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Diabetes mellitus presents high prevalence, severe complications, clinical repercussions, costs and occupational implications. Their assessment requires the use of the medical history and support questionnaires. A literature review was conducted on the topic of clinical and occupational evaluation aspects of diabetes; the database searched was Medline. The search showed numerous papers about diabetes clinical and therapeutic aspects as well as social or public health aspects but the results lacked occupational aspects. To assess the disease, the use of questionnaires is generalized and each author selects those which fit best to their purpose. It is concluded that to carry out a clinical and occupational evaluation related to diabetes, an inter-specialities cooperation, based on a complete medical history including occupational risk factors, is recommended. The questionnaires are useful, adapted to the objective, recommending those valued in Spanish as in Fear of hypoglycemia questionnaire (EsHFS) and Diabetes-related quality of life questionnaire (EsDQOL).

Resumen La diabetes mellitus presenta elevada prevalencia, complicaciones severas, repercusion clinica, costes e implicaciones laborales. Su valoracion requiere el uso de la historia clinica y cuestionarios de apoyo. Se revisa en Medline la bibliografia sobre diabetes y la experiencia de los autores en valoracion clinico-laboral, con resultados que muestran cuantiosas publicaciones en aspectos clinicos y terapeuticos relacionados con diabetes o con aspectos sociales y de salud publica, pero reducida en aspectos laborales. El uso de cuestionarios para valoracion de la enfermedad es generalizado y cada autor debe seleccionar el que mejor se adapte a sus objetivos o experiencia. Se concluye que, para la valoracion clinica y laboral en diabetes se recomienda la colaboracion interespecialidades, partiendo de una historia clinica completa que incluya los riesgos del trabajo. Son de ayuda los cuestionarios, adaptados a objetivo, recomendandose los validados en espanol como Encuesta sobre el miedo a la hipoglucemia (EsHFS) y Calidad de vida relacionada con la diabetes (EsDQOL).

Resumen Introduccion El dolor lumbar es una dolencia prevalente con repercusion sanitaria, social y laboral. Es objetivo de este trabajo valorar la influencia de las variables sociolaborales en pacientes con lumbalgia que trabajan. Metodo Estudio descriptivo en 349 sujetos con lumbalgia. Es variable independiente principal ser trabajador manual y no manual; tambien son recogidas otras variables sociolaborales y de estilo de vida. La incapacidad se obtuvo mediante la escala del cuestionario de Oswestry y la asociacion entre el tipo de tarea y el test se evaluo con regresion lineal multiple. Resultados Los trabajadores manuales consumen mas tabaco (47%), tienen mas dolor (74,3%), peor situacion economica (89,3%), consumen mas farmacos (57,7%), tienen limitacion en deambulacion (17,5%) y bipedestacion (25,6%), se les aplican protocolos de cargas (85,5%) y movimientos repetidos (77,4%), realizan movimientos de tronco (52,6%) y miembros superiores (24,8%) y reciben menor formacion preventiva (51,7%), pero utilizan proteccion lumbar (19,6%). Los trabajadores no manuales tienen mayor limitacion en cargas (37,4%) y sedestacion (43,5%) se les aplican protocolos de usuarios de pantallas (94,8%) y tienen peor tipificacion en clase social (57,1 clase media-baja). Realizar tareas manuales en el trabajo se asocia significativamente con un aumento de 2 puntos en el test de Oswestry respecto a los no manuales, ajustado por edad y genero (coeficiente β: 2, IC 95%: 0,65-3,36). Conclusion La lumbalgia es una dolencia prevalente, de curso desfavorable, que implica impacto individual, social y laboral. Realizar tareas manuales se asocia con un aumento en la escala de incapacidad, independientemente de la edad y el genero.

