Ecuadorian Provinces with High Morbidity and Mortality Rates Due to Asthma among the Working-Age Population: An Ecological Study to Promote Respiratory Health.

Asthma is a significant public health concern. This study identified the provinces with the highest morbidity and mortality rates due to asthma among the working-age population (15-69 years) in the Republic of Ecuador. The secondary objective was to explain the possible differences attributable to occupational exposure. This nationwide ecological study was conducted in 24 provinces between 2016 and 2019. Government databases were used as sources of information. Age-standardized rates were calculated for codes J45 and J46. The hospitalization morbidity rate for asthma decreased from 6.51 to 5.76 cases per 100,000 working-age population, and the mortality rate has consistently been low and stable from 0.14 to 0.15 deaths per 100,000 working-age population. Geographic differences between the provinces were evident. The risk of hospitalization and death due to asthma was higher in the Pacific coast (Manabí with 7.26 and 0.38, Esmeraldas with 6.24 and 0.43, Los Ríos with 4.16 and 0.40, El Oro with 7.98 and 0.21, Guayas with 4.42 and 0.17 and the Andean region (Azuay with 6.33 and 0.45, Cotopaxi (5.84 and 0.48)). The high rates observed in provinces with greater agricultural and industrial development could be national heterogeneity's main determinants and act as occupational risk factors. The contribution of occupational hazards in each province should be examined in depth through ad hoc studies. The findings presented here provide valuable information that should prompt further detailed studies, which will assist in designing public policies aimed at promoting and safeguarding the respiratory health of the population, particularly that of workers. We believe that this study will inspire the creation of regional networks for the research and surveillance of occupational health.

Comparative analysis of leukemia and risk estimation in working age population between provinces of Ecuador.

Leukemia is associated with exposure to radiation, benzene derivatives, and pesticides. Previous research has documented an increase in work-related leukemia in the Latin American Andean region. To date, there are only few studies in Ecuador on the impact of oil exploitation on adjacent indigenous communities. Our study aims to show the impact of leukemia on the working-age population. For the calculation of morbidity and mortality rates, we used hospital discharge and death records from the National Institute of Statistics of Ecuador. These data were collected and adjusted to the corresponding province's population for further analysis. Large differences were observed between provinces in adjusted rates of leukemia mortality and morbidity in the working-age population. The variations in altitude among different areas in Ecuador give the provinces a distinct geographic identity. Likewise, the provinces with the highest morbidity and mortality rankings, such as Azuay, Loja, Imbabura, and Tungurahua, have an average altitude above 2000 meters. As a result, there are variations in the average temperature, exposure to solar and cosmic radiation, and mining and farming methods. The observed differences warrant the future collection of geolocation data for affected individuals. This could help to better understand how leukemia cases have demogrpahic hotspots in the country, identify possible risk factors associated with the disease in each region, and design more effective prevention and control strategies.

La leucemia es una enfermedad a consecuencia, además de factores genéticos, de la exposición a radiaciones, derivados del benceno y pesticidas. Investigaciones anteriores han documentado un aumento de la leucemia ocupacional en la región andina de América Latina. Hasta la fecha, existen sólo unos pocos estudios en Ecuador sobre el impacto de la explotación petrolera en las comunidades indígenas. Nuestro objetivo es mostrar el impacto de la leucemia en la población en edad de trabajar. Para el cálculo de las tasas de morbimortalidad se utilizaron los registros de altas hospitalarias y defunciones del Instituto Nacional de Estadística del Ecuador. Estos datos fueron recopilados y estimadas las tasas ajustadas. Se observaron grandes diferencias entre provincias en las tasas ajustadas de mortalidad y morbilidad por leucemia en la población en edad de trabajar. Asimismo, las provincias con mayor ranking de morbilidad y mortalidad, como Azuay, Loja, Imbabura y Tungurahua, coinciden en tener una altitud promedio superior a los 2000 metros. Hay provincias de baja altitud en la costa y provincias por encima de los 2000 metros en la sierra, lo que le da a las provincias del Ecuador una identidad geográfica distintiva. Como resultado, existen variaciones en la temperatura promedio, la exposición a la radiación solar y cósmica, y actividades de minería y agricultura. Las diferencias observadas, recomiendan la recopilación futura de datos de geolocalización de las personas afectadas. Esto podría ayudarnos a comprender mejor cómo se distribuyen los casos de leucemia, identificar posibles factores de riesgo asociados a la enfermedad en cada región y diseñar estrategias de prevención y control más efectivas.

Mapping the conceptual structure of ergonomics, musculoskeletal disorders, treatment and return to work in manual jobs: A systematic review.

