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      Waiting time from identification to recognition an occupational disease in Spain Translated title: Tiempo de espera desde la identificación hasta el reconocimiento de una enfermedad profesional en España

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          Abstract

          Abstract Objective: To estimate the waiting time since a suspected an occupational disease (OD) is identified, notified and recognized in Spain. Method: A series of 34 patients attended at Occupational Diseases Unit (ODU) of Hospital del Mar in Barcelona were follow up since their identification until final resolution by the National Institute of Social Security (INSS). Median, and 25 and 75 percentiles (interquartile range [IQR]) were calculated in weeks by total time (n=27), ODU time (n=34), patient time (n=31) and INSS time (n=27). Results: Total time was 51 weeks (IQR: 33.6 and 122.6), of which 42 weeks (17.6-99.5) corresponded to the waiting period at the INSS. Conclusions: The disproportionately long waiting time since INSS receives a case could impact on the under-recognition of OD. Urgent improvement of the administrative process is needed to reduce the patient waiting time for the recognition of OD.

          Translated abstract

          Resumen Objetivo: Estimar el tiempo de espera desde que se identifica hasta que se notifica y reconoce una enfermedad profesional (EP) en España. Método: Se siguió a una serie de 34 pacientes atendidos en la Unidad de Enfermedades Profesionales (UPL) del Hospital del Mar de Barcelona, desde su identificación hasta la resolución por parte del Instituto Nacional de la Seguridad Social (INSS). Se calcularon las medianas y los percentiles 25 y 75 (rango intercuartílico [RIC]) en semanas para el tiempo total (n=27), el tiempo UPL (n=34), el tiempo paciente (n=31) y el tiempo INSS (n=27). Resultados: El tiempo total fue de 51 semanas (RIC: 33,6-122,6), de las que 42 semanas (17,6-99,5) correspondieron al periodo de espera en el INSS. Conclusiones: La larga espera para la resolución del INSS podría impactar en el infrarreconocimiento de las EP. Es urgente mejorar el proceso administrativo para reducir el tiempo de espera de los pacientes para el reconocimiento de las EP.

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          Work-related musculoskeletal disorders: the epidemiologic evidence and the debate.

          The debate about work-relatedness of musculoskeletal disorders (MSDs) reflects both confusion about epidemiologic principles and gaps in the scientific literature. The physical ergonomic features of work frequently cited as risk factors for MSDs include rapid work pace and repetitive motion, forceful exertions, non-neutral body postures, and vibration. However, some still dispute the importance of these factors, especially relative to non-occupational causes. This paper addresses the controversy with reference to a major report recently commissioned by the US Congress from the National Research Council (NRC) and Institute of Medicine (IOM) (2001). The available epidemiologic evidence is substantial, but will benefit from more longitudinal data to better evaluate gaps in knowledge concerning latency of effect, natural history, prognosis, and potential for selection bias in the form of the healthy worker effect. While objective measures may be especially useful in establishing a more secure diagnosis, subjective measures better capture patient impact. Examination techniques still do not exist that can serve as a "gold standard" for many of the symptoms that are commonly reported in workplace studies. Finally, exposure assessment has too often been limited to crude indicators, such as job title. Worker self-report, investigator observation, and direct measurement each add to understanding but the lack of standardized exposure metrics limits ability to compare findings among studies. Despite these challenges, the epidemiologic literature on work-related MSDs-in combination with extensive laboratory evidence of pathomechanisms related to work stressors-is convincing to most. The NRC/IOM report concluded, and other reviewers internationally have concurred, that the etiologic importance of occupational ergonomic stressors for the occurrence of MSDs of the low back and upper extremities has been demonstrated.
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            Trends in incidence of occupational asthma, contact dermatitis, noise-induced hearing loss, carpal tunnel syndrome and upper limb musculoskeletal disorders in European countries from 2000 to 2012.

            The European Union (EU) strategy for health and safety at work underlines the need to reduce the incidence of occupational diseases (OD), but European statistics to evaluate this common goal are scarce. We aim to estimate and compare changes in incidence over time for occupational asthma, contact dermatitis, noise-induced hearing loss (NIHL), carpal tunnel syndrome (CTS) and upper limb musculoskeletal disorders across 10 European countries.
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              Reported occupational respiratory diseases in Catalonia.

              A voluntary surveillance system was implemented in Catalonia (Spain) to ascertain the feasibility, incidence, and characteristics of occupational respiratory diseases and compare them with those of the compulsory official system. In 2002, in collaboration with the Occupational and Thoracic Societies of Catalonia, occupational and chest physicians and other specialists were invited to report, on a bimonthly basis, newly diagnosed cases of occupational respiratory diseases. Information requested on each case included diagnosis, age, sex, place of residence, occupation, suspected agent, and physician's opinion on the likelihood that the condition was work related. Compulsory official system data derived from statistics on work related diseases for possible disability benefits declared by insurance companies, which are responsible for declaring these diseases to the Autonomous Government of Catalonia. Of 142 physicians seeing patients with occupational respiratory diseases approached, 102 (74%) participated. Three hundred and fifty nine cases were reported, of which asthma (48.5%), asbestos related diseases (14.5%), and acute inhalations (12.8%) were the most common. Physicians rated 63% of suspected cases as highly likely, 28% as likely, and 8% as low likelihood. The most frequent suspected agents reported for asthma were isocyanates (15.5%), persulphates (12.1%), and cleaning products (8.6%). Mesothelioma (5.9%) was the most frequent diagnosis among asbestos related diseases. The number of acute inhalations reported was high, with metal industries (26%), cleaning services (22%), and chemical industries (13%) being the most frequently involved. The frequency of occupational respiratory diseases recorded by this voluntary surveillance system was four times higher than that reported by the compulsory official system. The compulsory scheme for reporting occupational lung diseases is seriously underreporting in Catalonia. A surveillance programme based on voluntary reporting by physicians may provide better understanding of the incidence and characteristics of these diseases. Persulphates and cleaning products, besides isocyanates, were the most reported causes of occupational asthma. Metal industries and cleaning services were the occupations most frequently involved in acute inhalations with a remarkably high incidence in our register.
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                Author and article information

                Journal
                gs
                Gaceta Sanitaria
                Gac Sanit
                Sociedad Española de Salud Pública y Administración Sanitaria (SESPAS) (Barcelona, Barcelona, Spain )
                0213-9111
                June 2022
                : 36
                : 3
                : 257-259
                Affiliations
                [1] Barcelona Cataluña orgnameUniversitat Pompeu Fabra orgdiv1Department of Experimental and Health Sciences orgdiv2CiSAL-Centre of Research in Occupational Health Spain
                [3] orgnameCIBER of Epidemiology and Public Health (CIBERESP) Spain
                [2] Barcelona orgnameIMIM-Institute Hospital del Mar of Medical Research Spain
                [4] Barcelona orgnameParc de Salut Mar orgdiv1Occupational Health Service Spain
                Article
                S0213-91112022000300257 S0213-9111(22)03600300257
                10.1016/j.gaceta.2022.01.006
                4f24c80a-9492-4848-9862-e50a9d4dcd7c

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 18 January 2022
                : 03 January 2022
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 10, Pages: 3
                Product

                SciELO Spain

                Categories
                Brief Originals

                Servicio de prevención de riesgos laborales,Medicina del trabajo,Salud laboral,Seguridad social,Enfermedades profesionales,Occupational health service,Occupational medicine,Occupational health,Social security,Occupational diseases

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