OBJECTIVE:To develop a job-exposure matrix specific to healthcare workers, based on a pilot study conducted at Hospital del Mar (Barcelona). METHOD:Experienced occupational risk prevention technicians assessed 27 ergonomic and hygiene-related occupational risk factors in 50 homogeneous exposure groups, comprising 5537 workers across six occupational categories (1122 physicians, 1574 nurses, 1186 nursing assistants, 361 residents, 496 technicians, and 798 administrative staff) from five centres within Hospital del Mar in 2023. Exposure intensity levels (1=low, 2=medium, 3=high) were assigned based on specific evaluation methodologies for each risk. Using this data, exposure prevalence was estimated by center and occupational category, based on the proportion of exposed workers. RESULTS:Regarding ergonomic risks by centre, there was a high prevalence of level 3 exposure to patient handling in almost all centres, ranging from Forum (52%) to Mar (19.7%). Similarly, the occupational category of technicians had the highest prevalence of level 3 exposure to patient handling: 42.3%. No level 3 prevalence of physical, chemical and biological risks have been found in any professional category. CONCLUSIONS:The job-exposure matrix of Hospital del Mar enables the identification of occupational exposure levels, facilitating the management of occupational risks for hospital workers. It is necessary to include safety and psychosocial work-related risks factors.

To estimate the prevalence of long COVID identified through hospital registry data and examine associated occupational and demographic factors among healthcare workers (HCWs) in Spain. A multicentre study was conducted between 2020 and 2023 in three Spanish hospitals (Madrid, n = 1; Barcelona, n = 2). Long COVID prevalence and 95

OBJECTIVES: The aim of this review was to map the characteristics and the effects of interventions that reduce working hours with full pay maintained on workers’ health, well-being and work–life balance and to assess whether a gender perspective was incorporated. METHODS: A scoping review was conducted following PRISMA-ScR and JBI guidelines. Scientific databases (PubMed, Scopus, Web of Science, PsycINFO, CINAHL, Cochrane, ProQuest, Epistemonikos) and grey literature sources (international, European and national labor and occupational health agencies) were systematically searched for studies published between April 2014 and May 2025 in English or Spanish. Eligible studies comprised employed adults in Scandinavian and Western European countries, the United States, Canada, Australia and New Zealand exposed to interventions reducing working hours with full pay maintained. Screening, data extraction, and quality appraisal were conducted independently. An evidence map was developed to synthesize the findings. RESULTS: Ten scientific articles and five grey literature reports were included, seven from Scandinavian, seven from Western European countries, and one that included both regions. Working time reductions ranged from 10–25%. Most studies reported positive effects on work–life balance (100%), mental health (81.8%), and general health and well-being (58.3%). Qualitative data confirmed improvements in recovery, fatigue, and family time. Eleven studies included a gender perspective, with eight providing stratified analyses. Several studies indicated that women increased the time dedicated to caregiving and household, reinforcing traditional roles, while men’s involvement rose slightly without shifting responsibility equity. CONCLUSIONS: Despite heterogeneity of interventions and limited implementation contexts, it seems that reducing working hours to around 30–35 per week without pay loss may improve work–life balance, health, and well-being. Gender differences emerged, with women often facing increased unpaid work. As the evidence is still scarce particularly regarding long-term effects, sector-specific interventions, and gendered effects, further research is needed to inform and evaluate policies that promote equitable and sustainable work-time arrangements.

Sickness absence (SA) is a key indicator of health and job performance. The COVID-19 pandemic increased workload and stress, potentially affecting healthcare workers’ (HCWs) health and retention. This study aimed at identifying vulnerable HCW groups by analysing SA trajectories before and after the pandemic. A retrospective longitudinal study was conducted using administrative data from HCWs at Hospital del Mar, Barcelona, Spain, 2018–2023. SA was measured as cumulative days per semester. Latent Class Growth Analysis with zero-inflated Poisson models identified SA trajectories. The associations between socio-demographic and employment variables (occupation, shifts, care setting) and SA trajectories was analysed using bivariate analysis and multinomial logistic regression, yielding adjusted odds ratios (aOR) and 95

