[Socioeconomic inequality and health in Mexico]. / Desigualdad socioeconómica y salud en México.

OBJECTIVE: To establish the relationship between socioeconomic inequality and health problems amongst Mexican population reviewing studies with national or regional representation. METHODS: A literature search was performed at national and international databases using the following keywords: health, disease, mental disorders, nutrition, food, social class, social status, unemployment, employment, occupation, income, wage, poverty and socioeconomic status. Reports of national or regional surveys conducted from the nineties were included. RESULTS: Mostly, diseases events were more common among people from low socioeconomic status: anencephaly, viral infections, anemia, transit accidents by run over, metabolic syndrome, hypertension, affective disorder, anxiety and substances abuse; some malignancies, difficulties to perform activities of daily living, and poor perceived health status. On the opposite, as it goes down in the social scale, are less frequent some protective factors (e.g. fruits or vegetables intake and physical activity) and there is less access to medical aid and preventive interventions (e.g. condom use or diagnosis and treatment for HIV infection, hypertension or obesity). CONCLUSIONS: Socioeconomic status affects all living conditions; therefore, its effects are not confined to certain diseases, but a general precarious state of health. The conceptual and public policy implications related with social inequalities in health are discussed.

Objetivo: establecer la relación entre la desigualdad socioeconómica y los problemas de salud en la población mexicana a partir de la revisión de estudios con representatividad nacional o regional. Métodos: la revisión bibliohemerográfica se realizó consultando bases de datos nacionales e internacionales, mediante el uso de las siguientes palabras clave: salud, enfermedad, trastornos mentales, nutrición, alimentación, clase social, estrato social, desempleo, empleo, ocupación, ingreso, salario, pobreza, nivel socioeconómico y estatus socioeconómico. Se incluyeron los reportes de encuestas nacionales y regionales realizados a partir de la década de los noventa. Resultados: la mayoría de los eventos de enfermedad fueron más comunes entre las personas de baja posición socioeconómica. Asimismo, conforme se desciende de la escala social, son menos frecuentes los factores protectores y es menor el acceso a la atención médica y a las medidas preventivas. Conclusiones: la posición socioeconómica afecta la totalidad de las condiciones de vida de las personas, por lo que sus efectos no se reducen únicamente a ciertas enfermedades, sino que condiciona un estado de salud precario. Las implicaciones conceptuales y en política pública de las desigualdades en salud son ampliamente discutidas.

[Risk Society and inequalities in the health of workers]. / La sociedad del riesgo y las inequidades en la salud de los trabajadores.

This is a reflection on the current health situation of workers, as well as a reflection on the characteristics of their care system in the context of a globalized world. In order to present this reflection, the first part is focused on the discussion of the main concepts of globalization and risk society. On the second part, and according to the conceptual framework established on the first part, a statistical perspective of workers' health around the world is suggested, emphasizing on the existing inequity between thought-to-be developed world and the developing or poor countries. On the next part, a discussion related to health insurance systems and their incompetence to tackle efficiently workers' health outcomes is established. On the final part, a reflection on the need to reframe the approach and action strategies for improving health status of workers and their families is suggested; this part of the reflection is focused on the recovery of "good life" and human sense of life.

La sociedad del riesgo y las inequidades en la salud de los trabajadores / Risk Society and inequalities in the health of workers

Reflexión sobre la situación de salud de los trabajadores, así como de las características que adquiere su cuidado dentro del contexto de un mundo globalizado. Para analizar este tema, se inicia con una discusión de los principales conceptos de globalización y sociedad del riesgo. En un segundo momento y bajo la perspectiva conceptual definida, se presenta un panorama estadístico de la salud de los trabajadores a nivel mundial, enfatizando la inequidad existente entre el mundo considerado desarrollado y el de los países pobres o en desarrollo. Posteriormente se discute acerca de los sistemas de salud y su incapacidad de dar respuesta eficiente a los problemas de salud de los trabajadores. Finalmente, se reflexiona en torno a la necesidad de replantear las estrategias de abordaje y de acción para contribuir a mejorar el estado de salud de los trabajadores y sus familias, poniendo en el centro el rescate de la "vida buena" y lo humano.

This is a reflection on the current health situation of workers, as well as a reflection on the characteristics of their care system in the context of a globalized world. In order to present this reflection, the first part is focused on the discussion of the main concepts of globalization and risk society. On the second part, and according to the conceptual framework established on the first part, a statistical perspective of workers' health around the world is suggested, emphasizing on the existing inequity between thought-to-be developed world and the developing or poor countries. On the next part, a discussion related to health insurance systems and their incompetence to tackle efficiently workers' health outcomes is established. On the final part, a reflection on the need to reframe the approach and action strategies for improving health status of workers and their families is suggested; this part of the reflection is focused on the recovery of "good life" and human sense of life.

