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. 2009 Jul-Aug;124 Suppl 1(Suppl 1):180-7.
doi: 10.1177/00333549091244S120.

Effectiveness of occupational injury prevention policies in Spain

Fernando G Benavides  1 , Ana M García, Maria Lopez-Ruiz, Josep Gil, Pere Boix, José Miguel Martinez, Fernando Rodrigo
Affiliations

Effectiveness of occupational injury prevention policies in Spain

Fernando G Benavides et al. Public Health Rep. 2009 Jul-Aug.

Abstract

Objective: We examined the effectiveness of preventive interventions against occupational injuries (preferential action plans [PAPs]) developed by Spanish regional governments starting in 2000.

Methods: We included 3,252,028 occupational injuries with sick leave due to mechanical causes occurring between 1994 and 2004 in manufacturing and private service companies. Time trends for occupational injury rates were estimated before and after implementation of PAPs in each region, with a control group defined for those regions in which no PAPs were implemented (e.g., Galicia, Madrid, and Cataluña). We determined annual change percentages and their 95% confidence intervals (CIs) through a negative binomial regression model. Regions were grouped into three categories according to formal quality of their PAPs.

Results: The regions with the best PAPs (Andalucia, Aragon, Valencia, and Murcia) showed annually increasing occupational injury rates (2.3%, 95% CI -2.5, 7.4) before implementation of PAPs. After PAPs were implemented, occupational injury rates decreased significantly to -7.4% (95% CI -10.2, -4.5). Similar results were also found for regions with PAPs of lower quality and even for regions that didn't implement a PAP (control group). These results did not vary substantially in stratified analysis by gender, age, type of contract, or length of sick leave.

Conclusion: PAPs are not related to a general decline in occupational injury rates in Spain starting in 2000. Reinforcement of Spanish health and safety regulations and labor inspection activities since 2000, resulting from a social agreement between central government and social agents, remains an alternative hypothesis requiring additional research.

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Figures

Figure 1
Figure 1
Nonfatal occupational injury rates in manufacturing (a) and private service companies (b) for each of the four Spanish regions, grouped according to the formal quality (excellent, good, and fair) of their PAPs and a control group without a PAP, Spain, 1994–2004 PAP = preferential action plan
Figure 2
Figure 2
Spanish regions grouped according to the formal quality (excellent, good, and fair) of their PAPs and a control group without a PAPa aComparison of annual change percentages (with 95% confidence intervals) for mechanical nonfatal occupational injuries before and after starting PAPs in manufacturing and private service companies PAP = preferential action plan
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