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

Healthcare workers (HCWs) may have a higher risk of developing long COVID due to greater exposure to COVID-19, with symptoms extending beyond the acute phase impacting their daily living activities and job performance. To systematically map the existing literature on the impact of long COVID on HCWs’ job performance, focusing on their time to return to work and work ability. A scoping review following PRISMA-ScR guidance included peer-reviewed studies in English or Spanish (January 2020–December 2024). Four databases were searched. Experimental, epidemiological and qualitative studies were eligible. Two reviewers independently screened records. Methodological quality was appraised using the Mixed-Methods Appraisal tool (MMAT). Nineteen studies were included, mainly European and predominantly cross-sectional. Long COVID was most often defined as symptoms lasting ≥ 3 months. Among HCWs with prior infection or whole-staff samples, prevalence ranged from 10

The data presented here derives from the Sustainable Working Conditions in Academia survey (STAIRCASE) on researcher mental health. The survey addresses the ongoing mental health crisis in academia by providing comprehensive, multilevel data on researcher well-being and its structural determinants. We employed a cross-sectional between-participant study design to collect data from 4,296 researchers between September 15, 2023, and August 26, 2024. The sample, which primarily includes researchers based in European countries, has a mean age of 38.1 years (SD = 10.7) and consists of 63.7% female participants. Participants provided data on key mental health outcomes – including depression, anxiety, stress, burnout, and well-being – alongside detailed assessments of working conditions, leadership behavior, and organizational characteristics. The dataset facilitates a holistic, multilevel investigation of academic mental health beyond individual risk factors by including the individual, leadership, institutional, and national context. By enabling analyses across hierarchical levels this dataset provides the necessary evidence to identify systemic drivers of mental (ill) health and inform the development of effective, system-wide strategies for meaningful change in academic work environments.

The long-standing delay in the institutionalization of public health in Spain is directly related, both as a cause or effect, to its academic and professional weaknesses. This second part examines the necessary, yet challenging, relationship between academia and administration, describing how public health research and training have developed in the country, primarily since the transition to democracy. One of the keys to consolidating the progress already made is connecting the day-to-day work of research with professional practice. That is linking the knowledge generated through research and innovation with the implementation of policies and programs. Investing in research and professional training, with sufficient and sustained resources, is the best way to prepare ourselves to face the present and future challenges of public health. Scientific societies play a unique role in connecting academia and administration.

Agradecemos la carta enviada por Alatrista Huertas, por cuanto anima al debate que buscaba nuestra editorial, además de por señalar algunos puntos críticos en la aplicación de la normativa comentada que nos parecen de mucho interés. Entre ellos, coincidimos especialmente con la dificultad de incluir los exámenes de salud laboral en la cobertura que prestan los servicios de atención primaria a las empleadas de hogar informales (sin contrato ni alta en la seguridad social). La formalidad es una premisa sin la cual no se puede aplicar la normativa. Un objetivo que compete a la inspección de trabajo, sabiendo lo difícil que es fiscalizar las irregularidades en este ámbito de las empleadas de hogar, donde quien contrata es una persona en el ámbito del hogar familiar. Hay que persistir, pero no hay milagros…

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.

El retraso secular de la institucionalización de la salud pública en España tiene su correlato, sea como causa o como efecto, en su debilidad académica y profesional. En esta segunda parte se examina la necesaria, pero difícil, relación entre la academia y la administración, describiendo cómo se han ido configurando la investigación y la formación en salud pública en el país, principalmente desde la llegada de la democracia. Una de las claves para consolidar los avances ya experimentados es conectar el día a día de la investigación y la práctica profesional; esto es, entre el saber generado en la investigación y la innovación y el hacer de las políticas y los programas. Apostar por la investigación y la formación de los profesionales, con recursos suficientes y sostenidos en el tiempo, es la mejor manera de prepararnos para hacer frente a los retos presentes y futuros de la salud pública. Las sociedades científicas desempeñan un papel de facilitador de la conexión entre la academia y la administración.