[Harassment experiences among students of health-related professional careers in Mexico]. / Experiencias de acoso en estudiantes del área de la salud de la ciudad de México.

OBJECTIVE: This study focuses on the frequency with which students of health-related professional careers have perceived themselves as victims of sexual harassment, how this has occurred, and the characteristics of those students associated with that experience. METHODS: Cross-sectional descriptive study, with a sample of 530 students from health-related schools at the Universidad Autónoma Metropolitana Xochimilco in Mexico City. Statistical analysis was stratified by sex, age, race, perception of physical attractiveness, transgression of gender stereotypes, and sexual orientation. Experiences of sexual harassment were assessed based on a scale of 19 questions. Five components were identified by factor analysis: verbal and/or physical harassment by inadequate staring/glancing, inadequate proposals, and comments. RESULTS: In general, women were more harassed by inadequate staring/glancing; those who perceived themselves as being more physically attractive were more verbally harassed, whereas those who transgressed gender stereotypes were more exposed to physical harassment and harrassing glances as compared to men who were seen themselves as being less attractive and who did not transgressed the gender stereotype. CONCLUSIONS: Sexual harassment is an existing situation occurring among students. It is necessary to detect and recognize the forms of presentation of gender inequalities to avoid imposing sanctions on conducts that are not adhered to gender stereotypes.

El seguro popular de salud en México: pieza clave de la inequidad en salud / Popular health insurance: key piece of inequity in health in Mexico

El objetivo central de este trabajo es presentar un análisis de la situación actual del Sistema Nacional de Salud mexicano, resultado de las sucesivas reformas realizadas desde la década de los ochenta. Interesa de manera especial, enfatizar el papel que ha jugado el Seguro Popular de Salud (SPS) como pieza clave de la mercantilización de la atención médica. Para tal efecto, en la primera parte se presentan los principales antecedentes de los cambios realizados durante las dos últimas décadas del siglo pasado, y en la segunda se analiza la situación actual a partir del inicio del nuevo milenio. El análisis se centra en una evaluación inicial de los alcances y limitaciones del Seguro Popular de Salud bajo la perspectiva de la equidad del acceso a la atención médica. El análisis concluye que debido a que no hay una perspectiva médica en las reformas estructurales, este seguro representa un programa discrecional, presidencial y focalizado que resta fondos a las instituciones grandes de la seguridad social, obligándolas, en muchos casos, a realizar adecuaciones presupuestarias en detrimento de la calidad de la atención. Esta situación constituye, en el futuro inmediato, una segmentación del Sistema Nacional de Salud que determinará nuevas condiciones diferenciales del acceso de la población a los servicios médicos, aumentará la inequidad en salud y contribuirá a incrementar la gran desigualdad social prevaleciente en México.

This work is aimed at presenting an analysis of the Mexican health system’s current situation resulting from successive reforms which have been carried out since the 1980s. Special interest is placed on the role which the Seguro Popular de Salud (SPS - a "popular", meaning universal, health insurance plan) has played, being a key piece in commercialising medical attention. The first part of this work thus presents the main antecedents for the changes made during the last two decades of the last century and analyses the current situation since the start of the new millennium. Such analysis is centred on an initial evaluation of the Seguro Popular de Salud’s scope and limitations from the perspective of equity in gaining access to medical attention. The analysis concludes that due to a medical perspective not having been present in the structural reforms, then this insurance policy represents a discretional, presidential and focalised programme taking funds away from the large social security institutions, obligating them (in many cases) to make budgetary adaptations to the detriment of providing quality attention. This situation will constitute (in the immediate future) a segmentation of the National Health System which will determine new conditions regarding the population’s differential access to medical services, increase inequity in health and contribute towards increasing the great social inequality prevailing in México.

