National working conditions surveys in Latin America: comparison of methodological characteristics.

BACKGROUND: High-quality and comparable data to monitor working conditions and health in Latin America are not currently available. In 2007, multiple Latin American countries started implementing national working conditions surveys. However, little is known about their methodological characteristics. OBJECTIVE: To identify commonalities and differences in the methodologies of working conditions surveys (WCSs) conducted in Latin America through 2013. METHODS: The study critically examined WCSs in Latin America between 2007 and 2013. Sampling design, data collection, and questionnaire content were compared. RESULTS: Two types of surveys were identified: (1) surveys covering the entire working population and administered at the respondent's home and (2) surveys administered at the workplace. There was considerable overlap in the topics covered by the dimensions of employment and working conditions measured, but less overlap in terms of health outcomes, prevention resources, and activities. CONCLUSIONS: Although WCSs from Latin America are similar, there was heterogeneity across surveyed populations and location of the interview. Reducing differences in surveys between countries will increase comparability and allow for a more comprehensive understanding of occupational health in the region.

Work-related psychosocial risk factors and musculoskeletal disorders in hospital nurses and nursing aides: a systematic review and meta-analysis.

OBJECTIVES: To estimate the association between psychosocial risk factors in the workplace and musculoskeletal disorders (MSD) in nurses and aides. DESIGN: Systematic review and meta-analysis. DATA SOURCES: An electronic search was performed using MEDLINE (Pubmed), Psychinfo, Web of Science, Tripdatabase, Cochrane Central Controlled Trials, NIOSHTIC and Joanna Briggs Institute of Systematic Reviews on Nursing and Midwifery, to identify observational studies assessing the role of psychosocial risk factors on MSD in hospital nurses and nursing aides. REVIEW METHODS: Two reviewers independently assessed eligibility and extracted data. Quality assessment was conducted independently by two reviewers using an adapted version of the Standardized Quality Scale. Random-effects meta-analysis was performed by subsets based on specific anatomical site and the exposure to specific psychosocial risk factors. Heterogeneity for each subset of meta-analysis was assessed and meta-regressions were conducted to examine the source of heterogeneity among studies. RESULTS: Twenty-four articles were included in the review, seventeen of which were selected for meta-analysis. An association was identified between high psychosocial demands-low job control with prevalent and incident low back pain (OR 1.56; 95% CI 1.22-1.99 and OR 1.52; 95% CI 1.14-2.01, respectively), prevalent shoulder pain (OR 1.89; 95% CI 1.53-2.34), prevalent knee pain (OR 2.21; 95% CI 1.07-4.54), and prevalent pain at any anatomical site (OR 1.38; 95% CI 1.09-1.75). Effort-reward imbalance was associated with prevalent MSD at any anatomical site (OR 6.13; 95% CI 5.32-7.07) and low social support with incident back pain (OR 1.82; 95% CI 1.43-2.32). Heterogeneity was generally low for most subsets of meta-analysis. CONCLUSION: This meta-analysis suggests that psychosocial risk factors at the workplace are associated with MSD in hospital nurses and nursing aides. Although most preventive strategies at the workplace are focused on ergonomic risk factors, improving the psychosocial work environment might have an impact on reducing MSDs.

Gender inequalities in occupational health related to the unequal distribution of working and employment conditions: a systematic review.