BACKGROUND: Musculoskeletal disorders constitute one of the major health problems of workers exposed to manual work throughout the world. Nevertheless, there is no study that maps its conceptual structure based on a systematic methodology. OBJECTIVE: To identify the conceptual structure of ergonomics, MSDs, treatment and return to work in manual jobs in the last 12 years by applying a systematic co-word network analysis methodology which describes the replicability of the search filters and emphasizes the rigor that has to be followed in the creation of the network. METHODS: The search filter was customized for each bibliographic database, and followed the PRISMA 2020 flowchart for the screening process. For the creation of the network, the titles, abstracts, and keywords were used as the unit of analysis extracting the noun phrases of the first two units. In the normalization process, the terms of the search filter were deleted and their associated terms, and standardized the similar terms. Regarding the plotting of the network, Vosviewer was used applying the network settings based on content analysis. RESULTS: The co-word network shows three communities: Ergonomic assessment and workplace intervention tools, factors related to rehabilitation and return to work, and physical and mental overload management. For each community, there is a framework that explains the relationship within terms. CONCLUSION: This study is aligned with the replicability, robustness, and relevance recommendations in the implementation of rigorous scientometric studies. The occupational health community is encouraged to implement scientometric studies following a rigorous methodology and working in interdisciplinary team.

Jornadas laborales prolongadas y lesiones por accidentes de trabajo: estimaciones de la Primera Encuesta sobre Condiciones de Seguridad y Salud en el Trabajo en Ecuador / Long working hours and occupational injuries: estimates from the First Survey on Safety and Health Conditions at Work in Ecuador

Objetivo: estimar la relación entre las jornadas de trabajo por semana y las lesiones por accidente de trabajo (LAT) en la población asalariada de la ciudad ecuatoriana de Guayaquil. Métodos: estudio transversal que empleó datos de la Primera Encuesta de Condiciones de Seguridad y Salud en el Trabajo para el Ecuador en 2017. Los encuestados fueron 1 005 trabajadores asalariados y se dividieron en dos grupos según las horas de trabajo semanales, ?43 y ?44 horas. La relación entre las jornadas laborales prolongadas y LAT por sexo se analizó mediante regresión logística (OR; IC95%) ajustado por características sociodemográficas (Modelo 1) y añadiendo las ocupacionales (Modelo 2). Resultados: El 30,9% de los trabajadores declaró trabajar 44 horas o más a la semana (50,7±6,3 horas) y la frecuencia de LAT en este grupo fue superior en los hombres (24,2%) respecto a las mujeres (12%). Las LAT en jornadas laborales prolongadas aumentaron con la edad en los hombres. Además, la probabilidad de sufrir una LAT fue mayor entre los hombres en comparación con la jornada de trabajo estándar, también para los ajustes del Modelo 1 y del Modelo 2. Conclusiones: Las jornadas laborales prolongadas están asociadas con las LAT en los hombres. En el caso de las mujeres no se observó una asociación estadísticamente significativa. La implementación de medidas preventivas que tomen en cuenta la duración de las jornadas de trabajo en las empresas podría resultar en una reducción de las LAT (AU)

Objective: to estimate the association between weekly working hours and occupational injuries (OI) among the salaried population in Guayaquil, Ecuador. Methods: a cross-sectional study that used data from the First Survey on Safety and Health Conditions at Work in Ecuador in 2017. The respondents were 1005 salaried workers, divid-ed into two groups according to weekly working hours, ≤43 and ≥44 hours. The relationship between long working hours and OI by gender was analyzed by using logistic regression (OR; CI 95%) adjusted for sociodemographic characteristics (Model 1) and also for occupa-tional characteristics (Model 2). Results: 30.9% of the workers declared ≥44 weekly working hours (50.7±6.3 hours) and the OI percentages in this group were higher in men (24.2%) compared to women (12%). OI among those working long hours increased with age in men. In addition, the odds of sustaining an OI were higher among men working long hours as compared to the stan-dard working day (OR = 3.08; 95% CI: 1.87–5.07), for Model 1 settings (OR = 2, 98; 95% CI: 1.79–4.95) and Model 2 (OR = 3.05; 95% CI: 1.82–5.11). Conclusions: Long working hours are associated with OI in men. In the case of women, despite the fact that the frequency of OI was higher in those exposed to long working hours compared to those exposed to standard working hours, no statistically significant associ-ations were observed. Implementation of preventive measures that consider the length of working hours in companies could result in the reduction of OI. (AU)

Letalidad por desplazamientos domicilio-trabajo-domicilio en el Ecuador, 2014-2019 y 2020 / Home-workplace-home commuting lethality in Ecuador, 2014-2019 and 2020