Diferencias entre sexos respecto a la elección de carrera en estudiantes de odontología de una universidad pública / Differences between genders regarding a career choice in dental students from a public university

Objetivo: en este trabajo se investigan las diferencias entre varones y mujeres estudiantes de la licenciatura en odontología respecto a los motivos que los llevaron a elegir su carrera. Se parte de la premisa de que dicha elección está influida por los roles de género y las características socioeconómicas de los futuros odontólogos. Material y métodos: Para analizar estas diferencias se diseñó y aplicó un cuestionario a alumnos de primer ingreso de la licenciatura en odontología de la Universidad Autónoma Metropolitana Unidad Xochimilco (UAM-X) (n = 206). A través del cuestionario se indagaron las siguientes variables: motivos de elección de la carrera, rasgos de estereotipos de género, distribución familiar del trabajo doméstico e información sobre la posición socioeconómica de la familia. Resultados: En comparación con los varones más mujeres reportaron haber elegido su carrera por considerarla compatible con su sexo (p = 0.069) y compatible con las labores del hogar (p = 0.001). Además, más mujeres reportaron que en sus hogares realizaban labores domésticas. Conclusión: Los resultados del estudio muestran que una proporción importante de mujeres que cursan la carrera de estomatología al elegir su carrera buscan compatibilizar el rol de género con el desarrollo profesional.

[Popular Health Insurance: key piece of inequity in health in Mexico]. / El Seguro Popular de Salud en México: Pieza Clave de la Inequidad en Salud.

This work is aimed at presenting an analysis of the Mexican health systems current situation resulting from successive reforms which have been carried out since the 1980s. Special interest is placed on the role which the Seguro Popular de Salud (SPS--a 'popular', meaning universal, health insurance plan) has played, being a key piece in commercializing medical attention. The first part of this work thus presents the main antecedents for the changes made during the last two decades of the last century and analyses the current situation since the start of the new millennium. Such analysis is centred on an initial evaluation of the Seguro Popular de Saluds scope and limitations from the perspective of equity in gaining access to medical attention. The analysis concludes that due to a medical perspective not having been present in the structural reforms, then this insurance policy represents a discretional, presidential and focalised programme taking funds away from the large social security institutions, obligating them (in many cases) to make budgetary adaptations to the detriment of providing quality attention. This situation will constitute (in the immediate future) a segmentation of the National Health System which will determine new conditions regarding the populations differential access to medical services, increase inequity in health and contribute towards increasing the great social inequality prevailing in México.

Motivos de elección de carrera en mujeres estudiantes de profesiones de la salud / Health sciences careers choice reasons of women students

Objetivo: Analizar los motivos por los que mujeres estudiantes del área de la salud elijen sus carreras. Material y método: La recolección de información se realizó a través de encuestas de autorespuesta para estudiantes de nuevo ingreso en el año del 2004 de las carreras de medicina, enfermería, odontología y nutrición de la Universidad Autónoma Metropolitana - Xochimilco, México. Solamente se consideraron a las alumnas cuya primera opción fueron las carreras antes señaladas. En total se aplicaron 437 encuestas. La variable independiente fue la internalización de estereotipos de género evaluada mediante el Inventario de Masculinidad y Feminidad. La variable dependiente fueron los motivos por los cuales las estudiantes habían elegido su carrera. Resultados: Las mujeres de medicina tuvieron más rasgos masculinos que las de enfermería y odontología; mientras que las últimas tuvieron más características relacionadas con la sumisión. Las médicas con más frecuencia reportaron haber elegido su carrera por tener cualidades relacionadas con la masculinidad como la toma de decisiones o el prestigio social. Las nutriólogas con más frecuencia señalaron que eligieron su carrera pues les permitía aprender a mantenerse saludables. Las odontólogas indicaron que habían elegido su profesión debido a que les permite cuidar a sus hijos. Conclusiones: La influencia de las normas de género en la trayectoria académica de las mujeres se ve reflejada en las características de las mujeres que estudian cada profesión y en sus motivos de elección de carrera (AU)

Objective: To analyze the reasons by which student women of the health area choice their careers. Material and method:. The harvesting of the information was made through surveys of autoresponse for entrance students in 2004 of the medicine, nursing, odontology and dietetics careers of the Universidad Autónoma Metropolitana - Xochimilco, Mexico. Only were considered the students whose first option was these careers. Altogether 437 surveys were applied. The independent variable was the internalization of gender stereotypes evaluated by means of the Inventory of Masculinidad and Feminidad. The dependent variable was the reasons by which the students had chosen their career. Results: The women from medicine had more masculine characteristics than those of nursing and odontology; whereas the last ones had more characteristics related to the submission. The medical ones reported, with more frequency, to have chosen their career because it has qualities related to the masculinity as the decision making or social prestige. The dietitians with more frequency indicated that they chose their careers because it allowed them to learn to stay healthful. The odontology women indicated that they had chosen their profession because allowed themto take care of its children. Conclusions: The influence of the gender norms in the academic trajectory of the women is reflected in the characteristics of the women that study each profession and in their motives of career selection (AU)