INTRODUCTION: Gender inequalities exist in work life, but little is known about their presence in relation to factors examined in occupation health settings. The aim of this study was to identify and summarize the working and employment conditions described as determinants of gender inequalities in occupational health in studies related to occupational health published between 1999 and 2010. METHODS: A systematic literature review was undertaken of studies available in MEDLINE, EMBASE, Sociological Abstracts, LILACS, EconLit and CINAHL between 1999 and 2010. Epidemiologic studies were selected by applying a set of inclusion criteria to the title, abstract, and complete text. The quality of the studies was also assessed. Selected studies were qualitatively analysed, resulting in a compilation of all differences between women and men in the prevalence of exposure to working and employment conditions and work-related health problems as outcomes. RESULTS: Most of the 30 studies included were conducted in Europe (n=19) and had a cross-sectional design (n=24). The most common topic analysed was related to the exposure to work-related psychosocial hazards (n=8). Employed women had more job insecurity, lower control, worse contractual working conditions and poorer self-perceived physical and mental health than men did. Conversely, employed men had a higher degree of physically demanding work, lower support, higher levels of effort-reward imbalance, higher job status, were more exposed to noise and worked longer hours than women did. CONCLUSIONS: This systematic review has identified a set of working and employment conditions as determinants of gender inequalities in occupational health from the occupational health literature. These results may be useful to policy makers seeking to reduce gender inequalities in occupational health, and to researchers wishing to analyse these determinants in greater depth.

Welfare state regimes and gender inequalities in the exposure to work-related psychosocial hazards.

BACKGROUND: Gender inequalities in the exposure to work-related psychosocial hazards are well established. However, little is known about how welfare state regimes influence these inequalities. OBJECTIVES: To examine the relationship between welfare state regimes and gender inequalities in the exposure to work-related psychosocial hazards in Europe, considering occupational social class. METHODS: We used a sample of 27, 465 workers from 28 European countries. Dependent variables were high strain, iso-strain, and effort-reward imbalance, and the independent was gender. We calculated the prevalence and prevalence ratio separately for each welfare state regime and occupational social class, using multivariate logistic regression models. RESULTS: More female than male managers/professionals were exposed to: high strain, iso-strain, and effort-reward imbalance in Scandinavian [adjusted prevalence ratio (aPR) = 2·26; 95% confidence interval (95% CI): 1·87-2·75; 2·12: 1·72-2·61; 1·41: 1·15-1·74; respectively] and Continental regimes (1·43: 1·23-1·54; 1·51: 1·23-1·84; 1·40: 1·17-1·67); and to high strain and iso-strain in Anglo-Saxon (1·92: 1·40-2·63; 1·85: 1·30-2·64; respectively), Southern (1·43: 1·14-1·79; 1·60: 1·18-2·18), and Eastern regimes (1·56: 1·35-1·81; 1·53: 1·28-1·83). CONCLUSION: Gender inequalities in the exposure to work-related psychosocial hazards were not lower in those welfare state regimes with higher levels of universal social protection policies.

Encuestas de condiciones de trabajo y salud: su utilización en la investigación en salud laboral / Surveys on working conditions and health: their use in occupational health research

Objetivo: Analizar la utilización de las Encuestas de Condiciones de Trabajo y Salud (ECTS) en el ámbito de la investigación en salud laboral. Material y Métodos: Se realizó una revisión bibliográfica sobre ECTS incluyendo artículos originales publicados en revistas indexadas en PubMed y CISDOC 1990-2009. En los artículos seleccionados se identificaron objetivos, temáticas abordadas y vacíos conceptuales, entre otras dimensiones. Resultados: Inicialmente se localizaron 627 publicaciones, tras la selección se analizaron 15. Las temáticas más estudiadas fueron las condiciones de empleo y la salud (14 artículos en ambos). En las condiciones de trabajo se destacaron los riesgos ergonómicos (11 artículos) y psicosociales (10 artículos). Bajo la dimensión de salud 9 estudios analizaron los síntomas psicosomáticos. Sólo 4 estudios incluyeron una perspectiva de género y 3 incorporaron la clase social. Fue escasa la investigación en prevención (2 artículos) y participación de los trabajadores (1 artículo).Conclusiones: La literatura científica producida a partir de las ECTS refleja que ciertos tópicos, como la participación de los trabajadores y las intervenciones preventivas, han sido prácticamente inexplorados. Igualmente, sería de gran interés la introducción de la perspectiva de género, migraciones y clase social ocupacional en los artículos científicos basados en las ECTS (AU)

