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      Sickness presenteeism in Spanish-born and immigrant workers in Spain

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          Abstract

          Background

          Previous studies have shown that immigrant workers face relatively worse working and employment conditions, as well as lower rates of sickness absence than native-born workers. This study aims to assess rates of sickness presenteeism in a sample of Spanish-born and foreign-born workers according to different characteristics.

          Methods

          A cross-sectional survey was conducted amongst a convenience sample of workers (Spanish-born and foreign-born), living in four Spanish cities: Barcelona, Huelva, Madrid and Valencia (2008-2009). Sickness presenteeism information was collected through two items in the questionnaire ("Have you had health problems in the last year?" and "Have you ever had to miss work for any health problem?") and was defined as worker who had a health problem (answered yes, first item) and had not missed work (answered no, second item). For the analysis, the sample of 2,059 workers (1,617 foreign-born) who answered yes to health problems was included. After descriptives, logistic regressions were used to establish the association between origin country and sickness presenteeism (adjusted odds ratios aOR; 95% confidence interval 95%CI). Analyses were stratified per time spent in Spain among foreign-born workers.

          Results

          All of the results refer to the comparison between foreign-born and Spanish-born workers as a whole, and in some categories relating to personal and occupational conditions. Foreign-born workers were more likely to report sickness presenteeism compared with their Spanish-born counterparts, especially those living in Spain for under 2 years [Prevalence: 42% in Spanish-born and 56.3% in Foreign-born; aOR 1.77 95%CI 1.24-2.53]. In case of foreign-born workers (with time in Spain < 2 years), men [aOR 2.31 95%CI 1.40-3.80], those with university studies [aOR 3.01 95%CI 1.04-8.69], temporary contracts [aOR 2.26 95%CI 1.29-3.98] and salaries between 751-1,200€ per month [aOR 1.74 95% CI 1.04-2.92] were more likely to report sickness presenteeism. Also, recent immigrants with good self-perceived health and good mental health were more likely to report presenteeism than Spanish-born workers with the same good health indicators.

          Conclusions

          Immigrant workers report more sickness presenteeism than their Spanish-born counterparts. These results could be related to precarious work and employment conditions of immigrants. Immigrant workers should benefit from the same standards of social security, and of health and safety in the workplace that are enjoyed by Spanish workers.

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          Most cited references20

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          Self-rated health and mortality: a review of twenty-seven community studies.

          We examine the growing number of studies of survey respondents' global self-ratings of health as predictors of mortality in longitudinal studies of representative community samples. Twenty-seven studies in U.S. and international journals show impressively consistent findings. Global self-rated health is an independent predictor of mortality in nearly all of the studies, despite the inclusion of numerous specific health status indicators and other relevant covariates known to predict mortality. We summarize and review these studies, consider various interpretations which could account for the association, and suggest several approaches to the next stage of research in this field.
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            Immigrant populations, work and health--a systematic literature review.

            This paper summarizes the information on immigrant occupational health available from recent studies, incorporating varied study designs. A systematic search was carried out in PubMed employing terms of interest to the study and related terms supplied by the same search engine. Articles were selected through the following process: (i) reading the title and abstract, in English or Spanish, for the period 1990-2005, (ii) reading of the entire text of selected articles; (iii) making a manual search of the relevant citations in the selected articles; (iv) eliminating articles without a focus on the themes of central interest (immigration, work, and health), and (v) reading and analyzing the definitive article set. No quality criteria were used in the article selection. The location of studies was not straightforward and required careful thought about the search terms. The included 48 papers were often multifaceted and difficult to categorize. They generally came from countries historically associated with immigration and described occupational risk factors, health consequences, and the social, economic, and cultural influences on worker health. The authors of the studies highlighted the fact that the data were limited and that the [corrected] surveillance, training, and preventive measures used among these populations [corrected] were inadequate. Increased migration is a reality in industrialized countries all over the world, and it has social, political, and economic consequences for migrating groups, as well as for their sending and host societies. More reliable data, targeted appropriate interventions, and enforcement of existing regulations are necessary to improve the health of immigrant workers. Furthermore, studies in sending and developing countries should be encouraged to form a more complete understanding of this complex situation.
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              The validity of general health questionnaires, GHQ-12 and GHQ-28, in mental health studies of working people.

              The purpose of the study was to determine such cut-off points in the scores of General Health Questionnaires (GHQ-12 and GHQ-28) that allow for optimal identification of people with mental health disorders in the Polish working population attending primary health care settings. The groups under the study covered 419 and 392 patients for GHQ-12, and GHQ-28, respectively. In the GHQ-12 group, 90 and in the GHQ-28 group, 80 subjects filled in the questionnaires and agreed to participate in the second stage of the study--a psychiatric interview. The criterion validity of the GHQs was a mental health diagnosis, based on the Munich version of Composite International Diagnostic Interview. The complete computerized version of interview, covering all diagnostic sections, has been adopted. In the mental health diagnosis only disorders, which currently troubled patients were taken into consideration and disorders which created problems in the distant past were excluded. In the group covered by GHQ-12 examination, 55.6% of persons had at least one type of mental disorder diagnosed, based on the criteria of both Diagnostic and Statistical Manual for Mental Disorders (DSM-IV) and the International Classification of Diseases (ICD-10). In the GHQ-28 group, the percentage of persons with mental disorders was 47.5%. After excluding patients with nicotine dependence disorder only, the frequency of mental health problems decreased to 45.5% and 33.8%, respectively. The proposed cut-off points, 2/3 points for GHQ-12 and 5/6 points for GHQ-28, were established at the level of the highest possible sensitivity and specificity not lower than 75%. These principals have been accepted for a practical reason, as the acceptance of the lower level of specificity forces medical practitioners to devote too much time to practically healthy people. At the above mentioned cut-off points for GHQ-12 sensitivity is 64% and specificity--79%, while for GHQ-28 the values are 59% and 75%, respectively. These validity coefficients were calculated from distributions of groups, from which persons with nicotine dependence as the only disorder were excluded. Incorporation of these people in the whole sample reduced the questionnaires' validity. Modification of responses scoring from the standard one--GHQ to CGHQ has not improved the validity of questionnaires. Lower validity coefficients of GHQ-28, in comparison to GHQ-12 validity are the effect of greater influence of somatic disease on the results acquired in this scale version of the questionnaire.
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                Author and article information

                Journal
                BMC Public Health
                BMC Public Health
                BioMed Central
                1471-2458
                2010
                29 December 2010
                : 10
                : 791
                Affiliations
                [1 ]Centre for Research in Occupational Health, Universitat Pompeu Fabra, Barcelona, Spain
                [2 ]Preventive Medicine and Public Health Area, University of Alicante, Alicante, Spain
                [3 ]Faculty of Dentistry, University of Antioquia, Medellin, Colombia
                [4 ]CIBER Epidemiology and Public Health, Spain
                [5 ]Department of Preventive Medicine and Public Health, University of Valencia, Valencia, Spain
                [6 ]Trade Union Institute for Work, Environment and Health (ISTAS), Spain
                Article
                1471-2458-10-791
                10.1186/1471-2458-10-791
                3022860
                21190564
                2214c85b-3a35-4bfe-9016-ca7bfc7ab8aa
                Copyright ©2010 Agudelo-Suárez et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<url>http://creativecommons.org/licenses/by/2.0</url>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 30 July 2010
                : 29 December 2010
                Categories
                Research Article

                Public health
                Public health

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