[Disability leave and sick leave in Spain. 2016 legislative update]. / Discapacidad e incapacidad laboral en España. Actualización legislativa 2016.

In Spanish, the concepts of discapacidad (disability leave) and incapacidad (sick leave) jointly refer to the impairment of a person due to injuries, diseases or deficiencies that limit their activity in a social, personal or occupational field. However, this common link does not imply that both concepts are the same. Statistical data from INE (Instituto Nacional de Estadística: Statistic National Institute) show that Spain had in 2015 3.85 million persons with a disability (59.8% were women). Statistical data from 2015 from INSS (Instituto Nacional de Seguridad Social: Social Security National Institute) show high levels in the number of processes and in workers affected by temporary sick leave, with social costs to the social security system. Both concepts have been updated: about disability leave, Law 39/2006 adjusted terminology by avoiding the use of concepts with discriminating or pejorative connotation. Regarding sick leave, the Ley General de Seguridad Social (General Social Security Law)has been amended and came into effect in January, 2016. It is necessary to know and distinguish these aspects for a better administrative management, and a more oriented information to the affected patient.

Los conceptos de discapacidad e incapacidad hacen referencia conjuntamente al menoscabo de una persona por lesiones, enfermedades o deficiencias que limitan su actividad en el ámbito social, personal o laboral. Pero este nexo común no implica equiparación entre ambos. Datos estadísticos del 2015 del Instituto Nacional de Estadística (INE) muestran en España 3.85 millones de personas con alguna discapacidad, el 59.8% mujeres. Datos estadísticos del 2015 del Instituto Nacional de la Seguridad Social (INSS), tanto en número de procesos, como de trabajadores afectados por incapacidad muestran cifras elevadas, con costos sociales en prestaciones a cargo de la seguridad social. Ambos conceptos han sido objeto de actualización legislativa: en discapacidad, la Ley 39/2006 ajusta la terminología y evita el uso de conceptos con connotación peyorativa o discriminativa. En incapacidad, la Ley General de la Seguridad Social ha sido modificada y ha entrado en vigor en enero de 2016. Es necesario conocer y diferenciar estos aspectos para una mejor gestión administrativa, e información más orientada al paciente afectado.

Riesgo cardiovascular en la población laboral: Impacto en aspectos preventivos / Cardiovascular risk in the working population: Impact on the preventive aspects

Parámetros de obesidad en la población laboral española y la relación con los parámetros de riesgo cardiovascular. Objetivo: Establecer relaciones entre la obesidad y los diferentes parámetros de riesgo cardiovascular que faciliten la implantación de estrategias preventivas en el ámbito laboral. Método: Estudio transversal realizado a 1,447 trabajadores de empresas del sector servicios (terciario) de España. Se parte de los valores de la FAO (Food and Agriculture Organization) para la catalogación de sobrepeso/obesidad y se realiza el estudio bivariante con parámetros analíticos, de obesidad, estilo de vida, cálculo de la edad del corazón y riesgo cardiovascular-Framingham. Resultados: El sobrepeso muestra relaciones estadísticas significativas con riesgo incrementado de hipertensión arterial, glucemia basal y diabetes, incremento de grasa corporal, visceral y perímetro de cintura, menor masa muscular, índices elevados de lípidos, estilos de vida no saludables y coexistencia con patologías de riesgo cardiovascular. Los parámetros de edad del corazón, los años perdidos y Framingham son mayores en personas con sobrepeso. Conclusiones: La actuación preventiva desde las empresas parte de un conocimiento previo de la situación de riesgo cardiovascular de los trabajadores, facilitando una planificación más eficaz y menor coste de las acciones en promoción de la salud e intervención coordinadas con los especialistas involucrados en su control y seguimiento.

Obesity parameters in Spanish working population and its relation to cardiovascular risk parameters. Objective: Linking obesity and cardiovascular risk various parameters to facilitate the implementation of preventive strategies in the workplace. Method: Cross-sectional study of 1,447 workers in companies in the service sector (tertiary) of Spain. Values are part of FAO cataloging of overweight/obesity and bivariate study is performed with laboratory parameters, obesity, lifestyle, age calculation heart and Framingham-cardiovascular risk. Results: Overweight show significant statistical relationships with increased risk of blood pressure, fasting glucose and diabetes, increased body fat, waist circumference and visceral fat, decreased muscle mass, high levels of lipids, unhealthy life styles and coexistence with pathologies of cardiovascular risk. Parameters of heart age, lost years and Framingham are higher in overweight people. Conclusions: Preventive action from companies start with a prior knowledge of the situation of workers relative to cardiovascular risk, thus facilitating better planning and lower cost actions in health promotion and intervention, coordinated with specialists involved in control and monitoring.

[Prevalence of rhinitis and asthma respiratory symptoms in Spanish working population]. / Síntomas respiratorios de rinitis y asma en población laboral española.