Objetivo: Evidenciar las diferencias de letalidad según lugar de ocurrencia (desplazamientos = in itínere y en jornada laboral) en el periodo entre 2014 a 2019 y 2020 en el Ecuador. Material y Métodos: Análisis de 104.396 casos (1,2% mortales) utilizando registros oficiales. Se estimaron Tasas de Letalidad (TL) y Razón de Tasas de Letalidad (RTL) por lugar de ocurrencia y separadas por sexo. Resultados: Las TL y RTL mostraron descensos importantes. Sin embargo, las probabilidades de fallecimiento in itínere fueron mayores en comparación a los accidentes mortales ocurridos en jornada laboral, de forma global [1,51 (IC95% = 1,13-2,04); p = 0,006], en hombres, [1,58 (IC95% = 1,38-1,82); p = 0,000] y, en específico, en mujeres, [5,93 (IC95% = 1,86-16,34); p = 0,001]. Conclusiones: Se deberían realizar estudios epidemiológicos específicos y prestar mayor interés a este problema de seguridad vial laboral en el diseño de estrategias de salud pública y laboral. (AU)

Objective: To demonstrate the differences in fatality rates by place of occurrence (commuting = in itínere and during working hours) in the period from 2014 to 2019 and 2020 in Ecuador. Material and Methods: Analysis of 104,396 cases (1.2% fatal) using official records. Lethality Rates (LR) and Lethality Rate Ratio (LRR) were estimated by place of occurrence and separated by sex. Results: LR and LRR showed significant decreases. However, the odds of in itínere fatalities were higher in comparison to work-related fatalities, overall [1.51 (95%CI = 1.13-2.04); p = 0.006], in men, [1.58 (95%CI = 1.38-1.82); p = 0.000] and specifically in women, [5.93 (95%CI = 1.86-16.34); p = 0.001]. Conclusions: Specific epidemiological studies should be carried out and more interest should be given to this occupational road safety problem in the design of public and occupational health strategies. (AU)

[Long working hours and occupational injuries: estimates from the First Survey on Safety and Health Conditions at Work in Ecuador]. / Jornadas laborales prolongadas y lesiones por accidentes de trabajo: estimaciones de la Primera Encuesta sobre Condiciones de Seguridad y Salud en el Trabajo en Ecuador.

OBJECTIVE: to estimate the association between weekly working hours and occupational injuries (OI) among the salaried population in Guayaquil, Ecuador.  Methods: a cross-sectional study that used data from the First Survey on Safety and Health Conditions at Work in Ecuador in 2017. The respondents were 1005 salaried workers, divided into two groups according to weekly working hours, ?43 and ?44 hours. The relationship between long working hours and OI by gender was analyzed by using logistic regression (OR; CI 95%) adjusted for sociodemographic characteristics (Model 1) and also for occupational characteristics (Model 2).  Results: 30.9% of the workers declared ?44 weekly working hours (50.7±6.3 hours) and the OI percentages in this group were higher in men (24.2%) compared to women (12%). OI among those working long hours increased with age in men. In addition, the odds of sustaining an OI were higher among men working long hours as compared to the standard working day (OR = 3.08; 95% CI: 1.87-5.07), for Model 1 settings (OR = 2, 98; 95% CI: 1.79-4.95) and Model 2 (OR = 3.05; 95% CI: 1.82-5.11).  Conclusions: Long working hours are associated with OI in men. In the case of women, despite the fact that the frequency of OI was higher in those exposed to long working hours compared to those exposed to standard working hours, no statistically significant associations were observed. Implementation of preventive measures that consider the length of working hours in companies could result in the reduction of OI.

OBJETIVO: estimar la relación entre las jornadas de trabajo por semana y las lesiones por accidente de trabajo (LAT) en la población asalariada de la ciudad ecuatoriana de Guayaquil.  Métodos: estudio transversal que empleó datos de la Primera Encuesta de Condiciones de Seguridad y Salud en el Trabajo para el Ecuador en 2017. Los encuestados fueron 1 005 trabajadores asalariados y se dividieron en dos grupos según las horas de trabajo semanales, ?43 y ?44 horas. La relación entre las jornadas laborales prolongadas y LAT por sexo se analizó mediante regresión logística (OR; IC95%) ajustado por características sociodemográficas (Modelo 1) y añadiendo las ocupacionales (Modelo 2). RESULTADOS: El 30,9% de los trabajadores declaró trabajar 44 horas o más a la semana (50,7±6,3 horas) y la frecuencia de LAT en este grupo fue superior en los hombres (24,2%) respecto a las mujeres (12%). Las LAT en jornadas laborales prolongadas aumentaron con la edad en los hombres. Además, la probabilidad de sufrir una LAT fue mayor entre los hombres en comparación con la jornada de trabajo estándar, también para los ajustes del Modelo 1 y del Modelo 2.  Conclusiones: Las jornadas laborales prolongadas están asociadas con las LAT en los hombres. En el caso de las mujeres no se observó una asociación estadísticamente significativa. La implementación de medidas preventivas que tomen en cuenta la duración de las jornadas de trabajo en las empresas podría resultar en una reducción de las LAT.

