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1.
Rev. Asoc. Esp. Espec. Med. Trab ; 23(4): 438-445, dic. 2014.
Artigo em Espanhol | IBECS | ID: ibc-131505

RESUMO

OBJETIVOS: El objetivo de este estudio fue caracterizar las roturas dentales debidas a accidentes de trabajo. Material y MÉTODOS: Estudio observacional retrospectivo de 1.081 sujetos con roturas dentales de origen laboral pertenecientes a la población protegida de una mutua de accidentes de trabajo y enfermedades profesionales. Se seleccionaron todos los casos del periodo 2000-2010 con un diagnóstico único de rotura dental. Se realizaron análisis descriptivos y bivariados de las principales variables demográficas, laborales y clínicas. RESULTADOS: Las roturas dentales resultaron más frecuentes entre los hombres (9:1), en trabajadores menores de 40 años (74,2%) y con ocupaciones manuales (9:1). La causa más común fueron golpes al manipular piezas o herramientas durante la realización de una tarea manual (72,8%). Muchos de tales accidentes se produjeron con herramientas poco sofisticadas (llaves 18,9%; martillos 4%). Las causas de accidente variaron en función del sexo, edad y nivel ocupacional (p < 0,001). Entre los hombres, los trabajadores más jóvenes y con ocupaciones manuales, los accidentes durante la manipulación de piezas y herramientas u operaciones de carga y descarga fueron los más frecuentes. Entre las mujeres, trabajado res de mayor edad o con ocupaciones no manuales, la variedad de causas fue mayor. CONCLUSIONES: La mejora del entrenamiento en el uso de herramientas y de los equipos de protección individual, la formación acerca de los factores de riesgo y la inspección y mantenimiento de los equipos parecen ser aspectos esenciales para la prevención de este tipo de lesiones


OBJECTIVES: The aim of this study was to characterize dental fractures due to work accidents. MATERIAL AND METHODS: Observational retrospective study of 1,081 subjects with work-related dental fractures that were selected from the insured population of a Spanish Mutual Insurance Company for Accidents at Work and Professional Illnesses. All the cases from 2000 to 2010 with the only diagnosis of traumatic dental fracture were selected. Descriptive and bivariate analysis on demographic, work related and clinical variables were performed. RESULTS: Dental fractures were more frequent among males (9:1), younger than 40 years-old (74.2%) and blue-collar vs. white-collar workers (9:1). The most common cause of dental fractures in work-related accidents were bumps when manipulating components or tools (72.8%) and many of these events involved low-sophisticated tools (wrenches 18.9%; hammers 4%). Causes of the accidents significantly differed according to sex, age and occupational level (p < 0.001). Among men, younger and blue-collar workers, work accidents involving manipulation of components and tools and loading maneuvers accounted for the majority of the injuries. On the other hand, women, older and white-collar workers showed a greater variety of causes. CONCLUSIONS: Improved training on the use of tools and individual protective equipment, education on risk factors, and inspection and maintenance practices appear to be essential for prevention


Assuntos
Humanos , Masculino , Feminino , Fraturas dos Dentes/complicações , Fraturas dos Dentes/epidemiologia , Fraturas dos Dentes/prevenção & controle , Acidentes de Trabalho/prevenção & controle , Acidentes de Trabalho/estatística & dados numéricos , Fatores de Risco , Prevenção de Acidentes/métodos , Prevenção de Acidentes/estatística & dados numéricos , Traumatismos Ocupacionais/complicações , Traumatismos Ocupacionais/epidemiologia , Traumatismos Ocupacionais/prevenção & controle , Estudos Retrospectivos
2.
J Hypertens ; 32(10): 1970-8; discussion 1978, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25023154

