RESUMO
No disponible
Assuntos
Humanos , Riscos Ocupacionais , Vigilância Sanitária/legislação & jurisprudência , Vigilância Sanitária/organização & administração , Mitologia , Conformidade Social , Normas Sociais , Agências Internacionais/legislação & jurisprudência , Agências Internacionais/organização & administraçãoRESUMO
No disponible
Assuntos
Humanos , Medicina do Trabalho/legislação & jurisprudência , Medicina do Trabalho , Sociedades Médicas/legislação & jurisprudência , Sociedades Médicas/organização & administração , Riscos Ocupacionais , Medicina do Trabalho/organização & administração , Bélgica/epidemiologia , Prevenção de Acidentes/legislação & jurisprudênciaRESUMO
No disponible
Assuntos
Humanos , Medicina do Trabalho/tendências , Doenças Profissionais/epidemiologia , Sociedades Médicas , Congressos como AssuntoRESUMO
OBJECTIVES: Although routine workers' health examinations are extensively performed worldwide with important resource allocation, few studies have analyzed their quality. The objective of this study has been to analyze the medical practice of workers' health examinations in Catalonia (Spain) in terms of its occupational preventive aim. MATERIAL AND METHODS: A cross-sectional study was carried out by means of an online survey addressed to occupational physicians who were members of the Catalan Society of Safety and Occupational Medicine. The questionnaire included factual questions on how they performed health examinations in their usual practice. The bivariate analysis of the answers was performed by type of occupational health service (external/internal). RESULTS: The response rate was 57.9% (N = 168), representing 40.3% of the reference population. A high percentage of occupational physicians had important limitations in their current medical practice, including availability of clinical and exposure information, job-specificity of tests, and early detection and appropriate management of suspected occupational diseases. The situation in external occupational health services - that covered the great majority of Catalan employees - was worse remarkably in regard to knowledge of occupational and nonoccupational sickness absence data, participation in the investigation of occupational injuries and diseases, and accessibility for workers to the occupational health service. CONCLUSIONS: This study raises serious concerns about the occupational preventive usefulness of these health examinations, and subsequently about our health surveillance system, based primarily on them. Professionals alongside health and safety institutions and stakeholders should promote the rationalization of this system, following the technical criteria of need, relevance, scientific validity and effectiveness, whilst ensuring that its ultimate goal of improving the health and safety of workers in relation to work is fulfilled. Other countries with similar surveillance systems might be encouraged by our results to assess how their practices fit the intended purpose. Int J Occup Med Environ Health 2017;30(6):823-848.
Assuntos
Doenças Profissionais/prevenção & controle , Medicina do Trabalho/métodos , Exame Físico/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros , Médicos do Trabalho , Medicina do Trabalho/estatística & dados numéricos , Espanha , Inquéritos e QuestionáriosRESUMO
No disponible
Assuntos
Humanos , Saúde Ocupacional/tendências , Vigilância em Saúde do Trabalhador , Aptidão Física , 16360 , Melhoria de Qualidade/tendências , Medição de Risco/tendênciasRESUMO
Objetivo: Los exámenes de salud indiscriminados e inespecíficos para dar aparente cumplimiento a las obligaciones empresariales mediante un "listado de aptitudes" determinan la baja utilidad preventiva de nuestro sistema de vigilancia de la salud. Este estudio pretende realizar una interpretación técnica de la Ley de Prevención de riesgos laborales y proponer un nuevo marco conceptual que permita mejorar la vigilancia de la salud dentro de la normativa actual. Método: Mediante técnicas cualitativas de análisis del contenido se estudió el texto de la Ley, se identificaron los conceptos que dificultan el cumplimiento de los objetivos preventivos de la vigilancia de la salud, y se hizo una interpretación técnica, pero ajustada a normativa, para proponer un nuevo marco conceptual. Resultados: Este marco conceptual incluiría: diferenciar claramente vigilancia de la salud de examen de salud (uno de sus instrumentos) y de valoración de la aptitud para trabajar (concepto con entidad propia); reservar la obligatoriedad de la vigilancia para cuando sea «imprescindible» realizarla por la existencia de un riesgo sustancial para los trabajadores o terceros, incluyendo potenciales especialmente sensibles; y comunicar sus resultados mediante recomendaciones preventivas a la empresa, reservando los informes de aptitud para la vigilancia obligatoria y siempre en base a criterios de aptitud claros, preestablecidos y justificados en relación al riesgo. Conclusiones: El nuevo marco conceptual propuesto tiene cabida dentro de la Ley de Prevención de riesgos laborales y su puesta en práctica podría contribuir a mejorar la utilidad preventiva de la vigilancia de la salud sin necesidad de reformar la legislación
Objective: In Spain, the limited preventive usefulness of health surveillance is determined by the indiscriminate use of nonspecific «generic» health examinations aimed at producing a «fitness for work list», presumably allowing companies to comply with health and safety regulations. This study aimed to produce a technical interpretation of the Spanish Prevention of Risks at Work Act and propose a new conceptual framework to favour greater preventive usefulness of health surveillance within the current regulatory framework. Methods: Using qualitative techniques of content analysis, the text of the Law was studied, the key concepts that impeded the fulfilment of the preventive objectives of health surveillance were identified, and a technical interpretation adjusted to regulations was made in order to propose a new conceptual framework Results: This conceptual framework would include: clearly differentiating health surveillance from health examinations (one of its instruments) and from fitness for work evaluations (an independent concept in itself); restricting mandatory health surveillance to situations in which it is «imperative» to carry it out because of the existence of a substantial risk to workers or third parties, including potentially vulnerable workers; and communicating the results of health surveillance through preventive recommendations to the company, reserving fitness for duty certificates -always based on clear, pre-established and justified criteria in relation to risk- for mandatory surveillance. Conclusions: The proposed new conceptual framework falls within the scope of the Spanish Prevention of Risks at Work Act, and its implementation could contribute to improving the preventive usefulness of health surveillance without the need to reform the legislation
