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Biomedical subjects

J Benach

Publications and source records attributed to J Benach.

At least 19 recordsLinked to original sources

Associations between temporary employment and occupational injury: what are the mechanisms?

OBJECTIVE: To determine whether observed higher risks of occupational injury among temporary workers are due to exposure to hazardous working conditions and/or to lack of job experience level. METHODS: Data systematically recorded for 2000 and 2001 by the Spanish Ministry of Labour and Social Affairs on fatal and non-fatal traumatic occupational injuries were examined by type of employment and type of accident, while adjusting for gender, age, occupation, and length of employment in the company. In the study period there were 1500 fatal and 1 806 532 non-fatal traumatic occupational injuries that occurred at the workplace. Incidence rates and rate ratios (RR) were estimated using Poisson regression models. RESULTS: Temporary workers showed a rate ratio of 2.94 for non-fatal occupational injuries (95% CI 2.40 to 3.61) and 2.54 for fatal occupational injuries (95% CI 1.88 to 3.42). When these associations were adjusted by gender, age, occupation, and especially length of employment, they loose statistic significance: 1.05 (95% CI 0.97 to 1.12) for non-fatal and 1.07 (95% CI 0.91 to 1.26) for fatal. CONCLUSIONS: Lower job experience and knowledge of workplace hazards, measured by length of employment, is a possible mechanism to explain the consistent association between temporary workers and occupational injury. The role of working conditions associated with temporary jobs should be assessed more specifically.

Accidents, Occupational↗

Trends in smoking behaviour between 1985 and 2000 in nine European countries by education.

OBJECTIVE: To examine whether trends in smoking behaviour in Western Europe between 1985 and 2000 differed by education group. DESIGN: Data of smoking behaviour and education level were obtained from national cross sectional surveys conducted between 1985 and 2000 (a period characterised by intense tobacco control policies) and analysed for countries combined and each country separately. Annual trends in smoking prevalence and the quantity of cigarettes consumed by smokers were summarised for each education level. Education inequalities in smoking were examined at four time points. SETTING: Data were obtained from nine European countries: Norway, Sweden, Denmark, Finland, the United Kingdom, the Netherlands, Germany, Italy, and Spain. PARTICIPANTS: 451 386 non-institutionalised men and women 25-79 years old. MAIN OUTCOME MEASURES: Smoking status, daily quantity of cigarettes consumed by smokers. RESULTS: Combined country analyses showed greater declines in smoking and tobacco consumption among tertiary educated men and women compared with their less educated counterparts. In country specific analyses, elementary educated British men and women, and elementary educated Italian men showed greater declines in smoking than their more educated counterparts. Among Swedish, Finnish, Danish, German, Italian, and Spanish women, greater declines were seen among more educated groups. CONCLUSIONS: Widening education inequalities in smoking related diseases may be seen in several European countries in the future. More insight into effective strategies specifically targeting the smoking behaviour of low educated groups may be gained from examining the tobacco control policies of the UK and Italy over this period.

Adult↗

The geography of the highest mortality areas in Spain: a striking cluster in the southwestern region of the country.

AIMS: To determine the areas of Spain with the most increased mortality risk. METHODS: Age adjusted relative risk of death by gender was estimated in each of 2218 small areas of the country using a non-parametric empirical Bayes method. To determine areas with "significantly increased risk" a Poisson based score test was used. RESULTS: Mapping of the highest risk areas showed a striking geographical clustering in the southwestern region of the country. This region, comprising 8% of the Spanish population, accounts for about one third (2884 deaths) of the total excess mortality.

Cluster Analysis↗

Distribution of sickness absence in the European Union countries.

AIMS: To determine the sickness absence frequency in European Union (EU) countries. METHODS: Sickness absence was measured by questionnaire using the Third European Survey on Working Conditions. Employees were considered to have sickness absence if they reported to be absent at least one day in the past 12 months because of an accident at work, work related problems, or by other health problems. RESULTS: Sickness absence percentages were lower in Southern European countries compared with Central and Northern European countries, and, in general, slightly higher in men than in women. CONCLUSION: This is the first description of sickness absence in each of the 15 EU countries. Examination of the sickness absence patterning between EU countries could indicate countries where important lessons to reduce sickness absence are to be learned and diffused across the EU.