RESUMO

OBJECTIVE: This study aims to investigate the influence of estimated glomerular filtration rate (eGFR) with two equations (and by one or two separate measurements), on the prevalence of chronic kidney disease (CKD) and its association with blood pressure, and cardiovascular and metabolic risk factors. METHODS: Between January 2010 and October 2011, the Ibermutuamur CArdiovascular RIsk Assessment project included 128 588 workers (77.2% men, mean age 39.3 years, range 16-75), who underwent two consecutive yearly medical check-ups and had information for eGFR according to the MDRD-IDMS and CKD-EPI equations (serum creatinine was measured by a isotope-dilution mass spectrometry traceable method in a single central laboratory). CKD was defined by an eGFR less than 60 ml/min per 1.73 m. Subclinical (occult) renal disease was defined as an eGFR less than 60 ml/min per 1.73 m in patients with serum creatinine below 1.3 mg/dl and below 1.2 mg/dl in men and women, respectively. RESULTS: In this working population, prevalence of CKD was very low, but two to six times lower when two separate eGFRs below 60 ml/min per 1.73 m were used. The prevalence of CKD was significantly lower with the CKD-EPI compared to the MDRD-IDMS equation. The same applies to occult CKD. In male workers, occult CKD was practically nonexistent.Multivariate analyses show that blood pressure, total serum cholesterol, and serum glucose (positively), and high-density lipoprotein and low-density lipoprotein (negatively) were associated with CKD, with both equations. Another metabolic factor (waist circumference) was only associated (positively) with CKD defined by the CKD-EPI equation, which appears to be associated with most components of the metabolic syndrome. CONCLUSIONS: The CKD-EPI formula, calculated on the basis of two reported blood samples, may provide the most specific definition of CKD.


Assuntos
Taxa de Filtração Glomerular/fisiologia , Insuficiência Renal Crônica/epidemiologia , Adolescente , Adulto , Idoso , Doenças Cardiovasculares/epidemiologia , Creatinina/sangue , Feminino , Humanos , Testes de Função Renal , Lipoproteínas HDL/sangue , Lipoproteínas LDL/sangue , Masculino , Pessoa de Meia-Idade , Prevalência , Insuficiência Renal Crônica/fisiopatologia , Medição de Risco , Fatores de Risco , Espanha/epidemiologia , Adulto Jovem
3.
Arch. prev. riesgos labor. (Ed. impr.) ; 17(2): 84-90, abr.-jun. 2014. tab
Artigo em Espanhol | IBECS | ID: ibc-121846

RESUMO

Objetivo: Determinar la prevalencia de hígado graso no alcohólico (HGNA) y factores de riesgo asociados en directivos de la Comunidad de Madrid. Métodos: Estudio descriptivo de corte transversal y retrospectivo, con la participación de 1.838 trabajadores (78,5%hombres), que acudieron a reconocimiento médico como parte del Programa de Vigilancia de la Salud entre el 01/01/2010y el 31/12/2010. Se recogieron datos de la anamnesis, mediciones antropométricas, determinaciones bioquímicas y estudio ecográfico del hígado. Resultados: La prevalencia total de HGNA fue del 44,0% (54,0% en varones y 7,3% en mujeres; p<0,001). La presencia de HGNA se asocia en ambos sexos a mayor edad, peso más elevado, talla más baja, mayor índice de masa corporal perímetro abdominal y síndrome metabólico, así como a niveles más elevados de ácido úrico y glucosa en sangre. En el análisis de regresión logística multivariante se apreció riesgo elevado de HGNA para perímetro abdominal ≥102cm en varones y≥88cm mujeres (odds ratio OR=5,2; IC95% 3,8-7,1), edad ≥40 años (OR=3,0; IC95% 2,3-4,0), triglicéridos ≥150mg/dl(OR=2,1; IC95% 1,5-2,8), colesterol HDL <45mg/dl en mujeres y <40 mg/dl en hombres (OR: 1,6; IC95% 1,1-2,2) y colesterol total >200mg/dl (OR=1,4; IC95% 1,0-1,9).Conclusiones: La prevalencia de HGNA presenta diferencias muy marcadas por sexo y está asociada a hipertrigliceridemia, hipercolesterolemia, bajo colesterol HDL, obesidad abdominal y síndrome metabólico. La introducción del cribado del HGNA en la de Vigilancia de la Salud de los trabajadores podría ser una medida de interés para la Medicina del Trabajo