Objetivo Desarrollar una matriz de empleo-exposición específica para profesionales de centros sanitarios a partir de un estudio piloto en el Hospital del Mar (Barcelona). Método Técnicos de prevención con amplia experiencia evaluaron 27 factores de riesgo laborales ergonómicos e higiénicos en 50 grupos homogéneos de exposición, que incluyen 5537 trabajadores en seis categorías laborales (1122 medicina, 1574 enfermería, 1186 auxiliar de enfermería, 361 residentes, 496 técnicos, 798 administración) en cinco centros del Hospital del Mar en 2023, asignando niveles de intensidad de exposición (1=bajo, 2=medio, 3=alto) según las metodologías de evaluación específicas para cada riesgo. A partir de estos, se estimó la prevalencia de exposición por centro y categoría laboral, en función de la proporción de trabajadores expuestos. Resultados En relación con los riesgos ergonómicos por centros de trabajo, se observó una elevada prevalencia de exposición de nivel 3 a la movilización de pacientes en prácticamente todos los centros, que varió entre el 19,7% (centro H. Mar) y el 52% (centro Fórum). De acuerdo con la categoría laboral, se observó que los técnicos presentan las prevalencias más elevadas de exposición de nivel 3 a la movilización de pacientes, con una prevalencia del 42,3%. No se han observado prevalencias de nivel 3 para riesgos higiénicos de naturaleza física, química y biológica en ninguna categoría profesional. Conclusiones La matriz de empleo-exposición del Hospital del Mar permite identificar niveles de exposición laboral, facilitando la gestión de los riesgos en los profesionales hospitalarios. Es necesario incluir riesgos de seguridad y psicosociales.

OBJECTIVE:This review aimed to appraise the quality of existing guidelines on the management of occupational risks for employed women during pregnancy, identifying and describing their characteristics. METHODS:We systematically identified guidelines in MEDLINE, Embase, CINAHL, UpToDate, GIN International Guidelines Library, ECRI Guidelines Trust and websites of institutions and scientific societies. Four reviewers independently appraised each included document using the Appraisal of Guidelines for Research and Evaluation (AGREE II), generating domain scores of 0-100% (lowest to highest quality). An overall quality score for each guideline was assigned to each document by consensus among reviewers. RESULTS:The study included 31 documents: only 4 (12.9%) had good methodological quality for use in clinical practice; 27 (87.1%) scored poorly in domain III (rigor of development), failing to describe literature searches and formulation of recommendations methods, relationship between scientific evidence and recommendations or updating procedures. Domain IV (clarity of presentation) scores were higher as most documents presented their recommendations clearly, and 14 (45.1%) achieved scores of >60% for ease of identification and interpretation. Guidelines were generally clearer in defining their objectives, but none provided implementation tools. CONCLUSIONS:Guidelines for the management and prevention of occupational risks during pregnancy lacked sufficient rigor in their development. Despite generally clear objectives and presentation, critical gaps in methodology undermine their utility and applicability. There is a clear need to improve the development process of guidelines for the management and prevention of occupational risks during pregnancy.

Aims To estimate the prevalence of persistent post-COVID symptoms and self-reported long COVID diagnosis among healthcare workers (HCWs) in Spain, and to describe differences by sex, age and occupational group. Methods Cross-sectional study based on an online survey conducted in two Spanish public hospitals (Alicante and Barcelona) in 2023–2024. The study included HCWs with a previous COVID-19 infection. Outcomes were (1) persistent symptoms lasting > 3 months after acute infection and (2) formal medical diagnosis of long COVID. Descriptive analyses estimated prevalence and 95% confidence intervals (CIs), overall and stratified by sex, age and occupational group. Results A total of 363 HCWs (79.9% women) responded to the survey. Overall, 48.5% (95% CI 43.4–53.6) reported persistent symptoms lasting more than three months after acute COVID-19, with similar prevalence among women (49.3%) and men (43.7%). Formal long COVID diagnosis was reported by 3.9% (95% CI 2.3–6.4), while 6.6% (95% CI 4.5–9.6) reported suspected long COVID without a confirmed diagnosis. Persistent symptoms were reported by 49.3% of women and 43.7% of men; diagnosed long COVID was reported by 3.8% of women and 1.4% of men. Diagnosis prevalence increased with age and was higher among nurse assistants and support staff. Conclusions Among surveyed HCWs with previous COVID-19, persistent symptoms like fatigue were common, but formal long COVID diagnosis was uncommon, suggesting substantial under-recognition. These findings support strengthening identification and follow-up pathways for post-COVID conditions, with potential implications for primary care and occupational health coordination.