Resumen Introducción: Las enfermedades reumáticas son patologías de alta prevalencia, impacto y repercusión, caracterizadas por dolor y limitación funcional. Para valorar la limitación, la historia clínica es el punto de partida, junto con las pruebas específicas necesarias, según el tipo de padecimiento. De forma complementaria, se recomienda el uso de herramientas clinimétricas. Objetivo: Comparar algunas herramientas o cuestionarios usados en las enfermedades reumáticas más prevalentes, revisando la bibliografía para destacar sus aportes y su utilidad en la labor del médico con finalidad clínica o pericial. Método: Se revisan las características básicas de los cuestionarios y herramientas más usadas en: osteoartritis, artritis reumatoide y artritis psoriásica, espondilitis anquilosante y lupus eritematoso sistémico. Se revisa en Medline la experiencia de los autores con algunos cuestionarios en función de la patología y de sus diversos usos. Resultados: Los cuestionarios se utilizan en su mayoría para la valoración de la calidad de vida, la discapacidad y la evolución clínico-terapéutica de los pacientes. No hay acuerdo entre los autores sobre si existe prioridad en el uso de algún cuestionario concreto por patología y se tiende a combinar varios. Los cuestionarios genéricos más utilizados son SF-36, NHP y EQ-5D. Por enfermedades: en artritis reumatoide, HAQy DAS28; en osteoartritis, WOMAC y Knoos; en Lupus, SLEDAI y BICLA, y en espondilitis, BASDAI y ASDAS. Conclusiones: En reumatología los cuestionarios son de uso habitual y resultan de utilidad de forma complementaria a la historia clínica y a las pruebas específicas. La elección por el profesional médico se basa en su experiencia y en la adecuación al objetivo buscado. Abstract Introduction: Rheumatic diseases are high prevalence, high impact and repercussion pathologies characterised by pain and functional limitation. To assess the limitation, the starting point is the clinical history, together with the specific tests required according to the type of condition. The use of complimentary clinometric tools is recommended. Objective: To compare some tools or questionnaires used in the most prevalent rheumatic diseases, and a review of the literature to highlight their contributions and usefulness in medical practice by the clinician or expert. Method: A review is made of the basic characteristics of the questionnaires and the most used tools in osteoarthritis, rheumatoid arthritis and psoriatic arthritis, ankylosing spondylitis and systemic lupus erythematosus. The experience of the authors is reviewed in Medline, with some questionnaires depending on the pathology and its various uses. Results: The questionnaires are used mainly to assess the quality of life, disability, and clinical-therapeutic evolution of patients. There is no agreement among the authors on whether there is a priority in the use of a specific questionnaire by pathology, and there is a tendency to combine several. The most commonly used generic questionnaires are SF-36, NHP and EQ-5D. For diseases: in rheumatoid arthritis, the HAQ and DAS28; in osteoarthritis, WOMAC and Knoos; in lupus, SLEDAI and BICLA; and in spondylitis, BASDAI and ASDAS. Conclusions: In rheumatology, questionnaires are commonly used, and are useful as a complement to the clinical history and specific tests. The choice by the medical professional is based on their experience and on the adaptation to the objective sought.

Introduction Rheumatic diseases are high prevalence, high impact and repercussion pathologies characterized by pain and functional limitation. To assess the limitation, the starting point is the clinical history, together with the specific tests required according to the type of condition. The use of complementary clinimetric tools is recommended. Objective To compare some tools or questionnaires used in the most prevalent rheumatic diseases, and a review of the literature to highlight their contributions and usefulness in medical practice by the clinician or expert. Method A review is made of the basic characteristics of the questionnaires and the most used tools in osteoarthritis, rheumatoid arthritis and psoriatic arthritis, ankylosing spondylitis and systemic lupus erythematosus. The experience of the authors is reviewed in Medline, with some questionnaires depending on the pathology and their various uses. Results The questionnaires are used mainly to assess the quality of life, disability, and clinical-therapeutic evolution of patients. There is no agreement among the authors on whether there is a priority in the use of a specific questionnaire by pathology, and there is a tendency to combine several. The most commonly used generic questionnaires are SF-36, NHP and EQ-5D. For diseases: in rheumatoid arthritis, the HAQ and DAS28; in osteoarthritis, WOMAC and Knoos; in lupus, SLEDAI and BICLA; and in spondylitis, BASDAI and ASDAS. Conclusions In rheumatology, questionnaires are commonly used, and are useful as a complement to the clinical history and specific tests. The choice by the medical professional is based on their experience and on the adaptation to the objective sought.