Objective: To determine the prevalence of non-alcoholic fatty liver disease (NAFLD) and associated risk factors in a group of managers from the Community of Madrid. Methods: Retrospective cross-sectional study of 1838 workers (78.5% male) who underwent medical examination between January 1, 2010 and December 31, 2010 as part of a worker health surveillance program. Data were collected from medical records, laboratory results, anthropometric measurements and hepatic ultrasound. Results: The prevalence of NAFLD was 44.0%: 54.0% in men and 7.3% in women (p<0.001). In both sexes, NAFLD was associated with increasing age, higher weight, shorter stature, higher body mass index, waist circumference and metabolic syndrome, as well as higher levels of uric acid and blood glucose. In the multivariate logistic regression analysis, the risk of NAFLD risk was associated with an abdominal circumference ≥ 102cm for men and ≥ 88cm in women (OR=5.2;95%CI 3.8-7.1 ), age ≥ 40 years (OR : 3.0; 95%CI 2.3-4.0), triglycerides ≥ 150mg/dl (OR=2.1; 95%CI 1.5-2.8), HDL cholesterol<45mg/dl in women and <40mg/dl in men (OR=1.6; 95%CI 1.1-2.2), and total cholesterol >200/dl mg (OR=1.4;95%CI 1.0-1.9) .Conclusions: NAFLD prevalence is notably different among sexes and is associated with hypertriglyceridemia, hypercholesterolemia, low HDL cholesterol, abdominal obesity and metabolic syndrome. Screening programs for NAFLD in worker medical surveillance programs could be of interest in occupational medicine


Assuntos
Humanos , Fígado Gorduroso/epidemiologia , Serviços de Saúde do Trabalhador/estatística & dados numéricos , Fatores de Risco , Estudos Retrospectivos , Serviços de Vigilância Epidemiológica
4.
Arch Prev Riesgos Labor ; 17(2): 84-90, 2014.
Artigo em Espanhol | MEDLINE | ID: mdl-24718630

RESUMO

OBJECTIVE: To determine the prevalence of non-alcoholic fatty liver disease (NAFLD) and associated risk factors in a group of managers from the Community of Madrid. METHODS: Retrospective cross-sectional study of 1838 workers (78.5% male) who underwent medical examination between January 1, 2010 and December 31, 2010 as part of a worker health surveillance program. Data were collected from medical records, laboratory results, anthropometric measurements and hepatic ultrasound. RESULTS: The prevalence of NAFLD was 44.0%: 54.0% in men and 7.3% in women (p<0.001). In both sexes, NAFLD was associated with increasing age, higher weight, shorter stature, higher body mass index, waist circumference and metabolic syndrome, as well as higher levels of uric acid and blood glucose. In the multivariate logistic regression analysis, the risk of NAFLD risk was associated with an abdominal circumference ≥ 102cm for men and ≥ 88cm in women (OR=5.2; 95%CI 3.8-7.1 ), age ≥ 40 years (OR : 3.0; 95%CI 2.3-4.0), triglycerides ≥ 150mg/dl (OR=2.1; 95%CI 1.5-2.8), HDL cholesterol <45mg/dl in women and <40mg/dl in men (OR=1.6; 95%CI 1.1-2.2), and total cholesterol >200/dl mg (OR=1.4; 95%CI 1.0-1.9). CONCLUSIONS: NAFLD prevalence is notably different among sexes and is associated with hypertriglyceridemia, hypercholesterolemia, low HDL cholesterol, abdominal obesity and metabolic syndrome. Screening programs for NAFLD in worker medical surveillance programs could be of interest in occupational medicine.


OBJETIVO: Determinar la prevalencia de hígado graso no alcohólico (HGNA) y factores de riesgo asociados en directivos de la Comunidad de Madrid. MÉTODOS: Estudio descriptivo de corte transversal y retrospectivo, con la participación de 1.838 trabajadores (78,5% hombres), que acudieron a reconocimiento médico como parte del Programa de Vigilancia de la Salud entre el 01/01/2010 y el 31/12/2010. Se recogieron datos de la anamnesis, mediciones antropométricas, determinaciones bioquímicas y estudio ecográfico del hígado. RESULTADOS: La prevalencia total de HGNA fue del 44,0% (54,0% en varones y 7,3% en mujeres; p<0,001). La presencia de HGNA se asocia en ambos sexos a mayor edad, peso más elevado, talla más baja, mayor índice de masa corporal perímetro abdominal y síndrome metabólico, así como a niveles más elevados de ácido úrico y glucosa en sangre. En el análisis de regresión logística multivariante se apreció riesgo elevado de HGNA para perímetro abdominal ≥102cm en varones y ≥88cm mujeres (odds ratio OR=5,2; IC95% 3,8-7,1), edad ≥40 años (OR=3,0; IC95% 2,3-4,0), triglicéridos ≥150mg/dl (OR=2,1; IC95% 1,5-2,8), colesterol HDL <45mg/dl en mujeres y <40 mg/dl en hombres (OR: 1,6; IC95% 1,1-2,2) y colesterol total >200mg/dl (OR=1,4; IC95% 1,0-1,9). CONCLUSIONES: La prevalencia de HGNA presenta diferencias muy marcadas por sexo y está asociada a hipertrigliceridemia, hipercolesterolemia, bajo colesterol HDL, obesidad abdominal y síndrome metabólico. La introducción del cribado del HGNA en la de Vigilancia de la Salud de los trabajadores podría ser una medida de interés para la Medicina del Trabajo.