La intersección entre el género y el estrato socioeconómico en la elección de profesión del área de la salud / Intersection between gender and socioeconomic status in medical sciences career choice

Objetivo. Analizar la relación de la identidad de género y del nivel socioeconómico con la elección de una carrera en estudiantes de licenciaturas relacionadas con la salud. Material y métodos. Se seleccionó un grupo de 637 estudiantes (n = 637) de recién ingreso de las licenciaturas de medicina, nutrición, odontología y enfermería de una universidad pública de la ciudad de México. La información se recabó mediante un cuestionario de autorrespuesta. La variable dependiente fue la carrera elegida por los estudiantes. Las variables independientes fueron el nivel socioeconómico, las normas de género que existían en los hogares de los estudiantes y la internalización de los estereotipos de género. Resultados. En las mujeres, más estudiantes de enfermería pertenecían al estrato socioeconómico bajo, mientras que las de medicina se ubicaban en el nivel alto. En los varones, más estudiantes de enfermería se ubicaban en el estrato alto, seguidos por los de medicina. Las y los estudiantes de nutrición y odontología se ubicaron en el estrato medio. Respecto a la relación entre condición socioeconómica y distribución del trabajo doméstico, en comparación con los varones del estrato alto, más varones del nivel bajo reportaron que en sus hogares los varones se encargaban de preparar y servir la comida; en el caso de las mujeres, conforme aumentaba el nivel socioeconómico se incrementaba la participación de hombres y mujeres en el arreglo de camas y en ir al mercado. En los indicadores de internalización de los estereotipos de género, en los hombres no se identificó algún patrón; en las mujeres, las de enfermería tuvieron las puntuaciones más altas en la escala de sumisión, y las más bajas en masculinidad y machismo; en ellas también se observó que conforme aumentaba el nivel socioeconómico aumentaban los rasgos de masculinidad y machismo. Conclusiones. En los estratos bajos existe mayor rigidez en los estereotipos de género lo que hace que las mujeres de esos estratos busquen estudiar carreras consideradas femeninas. En el caso de los hombres, no se observó una relación clara entre la carrera elegida, el nivel socioeconómico y la internalización de los estereotipos de género.

OBJECTIVE: Analyze the relationship between gender identity and socioeconomic level associated with career choice among undergraduate students selecting the area of health sciences. MATERIAL AND METHODS: Our sample was comprised of first year medical nutrition, dentistry and nursing students (n=637) admitted to the Universidad Autonoma Metropolitana - Xochimilco. A self administered questionnaire was used. The dependent variable was career choice. Independent variables included socioeconomic status, gender norms in student's homes, and gender stereotype internalization. RESULTS: More female nursing students came from low socioeconomic strata, while medical students had a higher socioeconomic status. Among males, more nursing and medical students belonged to a higher socioeconomicstrata. Nutrition and dentistry students belonged to a medium strata. In comparison with males from high socioeconomic strata more male participants reported that household chores were divided among men and women. For women, as the socioeconomic level increased, the participation of men and women also increased. In the indicators of internalization of gender stereotypes, nursing students had the highest rates in the submission scale, but the lowest for masculinity and machismo. As the socioeconomic strata increased, the characteristics of masculinity and machismo also increased. CONCLUSIONS: The present results seem to indicate that among women of low socioeconomic strata more traditional gender stereotypes prevail which lead them to seek career choices considered femenine. Among men, there is a clear relationship between career choice, socioeconomic level and internalization of gender stereotypes.

[Adjustment of the Andersen's model to the Mexican context: access to prenatal care]. / Adaptación del modelo de Andersen al contexto mexicano: acceso a la atención prenatal.

UNLABELLED: The aim of this work was to propose an adjustment to the Model of Andersen who answers better to the social inequality of the population in the Mexico City and allows to evaluate the effect of socioeconomic factors in the access to the prenatal care of a sample stratified according to degree of marginalization. MATERIAL AND METHODS: The data come from a study of 663 women, randomly selected from a framework sample of 21,421 homes in Mexico City. This work collects information about factors that affect utilization of health services, as well as predisposing factors (age and socioeconomic level), as enabling factors (education, social support, entitlement, pay out of pocket and opinion of health services), and need factors. The sample was ranked according to exclusion variables into three stratums. The data were analyzed through the technique of path analysis. RESULTS: The results indicate that socioeconomic level takes part like predisposed variable for utilization of prenatal care services into three stratums. Otherwise, education and social support were the most important enabling variables for utilization of prenatal care services in the same three groups. In regard to low stratum, the most important enabling variables were education and entitlement. For high stratum the principal enabling variables were pay out of pocket and social support. The medium stratum shows atypical behavior which it was difficult to explain and understand. There was not mediating role with need variable in three models. This indicated absence of equality in all stratums. However, the most correlations in high stratum perhaps indicate less inequitable conditions regarding other stratums.