Absenteeism↗

Structural role of conserved Asn179 in the short-chain dehydrogenase/reductase scaffold.

Short-chain dehydrogenases/reductases (SDR) constitute a large family of enzymes found in all forms of life. Despite a low level of sequence identity, the three-dimensional structures determined display a nearly superimposable alpha/beta folding pattern. We identified a conserved asparagine residue located within strand betaF and analyzed its role in the short-chain dehydrogenase/reductase architecture. Mutagenetic replacement of Asn179 by Ala in bacterial 3beta/17beta-hydroxysteroid dehydrogenase yields a folded, but enzymatically inactive enzyme, which is significantly more resistant to denaturation by guanidinium hydrochloride. Crystallographic analysis of the wild-type enzyme at 1.2-A resolution reveals a hydrogen bonding network, including a buried and well-ordered water molecule connecting strands betaE to betaF, a common feature found in 16 of 21 known three-dimensional structures of the family. Based on these results, we hypothesize that in mammalian 11beta-hydroxysteroid dehydrogenase the essential Asn-linked glycosylation site, which corresponds to the conserved segment, displays similar structural features and has a central role to maintain the SDR scaffold.

11-beta-Hydroxysteroid Dehydrogenase Type 1↗

[Emotional disorders in the working population: an emerging problem in occupational health?].

BACKGROUND: To know the prevalence of emotional disorders in a working population. SUBJECTS AND METHOD: Workers in four companies: construction (A), automobile components (B), electrical and electronic systems (C) and management services (D). The design of the study was cross-sectional with the GHQ-28 questionnaire. RESULTS: The prevalence fluctuated between 8,4% (A) and 24,0% (D). Sex, age, educational level and occupation showed significance differences in some companies. CONCLUSIONS: The results suggest an important prevalence of emotional disorders that likely increase as there will be more firms of services.

Adult↗

Genesis of Drosophila ADH: the shaping of the enzymatic activity from a SDR ancestor.

Drosophila alcohol dehydrogenase (ADH) is an NAD(H)-dependent oxidoreductase that catalyzes the oxidation of alcohols and aldehydes. Structurally and biochemically distinct from all the reported ADHs (typically, the mammalian medium-chain dehydrogenase/reductase-ethanol-metabolizing enzyme), it stands as the only small-alcohol transforming system that has originated from a short-chain dehydrogenase/reductase (SDR) ancestor. The crystal structures of the apo, binary (E.NAD(+)) and three ternary (E.NAD(+).acetone, E.NAD(+).3-pentanone and E.NAD(+).cyclohexanone) forms of Drosophila lebanonensis ADH have allowed us to infer the structural and kinetic features accounting for the generation of the ADH activity within the SDR lineage.

Alcohol Dehydrogenase↗

Social class inequalities in the use of and access to health services in Catalonia, Spain: what is the influence of supplemental private health insurance?

OBJECTIVE: To analyse social class inequalities in the access to and utilization of health services in Catalonia (Spain), and the influence of having private health insurance supplementing the National Health System (NHS) coverage. DESIGN: 1994 Catalan Health Interview Survey, a cross-sectional survey conducted in 1994. SETTING: Catalonia (Spain). STUDY PARTICIPANTS: The participants were a representative sample of people aged over 14 years from the non-institutionalized population of Catalonia (n = 12,245). MAIN OUTCOME MEASURES: Health services utilization, perceived health, having only NHS or NHS plus a private health insurance, and social class. RESULTS: Although one-quarter of the population of Catalonia had a supplemental private health insurance, percentages were very different according to social class, ranging from almost 50% for classes I and II to 16% for classes IV and V in both sexes. No inequalities by social class were observed for the utilization of non-preventive health care services (consultation with a health professional in the last 2 weeks and hospitalization in the last year) among persons with poor self-perceived health status, i.e. those in most need. However, social inequalities still remain in the use of health services provided only partially by the NHS, and when characteristics of last consultation are taken into account. Subjects who paid for a private service waited an average of 18.8 minutes less than those attending the NHS. Within the NHS, social classes IV and V waited longer (35.5 minutes) than social classes I and II (28.4 minutes). CONCLUSION: The NHS in Catalonia, Spain, has reduced inequalities in the use of health services. Social inequalities remain in the use of those health services provided only partially by the NHS.