Assuntos
Pessoal Administrativo , Fígado Gorduroso/epidemiologia , Saúde Ocupacional , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica , Prevalência , Estudos Retrospectivos , Fatores de Risco , Espanha , Saúde da População Urbana
5.
Rev Esp Salud Publica ; 86(2): 177-88, 2012.
Artigo em Espanhol | MEDLINE | ID: mdl-22991060

RESUMO

BACKGROUND: The aim of this study was to analyze the impact on tobacco consumption among working population of the Law 42/2010, which amends smoking regulations in Spain. METHODS: Data were obtained from 413,473 Occupational Health check-ups, conducted between July of 2009 and June of 2011, in the Society for Prevention of a Mutual Insurance Company. We analyzed changes in the biannual percentage of smokers and the magnitude of tobacco consumption among smokers in the overall set of medical check-ups, by gender, age, occupational level (manual vs. non-manual workers), and in the specific occupational subgroup of waiters, barmen and similar workers (chi-square test). RESULTS: In the overall set of medical check-ups, the percentage of smokers decreased by 5% (from 40.3% to 35.3%) over the period of study (p <0.001) and the group of smokers with lower daily consumption (< 10 cigarettes) became the most frequent (p <0.001). In the group of waiters, barmen and similar workers the differences in the biannual percentage of smokers did not reach statistical significance (p =0.07). In this group, smokers of < 10 cigarretes/ day also became the most common consumption group (increasing from 40.5% to 48.8%) and the percentage of 21-40 cigarretes/day decreased from 10.6% to 4% (p =0.008). CONCLUSIONS: These results suggest that the new regulation has been accompanied by a significant reduction in smoking among Spanish workers and strongly support population-level measures against tobacco consumption.


Assuntos
Abandono do Hábito de Fumar/estatística & dados numéricos , Fumar/epidemiologia , Poluição por Fumaça de Tabaco/legislação & jurisprudência , Adulto , Estudos de Coortes , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Saúde Ocupacional , Prevalência , Fumar/legislação & jurisprudência , Espanha/epidemiologia , Poluição por Fumaça de Tabaco/prevenção & controle
6.
Rev. esp. salud pública ; 86(2): 177-188, mar.-abr. 2012. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-100246

RESUMO

Fundamentos: El objetivo del presente trabajo consistió en analizar el impacto sobre el consumo de tabaco en población trabajadora de la Ley 42/2010 que modifica la normativa antitabaco en España. Métodos: Se obtuvieron datos de 413.473 reconocimientos médicos de Salud Laboral, realizados entre julio de 2009 y junio de 2011, en la Sociedad de Prevención de una Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social. Se analizó la evolución semestral del porcentaje de fumadores y la magnitud del consumo de tabaco en el total de reconocimientos, segmentando por sexo, edad, nivel ocupacional (trabajos manuales vs. no manuales) y en el subgrupo específico de camareros, bármanes y asimilados (test de chi2). Resultados: En el total de reconocimientos, el porcentaje de fumadores descendió un 5% (del 40,3% al 35,3%) a lo largo del periodo de estudio (p<0,001) y el grupo de fumadores con menor consumo diario (≤10 cigarrillos) se convirtió en el más frecuente (p<0,001). En el grupo de camareros, bármanes y asimilados las diferencias en el porcentaje semestral de fumadores no alcanzaron significación estadística (p=0,07). En este grupo, los fumadores de ≤10 cigarrillos/día también se convirtieron en el grupo de consumo más frecuente (pasando del 40,5% al 48,8%) y el porcentaje de fumadores de 21-40 cigarrillos/día disminuyó del 10,6% al 4% (p=0,008). Conclusiones: Los resultados sugieren que la nueva normativa se ha acompañado de una importante reducción del tabaquismo entre la población trabajadora española y respaldan fuertemente las medidas de lucha contra el tabaco de alcance poblacional(AU)