Introduction: Low back pain is a prevalent condition with health, social and occupational impact. The aim of this study is to assess the influence of social and occupational factors on worker patients with low back pain. Method: A descriptive study was conducted on 349 subjects with low back pain. The main independent variable was being a manual or non-manual worker. Other social-occupational and lifestyle variables were also considered. The level of disability was established according to the Oswestry low back pain disability questionnaire, and the association between the type of job and the test was evaluated using multiple linear regressions. Results: Manual workers are heavier smokers (47%), experience more pain (74.3%), have a lower economic status (89.3%), use more drugs (57.7%), have limitations in walking (17.5%) and standing (25.6%), used carrying protocols (85.5%), make repetitive movements (77.4%). They made trunk (52.6%) and upper limb movements (24.8%), and received less prevention training (51.7%), but used low back protection (19.6%). The non-manual workers had greater limitation in handling loads (37.4%) and sitting (43.5%), and computer screen user protocols were applied (94.8%), and had a lower social class classification (57.1 low-middle class). Performing manual tasks at work is significantly associated with an increase of 2 points in the Oswestry test compared to non-manual workers, when adjusted for age and gender (coefficient β: 2, 95% CI: 0.6-3.36). Conclusion: Low back pain is a prevalent condition, with an unfavorable prognosis that has an individual, social, and occupational impact. Performing manual tasks is associated with an increase in the disability scale, regardless of age and gender. RESUMEN Introducción: El dolor lumbar es una dolencia prevalente con repercusión sanitaria, social y laboral. Es objetivo de este trabajo valorar la influencia de las variables sociolaborales en pacientes con lumbalgia que trabajan. Método: Estudio descriptivo en 349 sujetos con lumbalgia. Es variable independiente principal ser trabajador manual y no manual; también son recogidas otras variables sociolaborales y de estilo de vida. La incapacidad se obtuvo mediante la escala del cuestionario de Oswestry y la asociación entre el tipo de tarea y el test se evaluó con regresión lineal múltiple. Resultados: Los trabajadores manuales consumen más tabaco (47%), tienen más dolor (74,3%), peor situación económica (89,3%), consumen más fármacos (57,7%), tienen limitación en deambulación (17,5%) y bipedestación (25,6%), se les aplican protocolos de cargas (85,5%) y movimientos repetidos (77,4%), realizan movimientos de tronco (52,6%) y miembros superiores (24,8%) y reciben menor formación preventiva (51,7%), pero utilizan protección lumbar (19,6%). Los trabajadores no manuales tienen mayor limitación en cargas (37,4%) y sedestación (43,5%) se les aplican protocolos de usuarios de pantallas (94,8%) y tienen peor tipificación en clase social (57,1 clase media-baja). Realizar tareas manuales en el trabajo se asocia significativamente con un aumento de 2 puntos en el test de Oswestry respecto a los no manuales, ajustado por edad y género (coeficiente β: 2, IC 95%: 0,65-3,36). Conclusión: La lumbalgia es una dolencia prevalente, de curso desfavorable, que implica impacto individual, social y laboral. Realizar tareas manuales se asocia con un aumento en la escala de incapacidad, independientemente de la edad y el género.

Resumen Introduccion El sindrome fibromialgico se caracteriza por dolor cronico asociado a sintomatologia somatica no especifica y con las limitaciones asociadas a su impacto personal, social, laboral y economico. Su valoracion se realiza de forma independiente, analizando sus aspectos clinicos, de severidad, los tratamientos y su efectividad, la repercusion en las actividades de la vida diaria y la repercusion o afectacion laboral. La herramienta FM-Check es una escala subjetiva que puede ser de ayuda para valorar de forma conjunta todos estos aspectos y servir de apoyo al profesional en el seguimiento del paciente y facilitar la colaboracion conjunta interprofesional. Metodo Para elaborar la FM-Check se parte de la historia clinica en la que se definen las variables que se van a utilizar agrupandolas en 4 bloques a los que se asignan porcentajes de limitacion para cada variable y cada bloque, para llegar a un porcentaje global de limitacion en los roles de las personas. Resultados La distribucion de porcentajes por cada bloque es en maximos: 10% para aspectos personales, 55% para clinico-terapeuticos, 24% para laborales y 10% para repercusion en la vida diaria. En funcion del porcentaje global obtenido tras la valoracion del paciente se asignan grados de limitacion: grado 1 hasta un porcentaje global 70%. Conclusion FM-Check pretende facilitar la labor medica en la evolucion del paciente y la toma de decisiones clinico-terapeuticas tras una valoracion global de la limitacion del paciente con fibromialgia, siguiendo una metodologia unificada que permita comparar resultados evolutivos individuales y la realizacion de estudios epidemiologicos colectivos.

