El abordaje de la depresión en el ámbito del trabajo: recomendaciones clave / Management of depression in the work setting: key recommendations

La depresión en el ámbito del trabajo representa una de las primeras causas de pérdida de productividad, absentismo laboral, incremento de accidentes laborales, utilización de los servicios de salud y jubilación anticipada. Los costes totales atribuibles a la depresión constituyen más del 1% del PIB, por lo que su correcto abordaje repercutirá no solo en el bienestar emocional de los trabajadores sino también en la productividad de las empresas y la sostenibilidad del Sistema Nacional de Salud. La depresión no solo es un problema estrictamente sanitario, sino que hay que enmarcarlo en un contexto mucho más amplio vinculado al bienestar social. El presente documento es el resultado de un proceso de consulta y reuniones entre un grupo multidisciplinar de expertos y ofrece una serie de recomendaciones sobre la definición, detección y opciones de tratamiento de la depresión, con especial interés en el ámbito del trabajo. Entre otras medidas, se propone promover programas que permitan concienciar y ayudar a los empleados y empleadores a reconocer y manejar la depresión en los lugares de trabajo, así como mejorar las políticas y la legislación que les protegen. Esta estrategia multidimensional y efectiva, basada en un acercamiento holístico al problema, debe situar la depresión como un problema clave en las empresas, cuyo abordaje debe ser un objetivo estratégico prioritario (AU)

Depression in the work setting is one of the leading causes of lost productivity, absenteeism, increased accidents, use of health services, and early retirement. As the total costs attributable to depression are more than 1% of GDP, the correct approach will impact not only on the emotional welfare of workers but also on business productivity and sustainability of the National Health System. Depression is not just a health problem, but should be framed it in a much broader context linked to social welfare. This document is the result of a process of consultation and meetings between a multidisciplinary group of experts, and offers a series of recommendations on the definition, detection and treatment options of depression, with special interest in the occupational setting. Among other measures, it intends to promote programs that should raise awareness and help employees and employers to recognise and manage depression in the workplace, and to improve policies and legislation that protect them. This multidimensional and effective strategy, based on a holistic approach to the problem, places depression as a key problem in companies, for which the approach should be a priority strategic objective (AU)

Estudio de polimorfismos genéticos que intervienen en el metabolismo de estatinas / Genetic polymorhisms involved ins tatins methabolism. descriptive study

Estudio transversal descriptivo de muestras de saliva obtenidas en 35 empleados caucásicos del sector servicios que acuden a su Servicio de Medicina del Trabajo. Se estudian 10 polimorfismos genéticos, a través de una DNA-chip, relacionados con el metabolismo de las distintas estatinas. Resultados: El 34,2% y 57,1% de la muestra se comportarán fenotípicamente como metabolizadores intermedios de los fármacos que utilizan las rutas metabólicas de los genes CYP2C19 y CYP2C8, respectivamente. El 54,2%, 69,7% y 31,4% se comportan como metabolizadores normales de los fármacos relacionados con los genes CYP2C9, CYP2D6 y MDR1, respectivamente. El conocimiento de las variables alélicas de genes que codifican enzimas que intervienen en el metabolismo de las estatinas puede facilitar la personalización del tratamiento de estos pacientes y evitar efectos adversos medicamentosos. Lo que justifica, desde nuestro punto de vista, la utilización de este tipo de información en el contexto de la Medicina del Trabajo individualizada (AU)

Transverse descriptive study of saliva's samples obtained in 35 caucasian employees in their Occupational Medicine Service. Ten genetic polymorphisms involved in statins metabolism were studied. Results: 34,2 % and 57,1 % were considered phenotipicaly as intermediate in the metabolic routes of CYP2C19 and CYP2C8, respectively. 54,2%, 69,7% y 31,4% were considered as normal in the metabolic routes of CYP2C9, CYP2D6 y MDR1, respectively. The knowledge of genetic allelic variables that codify enzymes involved in statins methabolism can facilitate the treatment and avoid adverse medicamental effects of these patients. In can be usefull in the individualized Occupational Medicine (AU)

Case-control study of semicircular lipoatrophy, a new occupational disease in office workers.

OBJECTIVES: Semicircular lipoatrophy (SL) is an emerging occupational pathology. Its etiology is poorly understood. We intend to establish the probable risk factors and estimate the relative risk. METHODS: A case-control study was performed. Our company had 55 diagnosed cases. As controls, we used the 3 closest healthy coworkers to each case. We calculated the chi square, odds ratio and logistic regression for different exposures, during the 3 years from September 2007 to August 2010. RESULTS: There was 100% participation for the cases and 70.9% for the controls (ratio 1 : 2.1 case-control). The only risk variables found were female gender (p<0.02) and exposure to leaning on the edge of a table (p<0.01). In addition, a breakdown by sex objectifies a much stronger association with leaning on the edge of a table in women (p<0.01) than men (p 0.67). CONCLUSIONS: Female gender and leaning on the edge of a table (repeated microtrauma), especially in women, are risk factors for development of SL. Other variables seem to be confounding factors associated with female gender. There were no SL cases showing statistically significant relations with history of cancer or autoimmune diseases. There was also no significance with regard to wearing jeans. There is therefore a new risk for office staff in addition to the more traditional disorders (musculoskeletal, ocular, and psychosocial). Further studies are necessary to evaluate what we consider an underdiagnosed condition, since there is a large percentage of people that are potentially exposed and we found very little information in the literature on the matter.

Grupo de Trabajo de Economía en Medicina del Trabajo / Task group of economics in ocupational medicine

La AEEMT propone determinadas iniciativas de carácter legislativo, organizativo y económico que pueden ayudar a la sostenibilidad del sistema español de seguridad social y público de salud, mediante la participación y potenciación de los servicios de medicina del trabajo en España (AU)

The AEEMT proposes a number of definite legislative, organizational and economic initiatives that might be of help for the supportability of the Spanish Social Security System and of the Spanish Public Health Care System, through the participation and enhancement of the Occupational Medicine Services in Spain (AU)