Arrizabalaga Baigorri Sara, García López Vega
Unidad Docente de Medicina del Trabajo de Navarra.
Rev Esp Salud Publica. 2017 Jul 7;91:e201707038.
Among the lesions produced by the professional use of the voice since 2007, the Vocal Nodules (VN) are recognized in Spain as an Occupational Disease. With the aim of promoting its notification in Navarre, the Sentinel Program was incorporated in 2013 and, with this study, we seek to verify its efficacy.
The study population were voice professionals reported for dysphonia as sentinel events during the years 2013 to 2015 in Navarre. Its effectiveness was validated by the cumulative incidence of 100,000 workers for each of the years and Positive Predictive Value as an indicator of suspicion. The declaration was verified as an occupational disease.
In the period April 2013 to December, 110 cases were reported, 71 nominal and 39 non-nominal. The annual incidence increased from 9.0 cases per 100,000 to 13.4. Of the cases investigated, 63 were women and 8 men. The mean age was 40.8 years (38.5-43.1 95% CI). 58 cases (81.7%) corresponded to teachers. In 22 of the 71 nodules (31%) and 9 coincidences were notified as an occupational disease. We found a greater presence of nodules in professionals with extra work use of voice (OR 4.2 IC 1.3-14.3) and better evolution of pathologies other than VN (OR = 2.5 CI 1.1-5.8 ). The suspicion was confirmed as occupational in 54 cases (positive predictive value 76.1%).
The centinel program is effective in reporting dysphonia although it is important to highlight the low declaration as occupational disease of the cases detected.
自2007年以来,因职业用嗓导致的病变中,声带小结(VN)在西班牙被认定为职业病。为促进其在纳瓦拉地区的报告,2013年纳入了哨点计划,通过本研究,我们试图验证其有效性。
研究人群为2013年至2015年期间在纳瓦拉地区因嗓音障碍作为哨点事件报告的嗓音职业者。通过每年每10万名工人的累积发病率以及作为怀疑指标的阳性预测值来验证其有效性。该申报被确认为职业病。
在2013年4月至12月期间,报告了110例病例,71例有明确信息,39例无明确信息。年发病率从每10万人9.0例增加到13.4例。在调查的病例中,63例为女性,8例为男性。平均年龄为40.8岁(95%置信区间为38.5 - 43.1)。58例(81.7%)为教师。在71个小结中,22个(31%)以及9个符合情况被报告为职业病。我们发现额外增加嗓音工作的职业者中结节出现的情况更多(比值比4.2,置信区间1.3 - 14.3),且除VN外的其他病症病情好转情况更好(比值比 = 2.5,置信区间1.1 - 5.8)。54例的怀疑被确认为职业性(阳性预测值76.1%)。
哨点计划在报告嗓音障碍方面是有效的,不过重要的是要强调所检测出的病例作为职业病申报率较低。