Comportamiento de lesiones por accidente de trabajo no mortales y con incapacidad temporal, en personas afiliadas al régimen general de seguridad social en Ecuador. Análisis temporal y territorial en ocupaciones manuales de las industrias manufacturera y de construcción, 2014-2019 / Behavior of non-fatal occupational injuries with temporary disability among members of Ecuador's general social security system. Temporal and territorial analysis in manual occupations in the manufacturing and construction industry, 2014 - 2019 / Comportamento de lesões profissionais não fatais e temporariamente incapacitadas em pessoas filiadas ao sistema geral de segurança social no Equador. Análise temporal e territorial em ocupações manuais das indústrias manufatureiras e de construção, 2014-2019

El análisis de datos cuantitativos de siniestralidad laboral es importante para orientar la gestión preventiva en la República del Ecuador. Se presenta un estudio ecológico exploratorio de la incidencia de lesiones por accidente de trabajo no mortales y con incapacidad temporal, en ocupaciones manuales de las industrias manufacturera y de construcción en 23 provincias del país, para el período comprendido entre 2014 y 2019. Como fuente se utilizaron los registros oficiales de trabajadoras y trabajadores afiliados al régimen general de seguridad social. Se apli- có el programa estadístico SPSS versión 21.0 y Tableau versión 3.0; se agruparon las provincias del Ecuador en cuartiles según el valor de la tasa de incidencia de las lesiones por cada 1.000 personas afiliadas, considerando año y actividad económica. Las tasas de incidencia mues- tran patrones similares para los dos sectores económicos y un decrecimiento progresivo en el período analizado, con valores semejantes en 2019. Los valores más altos se presentan en las provincias de Azuay, Guayas, Pichincha y Tungurahua. Se concluye que existen importantes di- ferencias geográficas, lo que demanda estrategias de prevención y disminución de accidentes de trabajo con participación de los equipos interdisciplinarios relacionados, incluyendo terapeutas ocupacionales.

Analyzing quantitative data on occupational accidents is essential to guide preventive management in the Republic of Ecuador. An exploratory ecological study of the incidence of non-fatal and temporary incapacity occupational injuries in manual occupations in the manufacturing and construction industries in 23 provinces is presented for the period 2014-2019. Official registers of workers registered in the general social security system were used as a source. The statistical software SPSS version 21.0 and Tableau version 3.0 were applied; Ecuador provinces were grouped into quartiles according to the value of the incidence rate of injuries per 1,000 registered persons, considering the year and economic activity. Incidence rates show similar patterns for the two economic sectors and a progres- sive decrease over the period analyzed, with similar values in 2019. The highest values are found in Azuay, Guayas, Pichincha and Tungurahua provinces. It is concluded that there are significant geographical differences, which calls for strategies to prevent and reduce occupational accidents with the participation of related interdisciplinary teams, including occupational therapists.

A análise de dados quantitativos sobre acidentes de trabalho é importante para orientar a gestão preventiva na República do Equador. Um estudo ecológico exploratório da in- cidência de acidentes de trabalho não fatais e de invalidez temporária é apresentado em ocupações manuais nas indústrias de manufatureira e de construção em 23 províncias do país, para o período entre 2014 e 2019. Como fonte, foram utilizados os registros oficiais dos trabalhadores filiados ao regime geral de previdência social. Os programas estatísticos SPSS (versão 21.0) e Tableau (versão 3.0) foram aplicados; as províncias do Equador foram agrupadas em quartis, de acordo com o valor da taxa de incidência de lesões por 1.000 afiliados, considerando ano e atividade econômica. As taxas de incidência apresentam padrões semelhantes para os dois setores econômicos e uma diminuição progressiva no pe- ríodo analisado, com valores semelhantes em 2019. Os maiores valores encontram-se nas províncias de Azuay, Guayas, Pichincha e Tungurahua. Conclui-se que existem diferenças geográficas importantes, que demandam estratégias de prevenção e de redução dos aciden- tes de trabalho com a participação de equipes interdisciplinares relacionadas, incluindo terapeutas ocupacionais.

[Safety and Health at Work in Ecuador]. / Seguridad y salud en el trabajo en Ecuador.