Background: The aim of this study was to analyze the impact on tobacco consumption among working population of the Law 42/2010, which amends smoking regulations in Spain. Methods: Data were obtained from 413,473 Occupational Health check-ups, conducted between July of 2009 and June of 2011, in the Society for Prevention of a Mutual Insurance Company. We analyzed changes in the biannual percentage of smokers and the magnitude of tobacco consumption among smokers in the overall set of medical check-ups, by gender, age, occupational level (manual vs. non-manual workers), and in the specific occupational subgroup of waiters, barmen and similar workers (chi-square test). Results: In the overall set of medical check-ups, the percentage of smokers decreased by 5% (from 40.3% to 35.3%) over the period of study (p <0.001) and the group of smokers with lower daily consumption (≤ 10 cigarettes) became the most frequent (p <0.001). In the group of waiters, barmen and similar workers the differences in the biannual percentage of smokers did not reach statistical significance (p =0.07). In this group, smokers of ≤ 10 cigarretes/ day also became the most common consumption group (increasing from 40.5% to 48.8%) and the percentage of 21-40 cigarretes/day decreased from 10.6% to 4% (p =0.008). Conclusions: These results suggest that the new regulation has been accompanied by a significant reduction in smoking among Spanish workers and strongly support population-level measures against tobacco consumption(AU)


Assuntos
Humanos , Masculino , Feminino , Fumar/epidemiologia , Fumar/legislação & jurisprudência , Prevenção do Hábito de Fumar , Prevenção do Hábito de Fumar , Medicina Preventiva/métodos , Monitoramento Epidemiológico/normas , Monitoramento Epidemiológico , Vigilância Sanitária/normas , Abandono do Hábito de Fumar/economia , Abandono do Hábito de Fumar/legislação & jurisprudência , Abandono do Uso de Tabaco/economia , Saúde Pública/legislação & jurisprudência
7.
Clín. investig. arterioscler. (Ed. impr.) ; 23(2): 62-71, mar.-abr. 2011. tab
Artigo em Espanhol | IBECS | ID: ibc-96902

RESUMO

Introducción: Los triglicéridos se consideran un factor independiente de riesgo vascular. La influencia, por separado, de polimorfismos en genes como APOE, APOA5, LPL, LIPC y CETP sobre dichos niveles está descrita, por lo que resulta de interés su análisis conjunto y el estudio de interacciones con factores ambientales. Métodos: Se han genotipado en 1.825 sujetos (80% varones, edad media 36 años) procedentes del estudio ICARIA, el polimorfismo de APOE, 2 variantes de APOA5 (S19W y -1131 T/C), 5 deLPL (D9N, N291S, PvuII, HindIII y S447X), 1 de LIPC (-250G/A) y 1 de CETP (TaqI ) mediante PCR-restricción y ensayos TaqMan. El efecto conjunto de las variantes se ha analizado mediante regresión lineal con la variable triglicéridos transformada logarítmicamente y corrigiendo porcovariables. Las interacciones se han explorado mediante contrastes múltiples. Resultados: El alelo 4 de APOE, los polimorfismos de APOA5 S19W y -1131T/C y las variantes de LPL, D9N y N291S mostraron un efecto elevador de triglicéridos significativo e independiente. Los polimorfismos HindIII y S447X de LPL se asociaron significativamente con una reducción de los niveles de TG. Las variantes PvuII (LPL), -250G/A (LIPC) y TaqI (CETP) no mostraron asociaciones significativas. Se encontró una tendencia estadística (p=0,048) para la interacción entre obesidad abdominal (perímetro de cintura >102 cm en hombres; >88 cm en mujeres) y elalelo APOE- 4 (AU)