La evolución positiva de citas recibidas y otros reconocimientos como la obtención del sello de FECYT o el ascenso a Q3 en SJR, nos permiten afirmar que Archivos de Prevención de Riesgos Laborales se está consolidando como un medio fundamental para la difusión de conocimientos y avances en el campo de la salud laboral, especialmente en el espacio hispanohablante. Su enfoque integral, su adaptación a los retos emergentes y su rigor científico hacen que sea un referente para quienes buscan impulsar la mejora continua de la seguridad y la salud en el trabajo.

BACKGROUND:Like other European systems, the Spanish national health system (NHS) is reaching a critical point. This article analyses sickness absence (SA) trends, as a direct indicator of this crisis, among healthcare workers (HCWs) in Spain, comparing the pre-pandemic, pandemic, and post-pandemic periods. METHODS:This study was based on a retrospective cohort of HCWs (n=7.918) hired at Hospital del Mar in Barcelona for at least three months during 2018-2023. The primary outcome was incident SA episodes. Incidence rates (IR) per 1,000 persons-day and 95% confidence intervals (95% CI) were calculated by sex, period, and occupational variables. Longitudinal entropy regression models were estimated to identify the factors influencing the frequency of transitions between the different HCWs' employment states (active or on SA). RESULTS:Increasing trends in IR (95%CI) were observed, rising from 1.77 (1.71; 1.83) episodes of SA per 1,000 workers-day during the pre-pandemic period to 5.04 (4.93; 5.15) during the post-pandemic among women, and from 1.23 (1.14; 1.31) to 3.79 (3.64; 3.95), respectively, among men. Nurses, nurse aides, orderlies/technicians, workers under 30, and those in intensive care units and emergency rooms showed the highest IR during and after the pandemic, with longitudinal entropy analysis revealing increased state changes, primarily affecting these groups. CONCLUSIONS:This study demonstrates a significant rise in SA incidence among HCWs during and after the pandemic and identifies vulnerable groups with higher incidence. Several hypotheses, such as poor working conditions, burnout, and patient complexity, have been suggested to explain these results. Urgent interventions are needed to safeguard HCWs' health, thus maintaining the sustainability and safety of the NHS.

AIMS:Studies conducted during the COVID-19 pandemic found high occurrence of suicidal thoughts and behaviours (STBs) among healthcare workers (HCWs). The current study aimed to (1) develop a machine learning-based prediction model for future STBs using data from a large prospective cohort of Spanish HCWs and (2) identify the most important variables in terms of contribution to the model's predictive accuracy. METHODS:This is a prospective, multicentre cohort study of Spanish HCWs active during the COVID-19 pandemic. A total of 8,996 HCWs participated in the web-based baseline survey (May-July 2020) and 4,809 in the 4-month follow-up survey. A total of 219 predictor variables were derived from the baseline survey. The outcome variable was any STB at the 4-month follow-up. Variable selection was done using an L1 regularized linear Support Vector Classifier (SVC). A random forest model with 5-fold cross-validation was developed, in which the Synthetic Minority Oversampling Technique (SMOTE) and undersampling of the majority class balancing techniques were tested. The model was evaluated by the area under the Receiver Operating Characteristic (AUROC) curve and the area under the precision-recall curve. Shapley's additive explanatory values (SHAP values) were used to evaluate the overall contribution of each variable to the prediction of future STBs. Results were obtained separately by gender. RESULTS:The prevalence of STBs in HCWs at the 4-month follow-up was 7.9% (women = 7.8%, men = 8.2%). Thirty-four variables were selected by the L1 regularized linear SVC. The best results were obtained without data balancing techniques: AUROC = 0.87 (0.86 for women and 0.87 for men) and area under the precision-recall curve = 0.50 (0.55 for women and 0.45 for men). Based on SHAP values, the most important baseline predictors for any STB at the 4-month follow-up were the presence of passive suicidal ideation, the number of days in the past 30 days with passive or active suicidal ideation, the number of days in the past 30 days with binge eating episodes, the number of panic attacks (women only) and the frequency of intrusive thoughts (men only). CONCLUSIONS:Machine learning-based prediction models for STBs in HCWs during the COVID-19 pandemic trained on web-based survey data present high discrimination and classification capacity. Future clinical implementations of this model could enable the early detection of HCWs at the highest risk for developing adverse mental health outcomes. STUDY REGISTRATION:NCT04556565.