La República del Ecuador (en adelante Ecuador) puede ser considerada como uno de los países latinoamericanos más privilegiados por sus contrastes geográficos, variedad climática y amplia biodiversidad. La Cordillera de los Andes divide al Ecuador en tres regiones (Amazonía, Sierra y Costa del Pacífico) con marcadas diferencias culturales. Además, existen el conjunto de las Islas Galápagos como cuarta región. La población (2020) es de 17,5 millones de habitantes (51% son mujeres) y la esperanza de vida aumentará significativamente en los próximos años (2010 fue de 75 años y para el 2030 será de 80,5 años). En contraste, los indicadores de salud, económicos y laborales muestran un paronarma preocupante. La tasa de mortalidad en los últimos años ha aumentado ligeramente, en 2014 fue de 4,1 por cada 1000 habitantes y en 2019 fue de 4,3 por cada 1000 habitantes. En 2019, la primera causa de muerte fueron las enfermedades isquémicas del corazón, tanto en mujeres y hombres, y en adultos de 30 a 64 años los accidentes de transporte. Aunque la economía de Ecuador ha mostrado un crecimiento hasta mediados de la última década, la caída del precio internacional del petróleo provocó una recesión económica, con pérdidas de plazas de empleo adecuado desde 2015 y que se mantienen progresivamente en la actualidad. El empleo informal ha crecido rápidamente, situándose en el 46,7% en 2019, y en condiciones precarias de trabajo y ausencia derechos de protección social. Desafortunadamente, la crisis sanitaria por el SARS-CoV-2 ha provocado aún más un entorno desfavorable y retroceso en los objetivos marcados para reducir las desigualdades sociales….

Association between informal employment and mortality rate by welfare regime in Latin America and the Caribbean: an ecological study.

OBJECTIVE: We aimed to estimate the association between informal employment and mortality in Latin America and the Caribbean (LAC) by comparing welfare state regimes. DESIGN: Ecological study using time-series cross-sectional analysis of countries. Informality was estimated from household surveys by the Center for Distributive, Labor and Social Studies in collaboration with the World Bank, and the adult mortality rates for 2000-2016 were obtained from the WHO databases. Countries were grouped by welfare state regimes: state productivist, state protectionist and familialist. We calculated the compound annual growth rate for each country and performed linear regression between the informality and the adult mortality rates stratified by sex and welfare state regime. SETTING: Seventeen countries from LAC with available data on informality and adult mortality rates for 2000-2016. PRIMARY OUTCOME MEASURE: The association between informality and mortality by welfare state regime. RESULTS: Between 2000 and 2016, mortality rates decreased an average 1.3% per year and informal employment rates 0.5% per year. We found a significant positive association between informality and mortality rates (women: R2=0.48; men: R2=0.36). The association was stronger among the state regime countries (women: R2=0.58; men: R2=0.77), with no significant association among the familialist countries. CONCLUSION: Informal employment negatively impacts population health, which is modified by welfare state regimes. Addressing informal employment could be an effective way to improve population health in LAC. However, linkage with public health and labour market agendas will be necessary.

Understanding the Relationship between Situational Strength and Burnout: A Multi-Sample Analysis.

Many studies have examined the effect of situational strength (clarity, consistency, constraints, and consequences) on organisational behaviour, but little has been investigated about its health effects. This study aimed to analyse the relationship between situational strength and burnout. Specifically, we examined whether situational strength characteristics may be associated with burnout, whether these characteristics are risk (or protective) factors for burnout, and whether a strong situation is related to higher levels of burnout. Examining three samples from different occupations, it was found that clarity and consistency are negatively associated with burnout, being protective factors, while constraints are positively associated with burnout, being risk factors. These results are consistent across the samples. In addition to the direct effects, interaction effects between clarity and consistency in the office employee's sample (two-way interaction), between constraints and consequences in the samples of office employees and teachers (two-way interaction), and among clarity, consistency, and constraints in the salespeople's sample (three-way interaction) were also significant, explaining from 20% to 33% of the variance of burnout. We concluded that situational strength is associated not only with behaviour but also with health. The theoretical and practical implications of these findings are discussed.

Salaried Workers' Self-Perceived Health and Psychosocial Risk in Guayaquil, Ecuador.

Self-perceived health is an important indicator of occupational health. This research explored the relationship between poor self-perceived health and exposure to psychosocial risk factors, taking into account potential socio-demographic, occupational, and employment determinants. Using data from the First Survey of Occupational Safety and Health Conditions, covering 1049 salaried workers in Guayaquil, Ecuador, descriptive and stratified binary logistic regression analyses (odds ratios with corresponding 95% confidence intervals) were carried out. A significant relationship was found between exposure to psychosocial risk factors and the probability of presenting poor self-perceived health by socio-demographic, occupational, and employment characteristics. Occupational exposure factors to psychosocial risks were predictors of self-perceived ill health and were related to the variables analyzed; the most frequently expressed factors among the respondents were cognitive demands (DCOG) and job insecurity (IL). The results have implications in terms of designing effective workplace interventions pursuant to ensuring the health and well-being of employees.