Introduction: Triglyceride levels are considered to be an independent vascular risk factor. The influence of polymorphisms in genes such as APOE, APOA5, LPL, LIPC and CETP on these levels has been separately described. The aim of the present study was to analyze the combined effects of these polymorphisms and their interaction with environmental factors. Methods: We genotyped the APOE polymorphism, two variants of APOA5 (S19W and -1131 T/C),five of LPL (D9N, N291S, PvuII, HindIII and S447X), one of LIPC (-250G/A) and one of CETP (TaqI )by polymerase chain reaction-restriction and TaqMan assays in 1825 subjects (80% male, meanage 36 years) from the ICARIA study. The combined effect of the variants was analyzed by linear regression with the log-transformed triglyceride variable and adjustment for covariates. The interactions were explored by multiple comparisons. Results: The 4 allele of APOE, the APOA5 polymorphisms S19W and -1131T/C and the LPL variants D9N and N291S independently and significantly increased triglyceride levels. The HindIII and S447X LPL polymorphisms were significantly associated with lower triglyceride levels. The PvuII (LPL), -250G/A (LIPC) and TaqI (CETP) variants showed no significant associations. There was a statistical trend (p = 0.048) for an interaction between abdominal obesity (waist circumference >102 cm in men and >88 cm in women) and the APOE- 4 allele. Conclusions: Our study shows the influence of the APOE- 4 allele, the S19W and -1131T/Cpolymorphisms of APOA5 and the LPL-D9N, N291S, HindIII and S447X variants on triglyceride levels and suggests that the effect of the 4 allele could by modulated by interaction with abdominal obesity (AU)


Assuntos
Humanos , Triglicerídeos , Obesidade Mórbida/genética , Variação Genética , Alelos , Genótipo
10.
Aten. prim. (Barc., Ed. impr.) ; 42(10): 498-505, oct. 2010. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-86430

RESUMO

ObjetivoEvaluar la efectividad de una estrategia de intervención preventiva sobre el estilo de vida, basada en entrevistas telefónicas.DiseñoEstudio de intervención cuasiexperimental.EmplazamientoServicio de Prevención de Ibermutuamur (Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social).Participantes4.792 trabajadores con nivel de riesgo cardiovascular (RCV) moderado/alto en el reconocimiento médico laboral (RML) que otorgaron su consentimiento. Se excluyeron los sujetos con antecedentes de enfermedad cardiovascular o que recibían tratamiento antihipertensivo, hipolipemiante o antidiabético.IntervenciónSe pudo contactar telefónicamente con 3.085 trabajadores, a los que se realizó seguimiento en los meses primero, cuarto y octavo tras el RML, enfatizando recomendaciones cardiosaludables. Al resto de trabajadores (n=1.707), solo se les realizó el RML inicial y final.Mediciones principalesEl RCV se estimó según el modelo SCORE europeo. Todos los sujetos recibieron un informe, una carta dirigida a su médico de atención primaria con los factores de RCV detectados, su nivel de riesgo y recomendaciones sobre modificación del estilo de vida(AU)


ResultadosEl 71,5% de los trabajadores eran mayores de 45 años, el 95,0% varones, el 76,6% trabajadores manuales y el 69,7% fumadores. Ambos grupos mostraron mejoría en los parámetros lipídicos, presión arterial, abandono del hábito tabáquico y RCV global en el segundo RML. El grupo A presentó una mayor mejoría en la presión arterial, lípidos (excepto colesterol-HDL), índice de masa corporal, glucemia, abandono del hábito tabáquico (23,5% vs 19,4%, p=0,001) y en el estrato de riesgo (46,6% vs 37,7%, p=0,0001). Un 52,9% de los trabajadores declaró haber llevado la carta informativa a su médico de Atención Primaria, que aconsejó modificar la dieta (47%), o añadir tratamiento antihipertensivo (19,5%), hipolipemiante (16,7%), antidiabético (4,4%) y antitabaco (2,9%).ConclusionesLa estrategia de intervención sobre el estilo de vida, basada en entrevistas telefónicas, en trabajadores de RCV moderado-alto, puede ser efectiva. El envío de información preventiva y la participación de Atención Primaria pueden contribuir, per se, a los cambios positivos observados(AU)


ObjectiveThis study assesses the effectiveness of a structured telephone survey on cardiovascular prevention, in modifying lifestyle, on cardiovascular risk parameters, percentage of smoking cessation and overall cardiovascular risk (CVR).DesignQuasi-experimental study of preventive intervention.SettingIbermutuamur (Spanish Accident and Health Insurance Company). Centres established throughout Spain.ParticipantsA total of 4,792 workers with moderate/high cardiovascular risk who had agreed to be contacted by phone. Subjects with a previous diagnosis of cardiovascular disease and those receiving treatment for hypertension, hypercholesterolemia or diabetes were excluded.InterventionA final total of 3,085 workers were contacted and were followed up by telephone surveys on the first, fourth and eighth month after the initial check up (CU) in order to emphasise cardiovascular health advice (Group A); we failed to contact 1,707 workers, who only attended the baseline and one year CUs (Group B).Principal outcomesCUs included medical records and physical examination, with two blood pressure measurements, Body Mass Index (BMI), and biochemical parameters.Principal outcomesCardiovascular risk was stratified following the European cardiovascular SCORE. Individuals with a relative risk higher than 4 were also considered as high-risk. All workers were informed about their cardiovascular risk profile (CVRF) and healthy cardiovascular lifestyle measures. They were also given a letter for their General Practitioner (GP) to inform them on the worker's cardiovascular risk level(AU)