Objectiu: Els exàmens de salut indiscriminats i inespecífics perdonar aparent compliment a les obligacions empresarials mitjançant un "llistat daptituds" deter minen la baixa utilitat preventiva del nostre sistema de vigilància de la salut. Aquest estudi pretén realitzar una interpretació técnica de la Llei de Prevenció de riscos laborals i proposarun nou marc conceptual que permeti millorar la vigilància de la salut dins de la normativa actual. Métode: Mitjançant tècniques qualitatives danàlisi del contingut es va estudiar el text de la Llei, es van identificarels conceptes que dificulten el compliment de ls objectius preventius de la vigilància de la salut, i es va fer una interpretación tècnica, per ò ajustada a la normativa, per proposar un nou marc conceptual. Resultats: Aquest marc conceptual inclouria: diferenciar clarament vigilància de la salut dexamen de salut (un dels seus instruments) i de valoració de laptitud per a treballar (concepte amb entitat pròpia); reservar l'obligatoriet at de la vigilància per quan sigui "imprescindible" realitzarla per lexistència dun risc substancial per als treballadorso tercers, incloent potencia ls especialmente sensibles; i comunicar els seus resultats mitjançant recomanacions preventives a lempresa, reservant els informes daptitud per a la vigilància obligatòria i sempre en base a criteris daptitud clars , preestablerts i justificats en relació al risc. Conclusions :El nou marc conceptual propos at té cabuda dins de la Llei de Prevenció de riscos laborals, i la seva posada en pràctica podria contribuir a millorar la utilitat preventiva de la vigilància de la salut sense necessitat de reformar la legislación
Assuntos
Humanos , Serviços Preventivos de Saúde/normas , Vigilância em Saúde do Trabalhador , Riscos Ocupacionais , Saúde Ocupacional/legislação & jurisprudência , Melhoria de Qualidade/normas , Pesquisa Qualitativa , Alocação de Recursos/tendências , Procedimentos Desnecessários/tendênciasRESUMO
OBJECTIVE: In Spain, the limited preventive usefulness of health surveillance is determined by the indiscriminate use of nonspecific "generic" health examinations aimed at producing a "fitness for work list", presumably allowing companies to comply with health and safety regulations. This study aimed to produce a technical interpretation of the Spanish Prevention of Risks at Work Act and propose a new conceptual framework to favour greater preventive usefulness of health surveillance within the current regulatory framework. METHODS: Using qualitative techniques of content analysis, the text of the Law was studied, the key concepts that impeded the fulfilment of the preventive objectives of health surveillance were identified, and a technical interpretation adjusted to regulations was made in order to propose a new conceptual framework RESULTS: This conceptual framework would include: clearly differentiating health surveillance from health examinations (one of its instruments) and from fitness for work evaluations (an independent concept in itself); restricting mandatory health surveillance to situations in which it is "imperative" to carry it out because of the existence of a substantial risk to workers or third parties, including potentially vulnerable workers; and communicating the results of health surveillance through preventive recommendations to the company, reserving fitness for duty certificates -always based on clear, pre-established and justified criteria in relation to risk- for mandatory surveillance. CONCLUSIONS: The proposed new conceptual framework falls within the scope of the Spanish Prevention of Risks at Work Act, and its implementation could contribute to improving the preventive usefulness of health surveillance without the need to reform the legislation.
RESUMO
No disponible
Assuntos
Humanos , Medicina do Trabalho , Especialização , Sociedades Médicas , Congressos como AssuntoRESUMO
OBJECTIVE: To analyze whether examinations for health surveillance in Catalonia are carried out with a high enough degree of quality as to comply with the preventive aim of the regulations, and to identify potential differences by type of prevention service. METHOD: Qualitative and quantitative techniques. Body of data: Spanish regulations related to health surveillance, and a self-reported questionnaire answered by occupational health professionals who performed health examinations in their usual practice. Content analysis of regulations, identifying concepts, and linking them to survey questions. Quality criteria were established for each concept, referring to the minimum that must be met to ensure that the professional practice can be of quality; quality indicators (percentage of professionals whose practice met the quality criteria) were calculated globally and by type of prevention service; and quality standards (fulfilment of quality criteria by 75% or more of the professionals) were set. RESULTS: The concepts identified were: availability of clinical and exposure information, job-specificity, identification of workers with special susceptibilities, referral to mutual insurance companies for appropriate diagnosis and treatment, development of preventive proposals, and professional independence and non detriment for workers. Quality indicators ranged between 0 and 88%. None of the concepts globally reached the quality standard. CONCLUSIONS: The quality of health examinations performed for health surveillance in Catalonia, doesn't seem to be high enough as to comply with the preventive aim of the regulations. The situation is worse in external prevention services.
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No disponible