Introduction Fibromyalgia syndrome is characterized by chronic pain associated with non-specific somatic symptoms, and has a personal, social, occupational, and economic impact. The assessment is performed independently, by analyzing the clinical aspects, severity, therapies, and their effectiveness, as well as the impact on daily life activities and its effect on employment. The FM-Check tool is a subjective scale that can be helpful in jointly assessing all these aspects, and provide professional support in monitoring the patient, as well as contribute to a multidisciplinary approach. Method To develop FM-Check is developed by starting with the clinical history in which the variables that are going to be used are defined, and grouped into 4 blocks to which a percentage limitation rate is assigned for each variable and each block. An overall percentage limitation is then calculated for the activities in each person. Results The distribution of assigned percentages was: a maximum of 10% for personal appearance, 55% for clinical-therapeutic aspects, 24% for work aspects, and 10% for impact on everyday life. The limitation levels were classified according to the overall percentage obtained after assessing the patient; grade 1: an overall percentage 70%. Conclusion FM-Check aims to make it easier for the clinician to monitor the patient and making medical-therapeutic decisions after an overall assessment of the limitation of the fibromyalgia patient. This achieved by following a unified methodology that can compare individual developmental outcomes, as well as for conducting joint epidemiological studies.

Introduction Tension-type headache (TTH) is a highly prevalent disorder with a significant socio-economic impact. The purpose of this study was to test the efficacy of three manual therapy treatments for reducing TTH-related anxiety and depression. Subjects and methods A clinical trial was conducted on 84 participants diagnosed with tension-type headache forming 4 groups: the first group received suboccipital soft tissue treatment (ST); the second group was treated with articulatory techniques (AT); the third group underwent a combination of both techniques (ST and AT), while the fourth group was the control group. Treatment sessions were administered over four weeks, with post-treatment assessment, and follow-up at one month. We conducted repeated measures analysis of covariance (RM-MANCOVA) to evaluate the effect of treatment on between and within-subject conditions and their interaction on reported depression and anxiety. Results All treatments resulted in a ‘moderate' reduction of psychological symptoms associated with TTH (Cohen's f = .31 for anxiety trait; f = .35 for anxiety state and f = .35 for depression). However, their efficacy varied across treatments, TTH types and the elapsed time between measurements. Conclusion Treatments including an articulatory technique showed a greater efficacy than a soft tissue technique, or a combination of both, for the reduction of TTH-related anxiety and depression levels in these participants. Clinical Trials.gov Identifier NCT02170259.

Diabetes mellitus presents high prevalence, severe complications, clinical repercussions, costs and occupational implications. Their assessment requires the use of the medical history and support questionnaires. A literature review was conducted on the topic of clinical and occupational evaluation aspects of diabetes; the database searched was Medline. The search showed numerous papers about diabetes clinical and therapeutic aspects as well as social or public health aspects but the results lacked occupational aspects. To assess the disease, the use of questionnaires is generalized and each author selects those which fit best to their purpose. It is concluded that to carry out a clinical and occupational evaluation related to diabetes, an inter-specialities cooperation, based on a complete medical history including occupational risk factors, is recommended. The questionnaires are useful, adapted to the objective, recommending those valued in Spanish as in Fear of hypoglycemia questionnaire (EsHFS) and Diabetes-related quality of life questionnaire (EsDQOL).

Introduction Hearing loss due to noise is considered within the prevention plans of the most common occupational diseases. In addition to evaluation of working conditions, other personal factors increasing the risk of hypoacusis, such as diabetes, should be taken into account. Objectives To explore hearing loss in the workplace and its relationship to impaired fasting baseline blood glucose levels. Methods An observational, cross-sectional study enrolling 1636 workers from service companies was conducted. Full audiometric evaluation was performed at different frequencies: high frequency (HF), early loss index (ELI), speech average loss (SAL), and monaural and binaural loss. Results were categorized by baseline blood glucose levels: G1 ( 125 mg/dl). Results Based on both HF and ELI, 11% of workers had clear indication of deafness. Women with G3 levels showed significant differences in the results of HF and ELI indexes as compared to the G1 group ( p = .038 and .046, respectively). A positive association was found between hearing loss and G3 blood glucose levels in HF (OR: .338; p = .002), ELI (OR: .407; p = .007), and the monaural test in the left ear (OR: 4.77 × 10 −5 ; p = .006). Conclusions Despite the methodological limitations of this study, there is evidence for an increased risk of high frequency hearing loss in workers with high baseline blood glucose levels.