Health inequity in workers of Latin America and the Caribbean.

BACKGROUND: Latin America and the Caribbean (LAC) is the world's most inequitable region in terms of wealth distribution. The full scale of social inequalities in health has been hidden by the lack of reliable data. This study aimed to measure and compare health inequalities in the working population within and between 15 countries of LAC. METHODS: A sample of 180,163 workers aged 18 years and older was drawn from the most recent national surveys of working conditions or health in 15 LAC countries. Poor self-perceived health (P-SPH) was used as a health indicator, and age, education level, and occupational category as inequality stratifiers. We calculated four measures: absolute and relative population-attributable risks, the Kuznets and weighted Keppel indexes. RESULTS: P-SPH prevalence ranged from 9% in men from Uruguay to 50% in women from Nicaragua. It was higher in women than in men in most countries. A clear gradient was shown, in which young people in non-manual skilled jobs and high education had the lowest prevalence. Nearly 45% of cases that reported P-SPH among men and 35% among women could be avoided if all the groups received a higher level of education. Also, approximately 42% of P-SPH reported by men and 31% by women could be avoided if they all shared the working and employment conditions of non-manual skilled jobs. CONCLUSIONS: Wide health inequalities were found between occupational and educational groups in LAC. However, country borders appear to be an even more important stratifier in the production of health inequalities. Urgent interventions to improve worker's health are needed in countries where prevalence of poor self-perceived health is high. Strengthening occupational health surveillance system in LAC countries should become a priority, in order to track the interventions to reduce occupational health inequity.

Saúde do trabalhador no Equador: uma comparação com inquéritos sobre condições de trabalho na América Latina / Occupational health in Ecuador: a comparison with Latin-American surveys on working conditions / La salud ocupacional en Ecuador: una comparación con las encuestas sobre condiciones de trabajo en América Latina

Resumo Introdução: o Equador realizou recentemente seu primeiro inquérito sobre condições de trabalho. Objetivo: descrever as condições de trabalho e emprego e o estado de saúde dos trabalhadores equatorianos em uma amostra que permita comparação com inquéritos latino-americanos anteriores. Métodos: uma amostra de 1.713 trabalhadores foi selecionada do primeiro inquérito sobre condições de trabalho no Equador. Prevalências e intervalos de confiança de 95% (IC95%) foram calculados e comparados com inquéritos anteriores na Colômbia, Argentina, Chile, América Central e Uruguai. Resultados: homens foram frequentemente mais expostos a trabalho em condições perigosas, sendo as mais relatadas trabalho com ruído (81% dos homens e 69% das mulheres) e com movimentos repetitivos (56% dos homens e 48% das mulheres). Cerca de 31% dos homens e 19% das mulheres trabalhavam mais de 40 horas por semana. Quase 11% das mulheres e dos homens relataram uma autopercepção de saúde ruim. A prevalência de agravos ocupacionais foi a mais alta da região: 15% para homens e 8,4% para mulheres. Conclusão: este é um primeiro levantamento das condições de trabalho e emprego e do estado de saúde de trabalhadores no Equador. Harmonizar e aperfeiçoar os Inquéritos sobre Condições de Trabalho na América Latina deve ser uma meta prioritária para melhorar a vigilância em saúde do trabalhador na região.

Abstract Introduction: Ecuador has recently implemented its First Working Conditions Survey. Objective: to describe working and employment conditions and workers' health status in Ecuador in a sample that allows comparison with previous Latin American surveys. Methods: a sample of 1,713 workers was drawn from the First Working Conditions Survey in Ecuador. Prevalence and a 95% confidence Interval (95%CI) were calculated and compared with previous Latin American surveys in Colombia, Argentina, Chile, Central America, and Uruguay. Results: men were more often exposed to hazardous working conditions, with noise (81% of men and 69% of women), and repetitive movements (56% and 48%, respectively) being the most frequently reported. About 31% of men and 19% of women worked more than 40 hours per week. Almost 11% of both women and men reported poor self-perceived health status. The prevalence of occupational injury was the highest in the region: 15% for men and 8.4% for women. Conclusions: this is a first approach to the working and employment conditions and workers' health status in Ecuador. To harmonize and improve Working Conditions Surveys in Latin America should be a priority goal for enhancing regional occupational health surveillance.