Objective: To analyse the use of the working and health conditions survey (WHCS) in occupational health research. Method: A literature review about working and health conditions survey (WHCS) was conducted in PubMed and CISDOC in the period 1990-2009 including research articles. In selected papers objectives, main issues and gaps were identified. Results: 627 publications were located and we analysed 15 papers about WHCS. Employment conditions and Health were the most explored issues (n=14). Considering working conditions, ergonomic (n=11) and psychosocial risk factors (n=10) were more described. 9 papers analysed psychosomatic symptoms and 7 papers described self-perceived health status. Only 4 papers included gender perspective and 3 papers incorporated social class within the analysis. Research on workers’ participation (n=1) and prevention (n=2) was scarcely. Conclusions: Scientific literature based on the WHCS show that some topics have been practically unexplored, such as workers participation, preventive interventions, and labour and familiar conciliation. The introduction of a gender perspective, migration and social class in the analysis of the scientific articles would be well acknowledged (AU)

Desigualdades de género en salud laboral en España / Gender inequalities in occupational health in Spain

Objetivos Analizar las desigualdades de género en las condiciones de empleo, trabajo, conciliación de la vida laboral y familiar, y en los problemas de salud relacionados con el trabajo en una muestra de la población ocupada en España en el año 2007 teniendo en cuenta la clase social y el sector de actividad. Métodos Las desigualdades de género se analizaron mediante 25 indicadores en los 11.054 trabajadores entrevistados en la VI Encuesta Nacional de Condiciones de Trabajo. Se calcularon las odds ratio (OR) y sus intervalos de confianza del 95% (IC95%) mediante modelos de regresión logística multivariados, estratificando por clase social ocupacional y sector de actividad. Resultados Más mujeres que hombres trabajaban sin contrato (OR=1,83; IC95%: 1,51-2,21), con alto esfuerzo o baja recompensa (1,14:1,05-1,25) y sufriendo acoso sexual (2,85:1,75-4,62), discriminación (1,60:1,26-2,03) y más dolores osteomusculares (1,38:1,19-1,59). Más hombres que mujeres trabajaban a turnos (0,86:0,79-0,94), con altos niveles de ruido (0,34:0,30-0,40), altas exigencias físicas (0,58:0,54-0,63) y sufriendo más lesiones por accidentes de trabajo (0,67:0,59-0,76). Las trabajadoras no manuales mostraron trabajar con un contrato temporal (1,34:1,09-1,63), expuestas a más riesgos psicosociales y sufriendo mayor discriminación (2,47:1,49-4,09) y enfermedades profesionales (1,91:1,28-2,83). En el sector de la industria las desigualdades de género fueron más marcadas. Conclusiones En España existen importantes desigualdades de género en las condiciones de empleo, trabajo y en los problemas de salud relacionados con el trabajo, que se ven influenciadas por la clase social y el sector de actividad, y que sería necesario tener en consideración en las políticas públicas de salud laboral(AU)

Objectives To analyze gender inequalities in employment and working conditions, the work-life balance, and work-related health problems in a sample of the employed population in Spain in 2007, taking into account social class and the economic sector. Methods Gender inequalities were analyzed by applying 25 indicators to the 11,054 workers interviewed for the VI edition of the National Working Conditions Survey. Multivariate logistic regression models were used to calculate odds ratios (OR) and 95% confidence intervals (95% CI), stratifying by occupational social class and economic sector. Results More women than men worked without a contract (OR=1.83; 95% CI: 1.51-2.21) and under high-effort/low-reward conditions (1.14:1.05-1.25). Women also experienced more sexual harassment (2.85:1.75-4.62), discrimination (1.60:1.26-2.03) and musculoskeletal pain (1.38:1.19-1.59). More men than women carried out shift work (0.86:0.79-0.94), with high noise levels (0.34:0.30-0.40), and high physical demands (0.58:0.54-0.63). Men also suffered more injuries due to occupational accidents (0.67:0.59-0.76). Women white-collar-workers were more likely than their male counterparts to have a temporary contract (1.34:1.09-1.63), be exposed to psychosocial hazards and discrimination (2.47:1.49-4.09) and have occupational diseases (1.91:1.28-2.83). Gender inequalities were higher in the industry sector. Conclusions There are substantial gender inequalities in employment, working conditions, and work-related health problems in Spain. These gender inequalities are influenced by social class and the economic sector, and should be considered in the design of public policies in occupational health (AU)

[Gender inequalities in occupational health in Spain]. / Desigualdades de género en salud laboral en España.

