Benavides Fernando G, Rodrigo Fernando, García Ana M, Lopez-Ruiz Maria, Gil Josep, Boix Pere, Martínez José Miguel
Unitat de Recerca en Salut Laboral, Universidad Pompeu Fabra.
Rev Esp Salud Publica. 2007 Nov-Dec;81(6):615-24. doi: 10.1590/s1135-57272007000600005.
[corrected] The strategic action plans have been the main preventive activities carried out by the Autonomous Community Governments in relation to occupational injuries in Spain since 1999. This study is aimed at evaluating the effectiveness of these plans.
A total of 4,714,080 cases of non-fatal traumatic occupational injuries leading to disability having occured within the 1994-2004 period due to mechanical causes and over-exertion at non-publicly owned service and manufacturing companies were included. Based on the annual incidence rates, the percentage of annual change and the 95% confidence interval (95% CI) were estimated for the periods prior to and following the start-up of the Strategic Action Plans by means of negative binomial regression.
The pattern found followed an upward trend during the periods prior to the start-up of the Strategic Actions Plans, followed by a downward trend as of the start-up of these plans. For example, in Aragon, where the Strategic Action Plan was started up in 999, a +5.3% rise was found within the 1994-1999 period, as compared to a -4.9% decrease during the 2000-2004 period. On the Balearic Islands, which started up their Strategic Action Plan in 2002, the corresponding trend was +5.4% for 1994-2001, as compared to -14% for 2002-2004. However, similar trends were found in Madrid (-3.9% for 2000-2004) or in Galicia (-4.8% for 2000-2004), where there is no record of any specific Strategic Action Plan having been gotten under way during the period under study.
These results do not make it possible to attribute the widespread drop in the non-fatal traumatic occupational injury incidence as of 2000 in Spain to the Strategic Action Plans. Possibly other actions of a general nature which may have had a bearing on all of the Autonomous Communities in the same manner (including those which have not developed their own Strategic Action Plans) might explain this drop in the incidence of the occupational injuries selected in this analysis.
[已修正]自1999年以来，战略行动计划一直是西班牙自治区政府针对职业伤害开展的主要预防活动。本研究旨在评估这些计划的有效性。
纳入了1994 - 2004年期间非公有制服务和制造公司内因机械原因及过度劳累导致致残的4,714,080例非致命性创伤性职业伤害病例。基于年发病率，通过负二项回归估计战略行动计划启动前后各时期的年变化百分比和95%置信区间（95%CI）。
在战略行动计划启动前各时期发现呈上升趋势，自这些计划启动后呈下降趋势。例如，在1999年启动战略行动计划的阿拉贡地区，1994 - 1999年期间上升了5.3%，而2000 - 2004年期间下降了4.9%。在2002年启动战略行动计划的巴利阿里群岛，1994 - 2001年相应趋势为上升5.4%，2002 - 2004年为下降14%。然而，在马德里（2000 - 2004年下降3.9%）或加利西亚（2000 - 2004年下降4.8%）也发现了类似趋势，在研究期间这些地区没有任何具体战略行动计划实施的记录。
这些结果无法将西班牙自2000年以来非致命性创伤性职业伤害发病率的普遍下降归因于战略行动计划。可能是其他具有普遍性质的行动以相同方式影响了所有自治区（包括那些未制定自身战略行动计划的地区），这或许可以解释本分析中所选职业伤害发病率的下降。