Resumen Introducción: Ecuador ha realizado recientemente su primera encuesta sobre las condiciones de trabajo. Objetivo: describir las condiciones de trabajo y empleo y el estado de salud de los trabajadores en Ecuador en una muestra que permita la comparación con encuestas anteriores en América Latina. Métodos: se seleccionó una muestra de 1.713 trabajadores de la Primera Encuesta de Condiciones de Trabajo en el Ecuador. Se calculó la prevalencia y el intervalo de confianza del 95% (IC95%) y se comparó con las encuestas anteriores realizadas en América Latina - Colombia, Argentina, Chile, América Central y Uruguay. Resultados: hombres se exponen con mayor frecuencia a condiciones de trabajo peligrosas, siendo las más frecuentes el ruido (81% de los hombres y 69% de las mujeres) y los movimientos repetitivos (56% y 48%, respectivamente). Alrededor del 31% de los hombres y el 19% de las mujeres trabajan más de 40 horas por semana. Casi el 11% de las mujeres y de los hombres reportaron mala salud autopercibida. La prevalencia de lesiones ocupacionales fue la más alta de la región: el 15% para los hombres y el 8,4% para las mujeres. Conclusiones: este es un primer acercamiento a las condiciones de trabajo y empleo y al estado de salud de los trabajadores en el Ecuador. Armonizar y mejorar las Encuestas de Condiciones de Trabajo en América Latina debería ser un objetivo prioritario para mejorar la vigilancia de la salud ocupacional en esta región.

Accidentes de tránsito relacionados con el trabajo: una prioridad en salud laboral y pública para Ecuador / Work-related traffic accidents: a priority for occupational and public health in Ecuador

Introducción: En Ecuador, los accidentes de tránsito relacionados con el trabajo han experimentado un incremento en los últimos años y han sido poco estudiados en seguridad y salud en el trabajo. Objetivo: Estimar el riesgo relativo de sufrir accidentes in-itínere en comparación con los accidentes ocurridos en el lugar de trabajo mediante el análisis de fuentes oficiales de información secundaria en el período de 2014 a 2016. Material y métodos: Estudio descriptivo de los accidentes de trabajo relacionados con el trabajo recopilados a través de fuentes oficiales de información secundaria. Para el análisis se utilizaron estadísticos descriptivos, cálculo del riesgo relativo (R.R.-IC95%) y la prueba chicuadrado de Pearson. Resultados: Las mujeres presentan mayor prevalencia y riesgo (R.R. = 1,86; IC95%: 1,80-1,92) de sufrir accidentes in-itínere. Asimismo, los trabajadores del sector industrial y servicios con edades entre los 18 a 35 años (R.R. = 1,16; IC95%: 1,12-1,20) muestran mayor probabilidad que el resto de actividades económicas y grupos etarios. Se observa una tendencia al aumento y probabilidad de fallecer por accidentes in-itínere (R.R. = 1,66; IC95%: 1,43-1,92) que en lugar de trabajo. Conclusiones: Los resultados del presente estudio conllevan a plantearse esta problemática como prioritaria en salud laboral y pública debido al incremento de este tipo de accidentes de trabajo. Surge la necesidad de continuar con futuras investigaciones y atención a este tipo de riesgos laborales por parte de los organismos públicos y empresas del Ecuador(AU)

Background: In Ecuador, work-related traffic accidents have experienced an increase in recent years, but are understudied from the perspective of occupational safety and health. Objective: To estimate the relative risk of suffering accidents initínere compared to workplace accidents by analyzing official sources of secondary information in Ecuador for the period from 2014 to 2016. Material and methods: Descriptive study of work-related accidents collected through official secondary information sources. For the analysis, descriptive statistics, relative risk calculation (R.R. and 95% confidence intervals, -95%CI) and the Pearson chi-square test were used. Results: Women presented a higher prevalence and risk (R.R. = 1.86, 95%CI: 1.80-1.92) of suffering traffic-related accidents. Likewise, industrial sector workers in the 18 to 35 year age group (R.R. = 1.16, 95%CI: 1.12-1.20) are at greater risk oftraffic-related accidents than other economic activity sectors and age groups. There is a trend toward an increased likelihood of dying from a traffic-related accident (R.R. = 1.66, 95%CI: 1.43-1.92) than from an accident at the workplace. Conclusions: Our results identify traffic-related occupational accidents as a priority in occupational and public health. There is a need for more research and increased awareness of these accidents on the part of public authorities and employers in Ecuador(AU)

Tendencias de los accidentes de tránsito en Ecuador: 2000-2015 / Trends in Traffic Accidents in Ecuador: 2000-2015 / Tendências em acidentes de trânsito no Equador: 2000-2015

Resumen Introducción: Los accidentes de tránsito constituyen un problema prioritario en salud pública a escala mundial, principalmente en los países de Latinoamérica, por ser una de las primeras causas de mortalidad en la región. Objetivo: Estudiar la evolución y tendencia de los accidentes de tránsito en Ecuador en el periodo del 2000 al 2015. Método: Estudio ecológico a partir de fuentes secundarias de información oficiales. Se presentan los resultados de las tasas de mortalidad poblacional por accidentes de tránsito y los índices de motorización, accidentabilidad, lesividad y letalidad, con el objeto de comparar las variaciones temporales en el periodo de estudio. Resultados: La tasa de mortalidad poblacional presentó una tendencia al aumento en el periodo de estudio y correlacionada con los índices de motorización y lesividad (p<0.01). Conclusiones: Se requiere un mayor esfuerzo para optimizar las actividades destinadas al cumplimiento de las normas legales de tránsito y educación vial para la población ecuatoriana.

