud pública y de derechos humanos. Los profesionales de atención primaria tienen un papel clave en su detección y abordaje. El objetivo de este estudio es determinar la frecuencia y los factores asociados a la realización de preguntas de detección de VCI en atención primaria, y describir las principales acciones desarrolladas en los casos identificados. Métodos: Estudio transversal en 15 centros de salud de cuatro comunidades autónomas, con 265 profesionales sanitarios. Recogida de información mediante el cuestionario PREMIS (Physician Readiness to Manage Intimate Partner Violence Survey) autocumplimentado, que incluye variables sobre realización de preguntas para detección, sociodemográficas, nivel de formación/conocimientos en VCI, percepciones y acciones. Se realizó un análisis descriptivo y analítico. Resultados: El 67,2% de los participantes señalan que preguntan sobre VCI en la consulta, siendo las acciones más frecuentes referir/derivar a otros servicios, consejo individual y entrega de información. Se asociaron a mayor probabilidad de indagar sobre VCI tener ≥21 de horas de formación, nivel formativo avanzado, conocer políticas y programas, y disponer de protocolo y recursos apropiados de referencia. La realización de preguntas aumenta a medida que los/las profesionales se sienten formados en VCI y provistos/as de un protocolo de manejo de casos. Conclusiones: Dos terceras partes de los/las profesionales sanitarios/as encuestados/as refirieron indagar sobre VCI. Dada la influencia de la formación en VCI y el conocimiento sobre los recursos para su abordaje, resulta imprescindible continuar invirtiendo en la formación en VCI del personal sanitario (AU)

Objective: Intimate partner violence (IPV) against women is a significant public health and human rights problem. Primary care professionals play a key role in detecting and addressing this issue. The aim of this study is to determine the frequency of IPV and its associated factors in primary care by means of a screening questionnaire and to describe the main actions taken in identified cases. Methods: Cross-sectional study in 15 health centers in four autonomous regions of Spain with a total of 265 health professionals. The information was collected through the self-administered PREMIS questionnaire (Physician Readiness to Manage Intimate Partner Violence Survey), which includes variables concerning screening questions, sociodemographic factors, level of training/knowledge about IPV, perceptions and actions. A descriptive and analytical study was conducted. Results: 67.2% of participants said they ask about IPV during consultations. The most frequent actions were: referring patients to other departments, individual counselling and information delivery. ≥21hours of training, an advanced training level, knowledge of policies and programmes and the implementation of an appropriate protocol and reference resources were all factors that increased the likelihood of investigating IPV. The asking of questions increases in line with professionals’ perceived level of training in IPV and the provision of a case management protocol. Conclusions: Two thirds of health professional respondents said they inquire about IPV. Given the influence of training in IPV and awareness of the resources to address the issue, it is essential to continue investing in the IPV training of healthcare personnel (AU)

Oportunidades y retos en el abordaje de la violencia de género en en el medio laboral: un contexto de oportunidad para la prevención / Opportunities and challenges in workplace gender violence: a context of opportunity for prevention

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[Detection of intimate partner violence in primary care and related factors]. / Detección de violencia del compañero íntimo en atención primaria de salud y sus factores asociados.

OBJECTIVE: Intimate partner violence (IPV) against women is a significant public health and human rights problem. Primary care professionals play a key role in detecting and addressing this issue. The aim of this study is to determine the frequency of IPV and its associated factors in primary care by means of a screening questionnaire and to describe the main actions taken in identified cases. METHODS: Cross-sectional study in 15 health centres in four autonomous regions of Spain with a total of 265 health professionals. The information was collected through the self-administered PREMIS questionnaire (Physician Readiness to Manage Intimate Partner Violence Survey), which includes variables concerning screening questions, sociodemographic factors, level of training/knowledge about IPV, perceptions and actions. A descriptive and analytical study was conducted. RESULTS: 67.2% of participants said they ask about IPV during consultations. The most frequent actions were: referring patients to other departments, individual counselling and information delivery. ≥21hours of training, an advanced training level, knowledge of policies and programmes and the implementation of an appropriate protocol and reference resources were all factors that increased the likelihood of investigating IPV. The asking of questions increases in line with professionals' perceived level of training in IPV and the provision of a case management protocol. CONCLUSIONS: Two thirds of health professional respondents said they inquire about IPV. Given the influence of training in IPV and awareness of the resources to address the issue, it is essential to continue investing in the IPV training of healthcare personnel.