Resumen Introduccion La hipoacusia ocupacional por ruido se considera dentro de los planes de prevencion de enfermedades profesionales mas comunes. Ademas del examen de las condiciones laborales se deben tener en cuenta otros factores personales que aumentan el riesgo de hipoacusia, como la diabetes. Objetivos Explorar la perdida de audicion en el ambito laboral y su relacion con las alteraciones de las cifras de glucemia basal en ayunas. Metodos Se realizo un estudio observacional y transversal en el que se incluyeron 1.636 trabajadores de empresas del sector servicios. Se hicieron audiometrias tonales completas midiendo: alta frecuencia (AF), indice de perdida precoz (ELI), indice promedio conversacional (SAL) y perdida perdida monoaural y binaural. Los resultados se categorizaron segun las cifras de glucemia basal: G1 ( 125 mg/dl). Resultados Segun la AF y el ELI el 11% de los trabajadores en cada caso presentaron claro indicio de sordera. Las mujeres con niveles G3 obtuvieron diferencias significativas en los resultados del indice AF y ELI respecto al grupo G1 (p = 0,038 y 0,046, respectivamente). Se encontro una asociacion positiva de hipoacusia y niveles de glucemia G3 en las pruebas de AF (OR: 0,338; p = 0,002), ELI (OR: 0,407; p = 0,007) y monoaural del oido izquierdo (OR: 4,77 × 10-5; p = 0,006). Conclusiones Pese a las limitaciones metodologicas de este estudio, existen indicios para pensar que los trabajadores con niveles elevados de glucemia basal podrian presentar un mayor riesgo de padecer hipoacusia de altas frecuencias.

Introduction and objectives To ascertain the socioeconomic impact of diabetes, it is essential to estimate overall costs, including both direct and indirect costs (premature retirements, working hours lost, or sick leaves). This study analyzed indirect costs for temporary disability (TD) due to diabetes and its complications in Spain in 2011 by assessing the related ICD-9 MC codes. Material and method For this purpose, the number of TD processes and their mean duration were recorded. The indirect costs associated to loss of working days were also estimated. Results In 2011, diabetes and its complications were related to 2567 TD processes, which resulted in the loss of 154,214 days. In terms of costs, this disease represented for Spanish public health administrations an expense of 3,297,095.3 €, with an estimated cost per patient and year of 141 €. Conclusions These data suggest an urgent need to devise plans for prevention and early diagnosis of diabetes and its complications, as well as programs to optimize the available health care resources by creating multidisciplinary teams where occupational medical services assume an important role. A decrease in absenteeism would result in benefits for diabetic patients, society overall, and companies or public institutions.

Resumen Introduccion y Objetivos Para conocer el impacto socioeconomico de la diabetes es indispensable realizar el calculo de los costes globales, de modo que se incluyan los gastos directos, pero tambien los indirectos (jubilaciones prematuras por enfermedad, perdida de horas de trabajo o bajas laborales). El presente trabajo estudio los costes indirectos por incapacidad temporal (IT) derivados de la diabetes y sus complicaciones en Espana en el ano 2011 mediante la evaluacion de los codigos CIE-9 MC relacionados con esta patologia. Material y metodo Para ello, se registraron el numero de procesos de IT y su duracion media. Ademas, se estimo el coste asociado a la perdida de dias laborales. Resultados La diabetes y sus complicaciones se relacionaron con 2.567 procesos de IT en 2011 que dieron lugar a una perdida de 154.214 dias. Traducido en costes, esta enfermedad supuso para las administraciones publicas de salud en Espana un gasto de 3.297.095,3 €, siendo el coste por IT estimado por paciente y ano de 141€. Conclusiones Estos datos hacen pensar en la necesidad urgente de planes de prevencion y diagnostico temprano de la diabetes y sus complicaciones, asi como programas de optimizacion de los recursos sanitarios existentes, mediante la formacion de equipos multidisciplinares en los que los servicios de medicina del trabajo cobran un papel importante. La disminucion del absentismo laboral redundaria en un beneficio para los pacientes diabeticos, la sociedad en general y las empresas e instituciones publicas.

Resumen Objetivo Valorar la legislacion espanola vigente y los criterios aplicables en discapacidad referentes a los procesos neoplasicos en general y al cancer de mama en particular, y revisar la conflictividad juridica que las reclamaciones por discapacidad, incapacidad o minusvalia generan en el cancer de mama. Metodos Se realizo una revision de la normativa espanola en discapacidad para el cancer en general y, de forma concreta, para el cancer de mama, y junto con ello se llevo a cabo una busqueda jurisprudencial mediante la base de datos juridica (Westlaw Insignis) en relacion con la conflictividad que generan estas materias, las areas de derecho involucradas y su evolucion por anos (1999-2012). Resultados La valoracion de la discapacidad asociada a cancer de mama ha de ajustarse de forma estricta a criterios legales y depende del estadio en que se encuentre, la respuesta a las terapias, las secuelas residuales y la adaptacion de la paciente a las limitaciones. En la jurisprudencia espanola, la conflictividad por estas materias es escasa, centrada en el ambito de lo social y con un incremento lento y paulatino en los ultimos anos. Conclusiones Es necesario que todos los sanitarios implicados en el tratamiento y seguimiento de los enfermos con cancer de mama posean un conocimiento basico de la normativa vigente y criterios de baremacion de la discapacidad por esta enfermedad, y se requiere de un trabajo coordinado entre todos los profesionales afectados por este tema para optimizar los medios y resultados finales.