Adaptación del modelo de Andersen al contexto mexicano: acceso a la atención prenatal / Adjustment of the Andersen's model to the Mexican context: access to prenatal care

OBJETIVO: Proponer una adaptación al modelo de Andersen que responda mejor a la desigualdad social de la población en la Ciudad de México y permita evaluar el efecto de factores socioeconómicos en el acceso a la atención prenatal de una muestra estratificada según grado de marginación. MATERIAL Y MÉTODOS: En la Ciudad de México, el marco muestral estuvo conformado por 21 421 hogares y la muestra probabilística quedó constituida por 663 casos. En la encuesta se obtuvo información de factores predisponentes al uso de servicios (edad y estrato socioeconómico), factores mediadores (escolaridad, apoyo social, seguridad social, pago de bolsillo y calidad de los servicios de salud) y de necesidad percibida. La muestra se distribuyó en tres estratos, de acuerdo con un índice de marginalidad. Para analizar la información se recurrió al análisis multivariado de senderos (path analysis). RESULTADOS: El modelo mostró ser eficiente para evaluar el efecto de la desigualdad social en el acceso a la atención prenatal pues en los tres estratos se observó que el nivel socioeconómico interviene como predisponente de la utilización de servicios de atención prenatal. De igual forma, la escolaridad y el apoyo social fueron las variables mediadoras más importantes para el uso de servicios de salud de control prenatal en los tres estratos. En relación con el estrato bajo, las variables mediadoras más importantes fueron escolaridad y seguridad social. El estrato medio mostró un comportamiento atípico difícil de caracterizar, y en el estrato alto las principales variables fueron pago de bolsillo y apoyo social.

The aim of this work was to propose an adjustment to the Model of Andersen who answers better to the social inequality of the population in the Mexico City and allows to evaluate the effect of socioeconomic factors in the access to the prenatal care of a sample stratified according to degree of marginalization. MATERIAL AND METHODS: The data come from a study of 663 women, randomly selected from a framework sample of 21 421 homes in Mexico City. This work collects information about factors that affect utilization of health services, as well as predisposing factors (age and socioeconomic level), as enabling factors (education, social support, entitlement, pay out of pocket and opinion of health services), and need factors. The sample was ranked according to exclusion variables into three stratums. The data were analyzed through the technique of path analysis. RESULTS: The results indicate that socioeconomic level takes part like predisposed variable for utilization of prenatal care services into three stratums. Otherwise, education and social support were the most important enabling variables for utilization of prenatal care services in the same three groups. In regard to low stratum, the most important enabling variables were education and entitlement. For high stratum the principal enabling variables were pay out of pocket and social support. The medium stratum shows atypical behavior which it was difficult to explain and understand. There was not mediating role with need variable in three models. This indicated absence of equality in all stratums. However, the most correlations in high stratum perhaps indicate less inequitable conditions regarding other stratums.

Computer use increases the risk of musculoskeletal disorders among newspaper office workers.

BACKGROUND: Our objectives were to estimate prevalence of musculoskeletal disorders among office workers at a newspaper in Mexico City, analyze the relationship between musculoskeletal disorders and use of the personal computer (PC) and associated ergonomic factors in the aforementioned population, and to analyze the modifying effect that psychosocial factors have on the relationship between ergonomic factors and musculoskeletal disorders and extant jobs at the newspaper. METHODS: A total of 73% (218 of 298) of office workers at a newspaper were studied. Information was collected by a questionnaire completed by participants. Cases for work-related musculoskeletal disorder in hands (WMSD-H), upper extremity (WMSD-UE), and back (WMSD-B) were established. Working conditions, computer use, and ergonomic and psychosocial factors were studied as independent variables. To study the relationship between musculoskeletal disorders and independent variables, prevalence ratios adjusted for potential confounders (sex, age, educational level, and marital status) were estimated. RESULTS: Risk of musculoskeletal disorders was greater among workers at the newspaper who used computers, those involved in editing work, and those who adopted uncomfortable positions. The modifying effect of psychosocial factors was observed only in the relationship between ergonomic factors and WMSD-B because among workers with control over work, WMSD-B risk was reduced by the greater number of work breaks. Among workers without social support, increase in number of postures and rotation/inclination of the neck was associated with substantial risk increase, while amid workers under psychological demand number of PC tasks and number of rest pauses were associated with increase in WMSD-B risk. CONCLUSIONS: The findings of our study showed that PC use increased risk of developing musculoskeletal disorders (WMSD-H and WMSD-UE). Such an increase is mediated by ergonomic factors such as mouse use, remaining seated for prolonged periods, adoption of inadequate or uncomfortable postures, performing certain PC tasks, and psychosocial factors.