Purpose We assessed mental health trajectories of Spanish healthcare workers (HCWs) during three years following the first COVID-19 wave, focusing on distal and proximal risk factors. Methods A prospective cohort of HCWs from 18 Spanish institutions was assessed seven times between May 2020 and June 2023 through institutional web-based surveys. Outcomes included: (1) any probable mental disorder (MDx)—depression (PHQ-8 ≥ 10), anxiety (GAD-7 ≥ 10), panic attack, post-traumatic stress disorder (PCL-5 ≥ 7), or substance use disorder (CAGE-AID ≥ 2); and (2) any suicidal thoughts or behaviors (STB, CSSRS). Risk factors comprised 11 distal (sociodemographic, professional, health-related) and 13 proximal (COVID-19 infection, work, health, financial, and family stressors) variables. Latent Class Growth Analysis identified trajectories. Results 4,809 were followed. Most were women (77.3%), hospital workers (57.6%), and nurses/nurse assistants (44.4%). Prevalence of any MDx declined from 45.5% (May–Sept 2020) to 31.2% (Apr–Jun 2023), while STB increased slightly from 8.4% to 9.4% (not significant). Common risk factors for MDx and STB were previous mental disorders, female gender, nurse assistant role, foreign-born status, primary care work, and physical comorbidities. Four trajectory classes were identified for both MDx and STB: persistent high (19.4%, 5.0%), decreasing from high prevalence (28.5%, 5.2%), increasing from low (5.9%, 4.2%), and persistent low (46.2%, 85.5%). Persistent high classes were associated with interpersonal stress, loved ones’ health, lack of preparedness/protective equipment, and ethically challenging care decisions. Conclusions Mental health problems remained substantial among Spanish HCWs during three years of follow-up, about one in five showing persistently high burden. Continued monitoring and support are warranted.

Definimos como personal sanitario a las personas que trabajan en actividades sanitarias, tengan contacto directo o no con los ciudadanos. En la actualidad, alrededor de 1,3 millones de personas (70% mujeres) trabajan en actividades sanitarias en España. Ello representa alrededor del 10% de la población activa, habiéndose incrementado un 33% desde 2008, un 100% las mujeres. Las organizaciones sanitarias, especialmente los hospitales, son lugares de trabajo de enorme complejidad, con condiciones de trabajo y empleo que se han precarizado, especialmente las ocupaciones más jerarquizadas, lo que los expone a numerosos riesgos laborales, fundamentalmente ergonómicos y psicosociales. Esto provoca frecuentes trastornos musculoesqueléticos y mentales, destacando por su alta prevalencia el burnout, que se estima en un 40% en algunos servicios como los de cuidados intensivos. Esta elevada morbilidad se ve reflejada en una alta frecuencia de incapacidades temporales, alrededor del 9% tras la pandemia. La pandemia, y sus consecuencias en los últimos 3 años, ha tensionado de forma extrema al sistema sanitario y evidencia de forma clara sus carencias en relación a las condiciones de trabajo y empleo. Los profesionales de salud laboral, sanitarios y técnicos, que forman parte de las organizaciones sanitarias, constituyen unos recursos muy valiosos para aumentar la resiliencia del Sistema Nacional de Salud (SNS). Recomendamos el fortalecimiento en recursos e institucionalmente de los servicios de salud laboral de los centros sanitarios, y la creación de un Observatorio sobre condiciones de trabajo, empleo y salud en el SNS, como instrumento para monitorizar los cambios y las soluciones propuestas.