OBJECTIVES: To analyze gender inequalities in employment and working conditions, the work-life balance, and work-related health problems in a sample of the employed population in Spain in 2007, taking into account social class and the economic sector. METHODS: Gender inequalities were analyzed by applying 25 indicators to the 11,054 workers interviewed for the VI edition of the National Working Conditions Survey. Multivariate logistic regression models were used to calculate odds ratios (OR) and 95% confidence intervals (95% CI), stratifying by occupational social class and economic sector. RESULTS: More women than men worked without a contract (OR=1.83; 95% CI: 1.51-2.21) and under high-effort/low-reward conditions (1.14:1.05-1.25). Women also experienced more sexual harassment (2.85:1.75-4.62), discrimination (1.60:1.26-2.03) and musculoskeletal pain (1.38:1.19-1.59). More men than women carried out shift work (0.86:0.79-0.94), with high noise levels (0.34:0.30-0.40), and high physical demands (0.58:0.54-0.63). Men also suffered more injuries due to occupational accidents (0.67:0.59-0.76). Women white-collar-workers were more likely than their male counterparts to have a temporary contract (1.34:1.09-1.63), be exposed to psychosocial hazards and discrimination (2.47:1.49-4.09) and have occupational diseases (1.91:1.28-2.83). Gender inequalities were higher in the industry sector. CONCLUSIONS: There are substantial gender inequalities in employment, working conditions, and work-related health problems in Spain. These gender inequalities are influenced by social class and the economic sector, and should be considered in the design of public policies in occupational health.

Sexual assault and other types of violence in intimate partner relationships.

OBJECTIVE: To investigate whether sexual assaults are more likely to co-occur with some types of abuse rather than others in violent intimate relationships. DESIGN: Cross-sectional study. SETTING: A self-administered questionnaire was sent to all Norwegian women's shelters. POPULATION: Women seeking refuge at Norwegian women's shelters in 2002 and 2003. METHODS: Sexual assault and experiences of intimate partner violence were measured using the Severity of Violence against Women Scale (SVAWS) and psychological violence was measured using the Psychological Maltreatment of Women Inventory (PMWI). MAIN OUTCOME MEASURES: Student's t-test analyses were performed between the mean values of the different acts of reported violence, and linear regression analyses were used to examine the association between sexual violence and the other forms of violence reported. RESULTS: Sexual violence correlated significantly with the other eight categories in SVAWS, and with violence directed at the pregnant woman's abdomen and psychological violence in PMWI. When we adjusted all categories for each other by linear regression analysis, sexual intimate partner violence was significantly associated with hair pulling, arm twisting, spanking or biting, dominance and isolation abuse and violence directed at the pregnant woman's abdomen. CONCLUSION: Sexual assaults are more likely to co-occur with some types of physical and psychological violence than with others. This knowledge may be important for improving our understanding of sexual violence in intimate partner relationships and in the efforts to detect intimate partner violence. Bruises, loss of hair and bite marks may suggest that sexual acts were committed against the victim's will.

[Necrotizing enterocolitis in the preterm infant: etiopathogenic considerations]. / Enterocolite necrotizzante nel neonato pretermine: considerazioni eziopatogenetiche.

Necrotizing enterocolitis (NE) represents the most frequent gastrointestinal emergency encountered in neonatal intensive care units. This necrotic-inflammatory bowel disease affects primarily premature patients and it is recorded as an important cause of neonatal morbidity and mortality. The NE aetiology seems to be multifactorial: prematurity, enteral feeding, hypoxia and micro-organisms toxicity are registered as the most important risk factors, able to trigger the phlogistic and necrotic way at the basis of necrotizing enterocolitis. Despite the NE first report was in the past century, the correct pathogenic sequence of this neonatal disease is still hypothetical.