OBJECTIVE: The aims were to examine the prevalence of respiratory symptoms associated with rhinitis and asthma in Spanish workers and its variations by age, sex, work sector, location in the workplace, smoking habits and the relationship between symptoms in the upper and lower respiratory tract. METHODS: The sample was of 2603 workers in different sectors and regions throughout the country. They agreed and answered the questions regarding respiratory symptoms, with the supervision of the company's physician. RESULTS: Chronic nasal symptoms were present in 438 workers (16.9 %); 193 (7.5 %) had pulmonary symptoms. With nasal and pulmonary symptoms were 124 patients (28.3 %). Likewise, of the 190 workers with pulmonary symptoms, 124 (64.2 %) had also nasal manifestations. We observed variations in nasal symptoms by sex, professional sector, work area and smoking habits, and variations in pulmonary symptoms by work sector. A higher prevalence was noted in the healthcare, postal, and transport sector as opposed to the construction, furniture or metal sector. CONCLUSIONS: The prevalence of nasal symptoms was higher than that of pulmonary symptoms in the working population. The workers affected by these pathologies were not treated adequately, despite they were presenting symptoms. We observed a relationship between pulmonary and nasal symptoms.

INTRODUCCIÓN: en salud laboral interesa conocer la prevalencia de los síntomas respiratorios relacionados con la rinitis y el asma en trabajadores españoles y sus variaciones por factores demográficos y laborales. El objetivo de esta investigación fue interrelacionar los síntomas respiratorios de vías altas y bajas. MÉTODOS: se solicitó a 2603 trabajadores de distintos sectores y provincias españolas contestar una encuesta que fue supervisada por un médico del trabajo. RESULTADOS: 438 trabajadores presentaron síntomas nasales crónicos (16.9 %) y 193 (7.5 %), síntomas pulmonares. De los 438 con síntomas nasales, 124 (28.3 %) presentaron síntomas pulmonares. Se observaron variaciones en los síntomas nasales por sexo, sector profesional, área de trabajo, tabaquismo y variaciones en los síntomas pulmonares por sector laboral, con mayor prevalencia en el sanitario, postal y transporte, en comparación con los sectores de la construcción, mueble o el metal. CONCLUSIONES: la prevalencia de los síntomas nasales en la población trabajadora fue más elevada que la de los síntomas pulmonares. Los trabajadores afectados estaban infratratados, a pesar de padecer síntomas. Se observó interrelación entre los síntomas pulmonares y nasales de los trabajadores afectados.

[Sick leaves caused by psychiatric diseases in Spain during 2011]. / La incapacidad temporal en España por algunas enfermedades psiquiátricas. (Trastornos esquizofrénicos, trastorno bipolar y trastornos ansiosos, depresivos y adaptativos).

BACKGROUND: Psychiatric and mood disorders may hamper the efficiency of workers and cause absenteeism. MATERIAL AND METHODS: Revision of sick leaves related to schizophrenia, bipolar diseases, anxiety, depression and adaptive disorders that were granted in Spain in the period January- December 2011. The mean number of days off work for each disease and the costs per each labor day lost were calculated. RESULTS: The total number of labor days lost for schizophrenia, bipolar diseases and mood disorders were 72,831; 899,107 and 3,666,055 days, respectively. The mean duration of sick leaves for the same diagnoses were 84; 100 and 64 days/year respectively. The total indirect costs of sick leaves for psychiatric diseases during 2011 were € 100 million approximately, corresponding to 4% of costs for all diseases. CONCLUSIONS: The high costs of absenteeism derived from psychiatric diseases should prompt measures to promote a better adaptation to work environments of people suffering these ailments.

La incapacidad temporal en España por algunas enfermedades psiquiátricas. (Trastornos esquizofrénicos, trastorno bipolar y trastornos ansiosos, depresivos y adaptativos) / Sick leaves caused by psychiatric diseases in Spain during 2011

Background: Psychiatric and mood disorders may hamper the efficiency of workers and cause absenteeism. Material and Methods: Revision of sick leaves related to schizophrenia, bipolar diseases, anxiety, depression and adaptive disorders that were granted in Spain in the period January- December 2011. The mean number of days off work for each disease and the costs per each labor day lost were calculated. Results: The total number of labor days lost for schizophrenia, bipolar diseases and mood disorders were 72,831; 899,107 and 3,666,055 days, respectively. The mean duration of sick leaves for the same diagnoses were 84; 100 and 64 days/year respectively. The total indirect costs of sick leaves for psychiatric diseases during 2011 were € 100 million approximately, corresponding to 4% of costs for all diseases. Conclusions: The high costs of absenteeism derived from psychiatric diseases should prompt measures to promote a better adaptation to work environments of people suffering these ailments.