ResultsA total of 71.5% of the workers were over 45 years, 95.0% males, 76.6% manual workers (“Blue Collar”) and 69.7% smokers. Both groups showed improvement in lipid parameters, blood pressure, smoking cessation and overall cardiovascular risk in the second CU. There were significant differences in favour of Group A as regards blood pressure, lipids (except HDL cholesterol), BMI, glycaemia, smoking cessation (A: 23.5%/B: 19.44%, P=0.001) and CVR stratum improvement (A: 46.6%/B: 37.7%, P=0.0001). The large majority (85%) of workers read preventive recommendations; 33% knew their risk level and 73% knew their CVRF. 52.9% gave the letter to the GP, which led them to start therapies on diet (47%), hypertension (19.5%), dyslipidaemia (16.7%), diabetes (4.4%) and smoking (2.9%) and no changes were made in 36.5% of cases.ConclusionsThe results of this study suggests that cardiovascular prevention strategy based on structured telephone surveys on high/moderate CVR subjects to promote lifestyle changes could be effective at reducing CVR. A clinical trial is required for confirmation. Sending information on CVRF following routine medial CUs and Primary Care involvement, could contribute to the positive changes observed(AU)


Assuntos
Humanos , Prevenção Primária/instrumentação , Prevenção Primária/métodos , Prevenção Primária/estatística & dados numéricos , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/patologia , Doenças Cardiovasculares/prevenção & controle , Estilo de Vida , Medicina Preventiva/instrumentação , Medicina Preventiva/estatística & dados numéricos , Medicina Preventiva/normas , Medicina do Trabalho/instrumentação , Medicina do Trabalho/estatística & dados numéricos , Medicina do Trabalho/normas
11.
Atherosclerosis ; 207(2): 573-8, 2009 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-19545869

RESUMO

AIM: To study the prevalence, risk factors, and vascular disease associated with moderate and severe hypertriglyceridemia in an active working population. DESIGN AND METHODS: Cross-sectional study of 594,701 workers from all Spanish geographical areas, occupation sectors, ages, and sexes who underwent a yearly routine checkup. Data collected from participants included age, sex, anthropometric measurements, vascular risk factors, lipidic profile and basic biochemical analysis, from a fasting blood sample. A cardiovascular risk assessment was performed. RESULTS: The study population included 428,334 males and 166,367 females, mean age 36+/-10 years. A total of 95,673 (16%) workers had mild hypertriglyceridemia (HTg) (Tg 150-399mg/dL), 7,081 (1.1%) had moderate HTg (400-999mg/dL), and 224 (0.03%) had severe HTg (>or=1000mg/dL). Of workers with hypertriglyceridemia, 90% were male. Age, obesity, type 1 and 2 diabetes, alcohol consumption, and vascular disease were associated with hypertriglyceridemia. Cardiovascular risk gradually increased for each HTg category. Amongst risk factors, the major independent predictor of mild-HTg was obesity (OR 2.42, CI 95% 2.37-2.48), whereas diabetes was a predictor of moderate HTg (OR 3.64, CI 95% 3.17-4.18) and severe HTg (OR 7.35, CI 95% 4.27-12.66). In multivariate analyses, HTg was gradually associated with vascular disease, even after adjusting for other risk factors. CONCLUSION: In this working population, preventive programs for HTg and associated vascular disease should consider obesity-diabetes control as its first objective.


Assuntos
Doenças Cardiovasculares/epidemiologia , Complicações do Diabetes/epidemiologia , Emprego , Hipertrigliceridemia/epidemiologia , Obesidade/epidemiologia , Saúde Ocupacional , Adulto , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/prevenção & controle , Estudos Transversais , Complicações do Diabetes/prevenção & controle , Feminino , Humanos , Hipertrigliceridemia/etiologia , Hipertrigliceridemia/prevenção & controle , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/terapia , Prevalência , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença , Espanha/epidemiologia
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