Atherogenic indices predict cardiovascular disease, as they provide a good reflection of the clinical and metabolic interactions of lipid fractions.A descriptive cross-sectional study was conducted on 60,798 workers in the Spanish Mediterranean area on whom different atherogenic indices (cholesterol/HDL, LDL/HDL, triglycerides/HDL) were determined, and the influence they have in the different productive work sectors.In women, the mean values of the different atherogenic indices are better in the health sector, while they are better in men in the primary sector. The percentage of working women with low values is also greater in the healthcare sector, while in men there is no clear predominant sector, with the best values being shown in the hospitality and primary sector.The distribution of cardiovascular risk factors and the values of the different atherogenic indices analyzed vary in different industrial sectors.

The aims were to examine the prevalence of respiratory symptoms associated with rhinitis and asthma in Spanish workers and its variations by age, sex, work sector, location in the workplace, smoking habits and the relationship between symptoms in the upper and lower respiratory tract.The sample was of 2603 workers in different sectors and regions throughout the country. They agreed and answered the questions regarding respiratory symptoms, with the supervision of the company's physician.Chronic nasal symptoms were present in 438 workers (16.9 %); 193 (7.5 %) had pulmonary symptoms. With nasal and pulmonary symptoms were 124 patients (28.3 %). Likewise, of the 190 workers with pulmonary symptoms, 124 (64.2 %) had also nasal manifestations. We observed variations in nasal symptoms by sex, professional sector, work area and smoking habits, and variations in pulmonary symptoms by work sector. A higher prevalence was noted in the healthcare, postal, and transport sector as opposed to the construction, furniture or metal sector.The prevalence of nasal symptoms was higher than that of pulmonary symptoms in the working population. The workers affected by these pathologies were not treated adequately, despite they were presenting symptoms. We observed a relationship between pulmonary and nasal symptoms.INTRODUCCIÓN: en salud laboral interesa conocer la prevalencia de los síntomas respiratorios relacionados con la rinitis y el asma en trabajadores españoles y sus variaciones por factores demográficos y laborales. El objetivo de esta investigación fue interrelacionar los síntomas respiratorios de vías altas y bajas. MÉTODOS: se solicitó a 2603 trabajadores de distintos sectores y provincias españolas contestar una encuesta que fue supervisada por un médico del trabajo.438 trabajadores presentaron síntomas nasales crónicos (16.9 %) y 193 (7.5 %), síntomas pulmonares. De los 438 con síntomas nasales, 124 (28.3 %) presentaron síntomas pulmonares. Se observaron variaciones en los síntomas nasales por sexo, sector profesional, área de trabajo, tabaquismo y variaciones en los síntomas pulmonares por sector laboral, con mayor prevalencia en el sanitario, postal y transporte, en comparación con los sectores de la construcción, mueble o el metal.la prevalencia de los síntomas nasales en la población trabajadora fue más elevada que la de los síntomas pulmonares. Los trabajadores afectados estaban infratratados, a pesar de padecer síntomas. Se observó interrelación entre los síntomas pulmonares y nasales de los trabajadores afectados.

To ascertain the socioeconomic impact of diabetes, it is essential to estimate overall costs, including both direct and indirect costs (premature retirements, working hours lost, or sick leaves). This study analyzed indirect costs for temporary disability (TD) due to diabetes and its complications in Spain in 2011 by assessing the related ICD-9 MC codes.For this purpose, the number of TD processes and their mean duration were recorded. The indirect costs associated to loss of working days were also estimated.In 2011, diabetes and its complications were related to 2.567 TD processes, which resulted in the loss of 154.214 days. In terms of costs, this disease represented for Spanish public health administrations an expense of 3,297.095.3 €, with an estimated cost per patient and year of 141 €.These data suggest an urgent need to devise plans for prevention and early diagnosis of diabetes and its complications, as well as programs to optimize the available health care resources by creating multidisciplinary teams where occupational medical services assume an important role. A decrease in absenteeism would result in benefits for diabetic patients, society overall, and companies or public institutions.