Objetivo. Describir y evaluar la metodología del índice de las encuestas de condiciones de trabajo, empleo y salud (ECoTES), diseñado para medir el desempeño de los sistemas nacionales de seguridad y salud en el trabajo (SST), tras su aplicación en un estudio piloto en seis países iberoamericanos. Método. El índice ECoTES se calculó para cada país con base a dos componentes: i) un cuestionario con 15 preguntas contestado por 47 personas expertas de Argentina, Chile, Costa Rica, España, Honduras y Perú; y ii) ocho indicadores estadísticos (tasa participación laboral, total y de mujeres, tasa de informalidad, porcentaje del producto interno bruto destinado a protección social excluida la salud, porcentaje de la población cubierta por seguros del riesgo del trabajo, porcentaje de la población cubierta por al menos una prestación social, tasa de lesiones mortales por accidentes de trabajo y tasa de mortalidad atribuible por riesgos laborales). Para simular el valor del índice, dimos distintos pesos a cada componente, y se valoró la correlación entre las puntuaciones de las personas expertas e indicadores estadísticos. Resultados. El cuestionario fue contestado sin dificultad y, además de permitir la construcción del índice, las respuestas también sirvieron para mejorar su redacción. Hubo una buena correlación entre las puntuaciones de los componentes del índice (r = 0,66) y del ranking entre países en las diferentes simulaciones (Spearman: entre 0,95 y 1). Conclusiones. El índice ECoTES mostró robustez metodológica, y es el primer indicador en el mundo que valora el desempeño de los sistemas nacionales de SST. Su aplicación periódica permitirá comparaciones en el tiempo y entre países, y contribuirá a estimular la mejora de los sistemas nacionales.

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.

Objective:The aim of the study was to explore the experiences of healthcare workers (HCWs) in Spain with long COVID and its impact on their job performance, from the perspectives of affected HCWs, healthcare providers, and key stakeholders.Methods:A phenomenological, constructivist approach was used. Seven online focus groups and four interviews were conducted from April to June 2024. Transcripts were thematically analyzed using Atlas.ti using a predefined guideline.Results:Long COVID significantly impaired work ability due to physical and cognitive limitations. Sick leave followed long-term or intermittent patterns, although many HCWs hesitated to take leave. Return-to-work experiences were shaped by workplace adaptations, institutional support, and persistent symptoms. Improvement proposals include formal recognition and holistic workplace support as they are essential to reduce its occupational burden.Conclusions:Long COVID significantly impacts affected HCWs job performance, highlighting a need for recognition, support, and workplace adaptation.

Introducción: Las matrices empleo-exposición (MEE) permiten estimar la exposición grupal a agentes de riesgo. Su utilidad está consolidada en estudios internacionales, como FINJEM y JEM Soignances, validados en el ámbito hospitalario. En España, su uso en el ámbito sanitario es limitado. Este estudio tuvo como objetivo construir una MEE centrada en riesgos químicos por inhalación en el Hospital del Mar (Barcelona), identificar los grupos funcionales homogéneos (GFH) potencialmente expuestos y estimar la prevalencia global y su distribución por niveles de riesgo. Método: Se realizó un estudio descriptivo exploratorio, aplicando la metodología cualitativa de la NTP 937 del Instituto Nacional de Seguridad y Salud en el Trabajo. Se evaluaron seis agentes químicos seleccionados por su uso hospitalario habitual y toxicidad por vía inhalatoria (formaldehído, tamoxifeno, ciclofosfamida, cisplatino, sevoflurano y desflurano) en una población de 4.834 trabajadores distribuidos en 46 GFH. Resultados: De los 46 GFH analizados, se identificó exposición en 10, agrupando a 1.502 trabajadores (31,1%). La mayoría (22,5%) presentó riesgo bajo, principalmente por gases anestésicos (sevoflurano y desflurano), así como formaldehído y citotóxicos en farmacia. Un 8,6% mostró riesgo moderado, vinculado a la manipulación de tamoxifeno, ciclofosfamida, cisplatino y formaldehído en unidades como hospital de día, agudos y bloque quirúrgico. No se detectaron exposiciones de nivel elevado. Conclusiones: Los resultados evidencian la presencia de riesgos químicos en áreas hospitalarias específicas. La MEE elaborada constituye una herramienta útil para orientar intervenciones preventivas, priorizar recursos y planificar estrategias de control adaptadas a las condiciones reales de exposición en el entorno sanitario.

La carga de enfermedad atribuible al trabajo es enorme, tanto en términos de salud y bienestar de las personas que trabajan, como también en términos de su impacto sobre la riqueza del conjunto del país y el estado de bienestar. Para hacer frente a estos enormes y complejos retos necesitamos de sistemas de seguridad y salud en el trabajo que garanticen el derecho fundamental a un trabajo seguro y saludable, como ha sido recientemente reconocido por la Organización Internacional del Trabajo en 2022. La reforma de la Ley de Prevención de Riesgo Laborales, como norma central que afecta de pleno al derecho fundamental a una vida laboral longeva y saludable, ha de contemplar en su aplicación estas interacciones entre el sistema productivo y los sistemas de seguridad social, definido por la Ley General de Seguridad Social, y de salud, definido por la Ley general de Sanidad. En este sentido, y desde la complejidad que representan los retos ya señalados, y centrando el objetivo fundamental en la reducción de la carga de la enfermedad asociada al trabajo, parece oportuno crear una Agencia estatal con autonomía de gestión que disponga de las competencias adecuadas para avanzar en la consecución del objetivo 8, del trabajo decente y productivo, de la Agenda 2030 de Naciones Unidas.