[Risks and health problems caused by the use of video terminals]. / Riesgos y daños a la salud derivados del uso de videoterminal.

OBJECTIVE: To evaluate the association between video display terminal (VDT) use and health hazards, occupational risks, and psychosocial factors, in newspaper workers. MATERIALS AND METHODS: A cross-sectional study was conducted in 1998 in a representative sample (n = 68) drawn from a population of 218 VDT operators in Mexico City. Data were collected using a self-administered questionnaire. Data were confirmed by performing physical examinations. The research hypothesis was that both the current and cumulative use of VDT are associated with visual, musculoskeletal system, and skin illnesses, as well as with fatigue and mental or psychosomatic disorders. Occupational health hazards were assessed (visual problems, postural risks, sedentary work, computer mouse use, excessive heat, and overcrowding), as well as psychosocial factors related to work organization (psychological demands, work control, and social support). Prevalence ratios were adjusted for confounding variables like age, sex and schooling. RESULTS: Women were more likely than men to have upper extremity musculoskeletal disorders (MSD), dermatitis, and seborrheic eczema. VDT use was associated with neuro-visual fatigue, upper extremity MSD, dermatitis, and seborrheic eczema. Computer mouse use and postural risks were significantly associated with health problems. Psychosocial factors were mainly associated with mental problems, psychosomatic disorders, and fatigue. CONCLUSIONS: Intense use of video screens has been found to cause musculoskeletal disorders of the hand. The diversification of tasks and control of labor processes itself had a protective effect against psychosomatic disorders and pathological fatigue.

Riesgos y daños a la salud derivados del uso de videoterminal / Health hazards associated with the use of video display terminals

OBJETIVO: Evaluar la relación de daños a la salud con el uso de videoterminal, riesgos laborales y factores psicosociales en trabajadores de un diario informativo. MATERIAL Y MÉTODOS: En 1998 se estudió una muestra representativa (n=68) de una población de 218 trabajadores de un diario informativo de la Ciudad de México. Se presentan los resultados obtenidos a partir de una encuesta de autoaplicación, los cuales fueron comparados posteriormente con datos de exámenes clínicos. La hipótesis de esta investigación sustenta que, tanto el uso actual como la exposición acumulada de videoterminal, se asocian con mayor riesgo de presentar padecimientos visuales, músculo-esqueléticos y dermatológicos; trastornos mentales y psicosomáticos, y fatiga general. Los resultados fueron analizados en función de diferentes riesgos laborales: (riesgo visual, trabajo sedentario, uso de mouse, riesgo postural, calor excesivo y hacinamiento) y factores psicosociales derivados de la organización del trabajo (demandas psicológicas, control sobre el trabajo y apoyo social). Para valorar su relación con los daños derivados del uso de videoterminal, se estimaron razones de prevalencias ajustadas por confusores potenciales (edad, sexo y escolaridad). RESULTADOS: Las mujeres presentaron prevalencias más elevadas de trastornos músculo-esqueléticos en la mayoría de los daños investigados, y las diferencias fueron significativas entre ambos sexos para dermatitis y eczema seborreico. El uso de videoterminal se asoció con mayor riesgo de fatiga neurovisual, trastornos músculo-esqueléticos en manos y extremidades superiores, dermatitis y eczema seborreico. De los riesgos laborales, los más asociados con trastornos fueron el uso de mouse y el riesgo postural. Los factores psicosociales se relacionaron principalmente con los padecimientos de naturaleza psicológica (trastornos mentales, psicosomáticos y fatiga general). CONCLUSIONES: Con el uso intensivo de videoterminal los padecimientos investigados son frecuentes, en especial, los trastornos músculo-esqueléticos en manos. Además, el enriquecimiento de las tareas y el propio control del proceso laboral tuvieron efecto protector contra los trastornos psicosomáticos y la fatiga patológica