Adolescent↗

Material deprivation and leading causes of death by gender: evidence from a nationwide small area study.

STUDY OBJECTIVE: To investigate the association between material deprivation and 10 leading causes of death by gender. DESIGN: Small area cross sectional ecological study using two dimensions of material deprivation (Index 1 and Index 2) drawn from 1991 census and cause specific mortality data aggregated for 1987-1995. SETTING: 2218 small areas in Spain. MAIN RESULTS: Strong detrimental associations of two deprivation indices were found with top six leading causes of death for men and top seven leading causes of death for women, except breast cancer. For men, the highest percentages of excess mortality (between 40% and 60%) were found for smoking and alcohol related causes of death such as lung cancer, chronic obstructive pulmonary diseases, and cirrhosis while for women the highest percentages of excess mortality (between 40% and 60%) were found for diet related causes such as diabetes and ischaemic heart disease. CONCLUSIONS: Health inequality is a widespread phenomenon in the majority of the top leading causes of deaths of the nation. Increasing levels of deprivation indices are associated with mortality risk differently by both cause and gender. Results suggest that deprivation effects mainly captured by Index 2 may manifest largely as unfavourable health behaviours leading to gender specific sets of causes of deaths. Findings of this study are consistent with the idea that material deprivation determines health inequality through both an increase of general susceptibility to ill health, leading to excess mortality in a wide range of causes, and a set of specific factors, resulting in an increased risk of death from a specific set of causes in each gender.

Cause of Death↗

Gender inequalities in health among workers: the relation with family demands.

OBJECTIVES: To analyse whether there are gender inequalities in health among male and female workers who are married or cohabiting and to assess whether there are gender differences in the relation between family demands and health. Additionally, for both objectives it will be examined whether these gender patterns are similar for manual and non-manual workers. DESIGN AND SETTING: The data have been taken from the 1994 Catalonian Health Survey (CHS), a cross sectional survey based on a representative sample of the non-institutionalised population of Catalonia, a region in the north east of Spain that has about 6 million inhabitants. The dependent variables were four ill health indicators (self perceived health status, limiting longstanding illness, having at least one chronic condition and mental health) and two health related behaviours closely related to having time for oneself (no leisure time physical activity and sleeping six hours or less a day). Family demands were measured with three variables: household size, living with children under 15 years and living with adults older than 65 years. The analysis was separated for gender and social class (manual and non-manual workers) and additionally adjusted for age. Gender differences for all dependent and independent variables were first tested at the bivariate level using the chi(2) test for categorical variables and the t test for age. Secondly, multivariate logistic regression models were fitted. PARTICIPANTS: Persons who were employed, married or cohabiting, aged 25 to 64 years (2148 men and 1185 women). RESULTS: A female excess for all the ill health indicators was found, while there were no gender differences in the health related behaviours analysed. Family demands had a greater impact on health and health related behaviours of female manual workers. In this group household size was positively related to four dependent variables. The adjusted odds ratios (ORs) to living in family units of more than four persons versus living only with the spouse were 2.74 (95%CI=1.22, 6.17) for poor self perceived health status, 3.16 (95%CI=0.98, 10.15) for limiting long standing illness, 3.28 (95%CI=1.45, 7.44) for having at least one chronic condition, and 2.60 (95%CI=1.12, 6.00) for sleeping six hours or less a day. Among female manual workers living with children under 15 years was positively associated with no leisure time physical activity (adjusted OR=2.37; 95% CI=1.43, 3.92) and with sleeping six hours or less a day (adjusted OR=1.91; 95% CI=1.13, 3.32). Living with adults older than 65 years had an unexpected negative relation with poor self perceived health status (adjusted OR=0.33; 95%CI=0.16, 0.66), and with chronic conditions (adjusted OR=0.45; 95%CI=0.24, 0.87) in female manual workers. Among male manual workers living with children under 15 years was positively associated with longstanding limiting illness (adjusted OR=2.44; 95%CI=1.36, 4.38). CONCLUSION: When gender differences in health are analysed, both the paid and the non-paid work should be considered as well as the interaction between these two dimensions, gender and social class. In Catalonia, as probably in Spain and in other countries, private changes such as sharing domestic responsibilities, as well as active public policies for facilitating family care are needed in order to reduce gender health inequalities attributable to the unequal distribution of family demands.