Healthcare workers are people who work in health activities, whether or not they have direct contact with citizens. Currently, around 1.3 million people (70% women) work in healthcare activities in Spain. This represents around 10% of the active population, having increased by 33% since 2008, especially the number of women, which has doubled. Healthcare organizations, especially hospitals, are extremely complex workplaces, with precarious working and employment conditions, especially in more hierarchical occupations, exposing healthcare workers to numerous occupational hazards, mainly from ergonomic and psychosocial conditions. These causes frequent musculoskeletal and mental disorders, highlighting burnout, which is estimated at 40% in some services such as intensive care units. This high morbidity is reflected in a high frequency of absences due to illness, around 9% after the pandemic. The pandemic, and its consequences in the last three years, has put extreme pressure on the health system and has clearly shown its deficiencies in relation to working and employment conditions. The hundreds of occupational health professionals, technicians and healthcare workers, who are part of the structures of health organizations, constitute very valuable resources to increase the resilience of the NHS. We recommend the strengthening in resources and institutionally of the occupational health services of health centers and the creation of an Observatory of working, employment and health conditions in the National Health Service, as an instrument for monitoring changes and proposing solutions.

To evaluate the cost-effectiveness of a multifaceted workplace intervention to reduce musculoskeletal pain (MSP) in nursing staff. The study was a 1-year cluster-randomized controlled trial. The intervention combined participatory ergonomics, health promotion, and case management. The control group received usual care. Societal and health system perspectives were used. Costs included direct health and indirect costs. The effects were MSP and quality-adjusted life years (QALYs). MSP was measured using the Standardized Nordic Questionnaire at baseline and 6- and 12-month follow-up. QALYs were measured using the EuroQol-5D-3L at 6- and 12-month follow-up. Incremental costs and QALYs were modelled using generalized linear models. MSP was analysed through generalized logistic models. Incremental cost-effectiveness ratios (ICERs) were calculated, and cost-effectiveness planes and acceptability curves were constructed. Total mean costs per person were €614 and €216 for the intervention and control group, respectively, with a societal perspective. The intervention mean cost was €38/person. From the societal perspective, the ICER showed that overall additional €68 (€9 from a health system perspective) were required to achieve 1-extra-percentage-point reduction of MSP. ICERs were €34 from the societal and €4 from the health system perspectives for neck, shoulders and upper back pain; €53 and €7 for low back; €179 and €23 for hands; €39 and €5 for legs; €115 and €14 for the knees; €36 and €5 for feet For MSP in the elbows. For participants with pain in the elbow, and for QALYs, the ICER showed that the intervention group was dominated by the control group. This intervention was not cost-effective in terms of QALYs. However, in terms of MSP, with a willingness to pay of €100, the probability of the intervention being cost-effective was around 90

Little is known about healthcare workers' (HCW) use of healthcare services for mental disorders. This study presents data from a 16-month prospective cohort study of Spanish HCW (n = 4,809), recruited shortly after the COVID-19 pandemic onset, and assessed at four timepoints using web-based surveys. Use of health services among HCW with mental health conditions (i.e., those having a positive screen for mental disorders and/or suicidal thoughts and behaviours [STB]) was initially low (i.e., 18.2 %) but increased to 29.6 % at 16-month follow-up. Service use was positively associated with pre-pandemic mental health treatment (OR=1.99), a positive screen for major depressive disorder (OR=1.50), panic attacks (OR=1.74), suicidal thoughts and behaviours (OR=1.22), and experiencing severe role impairment (OR=1.33), and negatively associated with being female (OR = 0.69) and a higher daily number of work hours (OR=0.95). Around 30 % of HCW with mental health conditions used anxiolytics (benzodiazepines), especially medical doctors. Four out of ten HCW (39.0 %) with mental health conditions indicated a need for (additional) help, with most important barriers for service use being too ashamed, long waiting lists, and professional treatment not being available. Our findings delineate a clear mental health treatment gap among Spanish HCW.

Un año más, mediante esta nota editorial, damos cuenta de las estadísticas y los principales avances de nuestra revista. En cuanto a las estadísticas editoriales, que se detallan en los apartados posteriores, podemos afirmar que son las de una revista consolidada: flujo nutrido y constante de trabajos recibidos/publicados, tasas de aceptación y rechazo proporcionadas, tiempos de gestión razonables y diversidad en las autorías. El logro más destacable del 2023 fue superar con éxito el proceso de evaluación de la Octava edición de Evaluación de la calidad editorial y científica de las revistas científicas españolas, comúnmente conocido como ‘Sello FECYT’…