Abstract Introduction: Traffic accidents are a priority problem in public health worldwide, mainly in Latin American countries, as it is one of the leading mortality causes in the region. Objective: To study the evolution and trend of traffic accidents in Ecuador in the period from 2000 to 2015. Method: An ecological study based on secondary official information sources. The results of the population mortality rates due to traffic accidents are presented, as well as motorization, accident, harmfulness, and fatality rates, in order to compare the temporal variations in the study period. Results: The population mortality rate showed an increasing tendency in the study period and correlated with motorization and harmfulness indexes (p <0.01). Conclusions: A greater effort is required to optimize the activities aimed at the compliance of the legal traffic laws and towards road safety education for the Ecuadorian population.

Resumo Introdução: Os acidentes de trânsito constituem um problema prioritário em saúde pública na escala mundial, principalmente nos países de Latino-américa, como uma das primeiras causas de mortalidade na região. Objetivo: Estudar a evolução e tendência dos acidentes de trânsito no Equador no 2000 a 2015. Método: Estudo ecológico a partir de fontes secundárias de informação oficiais. Apresentam-se resultados das taxas de mortalidade populacional por acidentes de trânsito e os índices de motorização, acidentalidade, lesividade e letalidade, com o objeto de comparar as variações temporais no período de estudo. Resultados: A taxa de mortalidade populacional apresentou tendência a aumentar no período de estudo e correlacionada com os índices de motorização e lesividade (p<0.01). Conclusões: Requere-se maior esforço para otimizar as atividades destinadas ao cumprimento das regulamentações legais de trânsito e educação para a população equatoriana.

Notificación de accidentes de trabajo y posibles enfermedades profesionales en Ecuador, 2010-2015 / Notification of occupational accidents and possible occupational diseases in Ecuador, 2010-2015

OBJETIVO: Describir la evolución de notificaciones por accidentes de trabajo y posibles enfermedades profesionales en Ecuador para el período desde 2010 a 2015. MATERIALES Y MÉTODOS: Estudio descriptivo a partir de fuentes secundarias reportadas al Seguro General de Riesgos de Trabajo del Instituto Ecuatoriano de Seguridad Social; se emplean frecuencias absolutas (n) y relativas (%), así como el cálculo de la tasa de incidencia en relación con las variables de interés. RESULTADOS: Se evidencia un incremento considerable del número de casos notificados por accidentes de trabajo y posibles enfermedades profesionales; la tasa de incidencia por accidentes aumentó de 381,2 en 2010 a 775,0 en 2015; asimismo, para los casos de enfermedades de 6,0 en 2010 a 28,4 en 2015. CONCLUSIONES: El aumento de registros de accidentes de trabajo y posibles enfermedades profesionales al Seguro General de Riesgos de Trabajo podría deberse a la entrada en vigor de normativas sobre la obligatoriedad de notificación en 2010 y 2011. No obstante, se evidencia la falta de implantación de medidas preventivas en los centros de trabajo, lo que supone plantearse una nueva reformulación de las políticas nacionales en seguridad y salud en el trabajo.

OBJECTIVE: To describe the evolution of reports of occupational accidents and possible occupational diseases in Ecuador for the period from 2010 to 2015. MATERIALS AND METHODS: Descriptive study from secondary sources reported to the General Occupational Risk Insurance of the Ecuadorian Social Security Institute; Absolute (n) and relative frequencies (%) are used, as well as the calculation of the incidence rate in relation to the variables of interest. RESULTS: There is a considerable increase in the number of cases reported due to occupational accidents and possible occupational diseases; The incidence rate for accidents increased from 381.2 in 2010 to 775.0 in 2015; Likewise, for cases of diseases from 6.0 in 2010 to 28.4 in 2015. CONCLUSIONS: The increase of records of occupational accidents and possible occupational diseases to the General Insurance of Occupational Risks could be due to the regulations on the obligation of notification that became effective in 2010 and 2011. However, it is evident the lack of implantation Of preventive measures in the work centers, what supposes to consider a new reformulation of the national policies in security and health in the work.