Adult↗

Structure-function relationships in Drosophila melanogaster alcohol dehydrogenase allozymes ADH(S), ADH(F) and ADH(UF), and distantly related forms.

Drosophila melanogaster alcohol dehydrogenase (ADH), a paradigm for gene-enzyme molecular evolution and natural selection studies, presents three main alleloforms (ADHS, ADHF and ADHUF) differing by one or two substitutions that render different biochemical properties to the allelozymes. A three-dimensional molecular model of the three allozymes was built by homology modeling using as a template the available crystal structure of the orthologous D. lebanonensis ADH, which shares a sequence identity of 82.2%. Comparison between D. lebanonensis and D. melanogaster structures showed that there is almost no amino-acid change near the substrate or coenzyme binding sites and that the hydrophobic active site cavity is strictly conserved. Nevertheless, substitutions are not distributed at random in nonconstricted positions, or located in external loops, but they appear clustered mainly in secondary structure elements. From comparisons between D. melanogaster allozymes and with D. simulans, a very closely related species, a model based on changes in the electrostatic potential distribution is presented to explain their differential behavior. The depth of knowledge on Drosophila ADH genetics and kinetics, together with the recently obtained structural information, could provide a better understanding of the mechanisms underlying molecular evolution and population genetics.

Alcohol Dehydrogenase↗

How do types of employment relate to health indicators? Findings from the second European survey on working conditions.

STUDY OBJECTIVE: To investigate the associations of various types of employment with six self reported health indicators, taking into account the part played by demographic variables, individual working conditions and four ecological indicators at the country level. DESIGN: Cross sectional survey (structured interview) of a sample of the active population of 15 European countries aged 15 years or over. Main independent variables were nine types of employment categorised as follows: small employers, full and part time permanent employees, full and part time fixed term employees, full and part time sole traders and full and part time temporary contracts. Main outcome measures were three self reported health related outcomes (job satisfaction, health related absenteeism, and stress) and three self reported health problems (overall fatigue, backache, and muscular pains). Logistic regression and multilevel models were used in the analyses. SETTING: 15 countries of the European Union. PARTICIPANTS: 15 146 employed persons aged 15 or over. MAIN RESULTS: Precarious employment was consistently and positively associated with job dissatisfaction but negatively associated with absenteeism and stress (as compared with full time permanent workers). Fatigue, backache and muscular pains also tended to be positively associated with precarious employment, particularly with full time precarious employment. Small employers reported high percentages of stress and fatigue, but absenteeism was relatively low. Sole traders generally reported high percentages of all outcomes, except for absenteeism, which was low. For each type of employment (except temporary contracts), full time workers tended to report worse health outcomes than part time workers. Patterns were generally consistent across countries. Associations persisted after adjustment for individual level working conditions and were not modified by country level variables. CONCLUSIONS: This study is the first to examine the relations between various types of employment and six health related indicators for all 15 member states of the European Union. Suggestive patterns worthy of further exploration have been found. Standardised definitions of types of underemployment and health related outcomes, more potent epidemiological designs and the inclusion of socioeconomic information (for example, social security systems, incapacity benefit schemes) at the regional level are proposed for inclusion in further research.

Adolescent↗