Determinación del riesgo de fracturaosteoporótica en población laboralespañola mediante la herramientaFRAX / Osteoporotic risk of hip fracture calculated using the FRAX toolfor the Spanish population

Introducción: las fracturas osteoporóticas constituyen una problemática de creciente trascendenciaen salud pública, por lo que la utilización de herramientas que permitan una valoraciónprecoz y adecuada del riesgo de fractura y el establecimiento de políticas preventivas deberíanser prioritarios. En este trabajo se valora el riesgo de sufrir diferentes tipos Materiales y métodos: se realizó un estudio descriptivotransversal en población general trabajadora delsector socio-sanitario español con edades comprendidasentre 40 y 65 años. El riesgo de fractura de cadera ymayor osteoporótica se calculó mediante la herramientaFRAX para población española. Se incluyeron en elestudio 749 trabajadores seleccionados aleatoriamente:251 varones, 251 mujeres no menopáusicas y 247 mujeresmenopáusicas.Resultados: las edades medias fueron de 46,8 años envarones, 43,9 años en mujeres no menopáusicas y 52,3años en las menopáusicas. El riesgo medio de fracturade cadera y mayor osteoporótica fue de 2,1±1,33 y de0,22±0,36 en varones, 2,65±2,16 y 0,27±0,94 enmujeres no menopáusicas y 3,1±2,93 y 0,44±0,88en mujeres menopáusicas. Presentaron criterios positivosde tratamiento según la National Osteoporosis Foundationel 0,8 % de las mujeres no menopáusicas, un 2 %de las menopáusicas y ninguno de los hombres.Conclusiones: el riesgo de sufrir fracturas osteoporóticasen este colectivo es muy bajo, sin embargo, el uso dela herramienta FRAX puede ser muy útil para detectarel riesgo en sus estadios iniciales y establecer políticas deprevención y actuación precoz que permitan un ahorroen costes y mejorar la salud de nuestra población generalmediante captación en su etapa laboral.

Purpose: Osteoporotic fractures are a significantgrowing problem of public health, so theuse of tools that allow a proper risk assessmentand establishing preventive policies should be apriority. This paper assesses the risk of differenttypes of fractures as much in men as in menopausaland non menopausal women.Patients and methods: A descriptive crosssectionalstudy in working population from theSpanish health system aged between 40 and65. The risk of increased osteoporotic hip fractureis calculated using the FRAX tool for the Spanishpopulation. 749 randomly selected workerswere included in the study, 251 men, 251 nonmenopausal women and 247 post-menopausalwomen.Results: Mean ages were 46.8 years in men, 43.9years in non-menopausal women and 52.3 yearsin the menopausal. The average risk of hip fractureand major osteoporotic was 2.1 ± 1.33 and0.22 ± 0.36 in males, 2.65 ± 2.16 and 0.27 ±0.94 in non-menopausal women 3.1 ± 2.93 and0.44 ± 0.88 in menopausal women. No men, 0.8% of menopausal women and 2 % of menopausaltreatment had positive criteria for treatmentaccording to the National OsteoporosisFoundation.Conclusion: The risk of osteoporotic fracturesin this group is very low, however the use of theFRAX tool can be very useful to detect the riskin its early stages and establishing preventionpolicies that allow cost savings and improve thehealth of our workforce.

[Fibromyalgia and laboral activities on the Spain legislation]. / Fibromialgia y trabajo. Valoración en la legislación española.

Fibromyalgia is a pain disorder listed in the International Classification of Diseases (ICD) of the World Health Organization under the code 729.1. It is a controversial disease that affects young people in many cases during their working years, posing a social and labour problem, in addition to the complexity of its diagnosis, which is based almost exclusively on clinical criteria as few objective data can be obtained from physical examination or additional tests. Nowadays, the criteria for clinical diagnosis of fibromyalgia are established and periodically revised by an Expert Consensus Panel; the most recent document is dated May, 2010. The occupational status of these patients attains an important significance due to the labour costs resulting from this disease and the difficulty in establishing clear and concise parameters for assessing the personal disability of the patients by the legally authorized organizations.

[No traumatic labor accident risk in diabetic patient. View from the Spanish legislation]. / Diabetes, accidente de trabajo y daño laboral. Revisión desde la legislación española.

The Spanish legislation includes the concept of industrial accidents and industrial damage since 1900, although since then in our country some legislative changes have been made, reaching the current Occupational Risk Prevention Law (ORPL) of 1995 and the legislation emanating from it. This is a controversial concept, if we talk about nontraumatic labor injury that carries consequences in the workplace, civil, criminal and contentious administrative disputes, and economic gains. It differs from others in both in qualifying risk and their benefits; the concept also exists in the other European Union countries and in different Spanish-American countries. Therefore the objective of the paper is to discuss the concept of traumatic industrial accident and non-traumatic labor injury in Spain from the point of view of our law and to establish future benchmarks with professionals of other countries around us for enabling collaboration and joint improvement of the safety and about the health of workers.