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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Obstructive sleep apnea-hypopnea syndrome &#40;OSAHS&#41; is a very common respiratory disorder in industrialized societies&#44; and occurs in 24&#37; of men and 9&#37; of women in middle age&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">1</span></a> It consists of repeated episodes of limited airflow or airflow blockage during sleep causing micro-awakenings and intermittent hypoxemia&#46; It has a serious impact on health&#44;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">2</span></a> causing hypertension<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">3</span></a> and cardiovascular disease&#46;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">4&#44;5</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">OSAHS patients often present significant cognitive limitations<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">6</span></a> and a generally poorer quality of life&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">7</span></a> Obesity and poor quality of rest&#44; which are often seen with this disorder&#44; are associated with mood disorders such as anxiety and depression&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">8</span></a> However&#44; one of the most debilitating symptoms of this syndrome is excessive daytime sleepiness&#46; Tiredness&#44; together with loss of alertness and attention deficit&#44; not only makes it difficult for OSAHS patients to function on a daily basis&#44; but also contributes to a general increase in mortality&#44; due to the increased risk of road traffic accidents&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">9</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Only 5&#37;&#8211;9&#37; of patients with OSAHS are diagnosed<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">10</span></a> and the burden on public health services in Western societies is considerable&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">11</span></a> Moreover&#44; OSAHS involves indirect costs that are very difficult to calculate&#44; such as limited ability to work&#44; accidents at work&#44; and loss of productivity&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">12</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Some studies have evaluated work performance in patients with OSAHS&#44; but results have been disputed&#46; The syndrome has been shown to have a negative impact on patients&#8217; ability to concentrate&#44; to organize time&#44; to learn new tasks and to carry out monotonous tasks&#46;<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">13&#44;14</span></a> Another study found that OSAHS&#44; when associated with excessive daytime sleepiness&#44; was detrimental to work performance&#46;<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">15&#44;16</span></a> Despite some methodological limitations&#44; cohort studies have found a higher rate of absenteeism in patients with symptoms of OSAHS&#46;<a class="elsevierStyleCrossRefs" href="#bib0270"><span class="elsevierStyleSup">17&#44;18</span></a> However&#44; no solid conclusions have been drawn regarding the relationship between OSAHS and absenteeism&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">19</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Some authors have reported a relationship between OSAHS symptoms and increased risk of work-related accidents&#46; In a prospective study&#44; Lindberg et al&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">20</span></a> showed a 2-fold increase in the risk of workplace accidents in patients who snored and who had daytime sleepiness vs patients without those symptoms&#46; Other large population studies&#44;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">21</span></a> including professional drivers<a class="elsevierStyleCrossRefs" href="#bib0295"><span class="elsevierStyleSup">22&#44;23</span></a> or rural workers&#44;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">24</span></a> found that some OSAHS symptoms&#44; such as snoring&#44; sleep apneas or daytime sleepiness&#44; evaluated by direct questioning or questionnaires&#44; were associated with a greater risk of accidents in the workplace&#46; However&#44; very few studies have evaluated the rate of work-related accidents in patients with a definitive diagnosis of OSAHS&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">In view of the lack of consensus between studies investigating productivity and work accidents in patients with OSAHS&#44; we designed a cross-sectional&#44; descriptive <span class="elsevierStyleItalic">ex postfacto</span> study of productivity and work accidents in a sample of OSAHS patients vs a group of non-OSAHS individuals&#46; A sleep study was performed in both the clinical group and the control group using the gold standard test&#44; polysomnography&#46; The study hypothesis was that participants in the clinical group would have a higher rate of work-related accidents and absenteeism than the control group&#44; 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The clinical group consisted of 182 patients with a diagnosis of OSAHS&#44; and 71 non-OSAHS subjects were included in the control group&#46; Patients with a diagnosis of other sleep disorders&#44; serious debilitating diseases&#44; alcohol or other drug addictions&#44; or who were receiving treatment with neuroleptics&#44; tranquilizers or other medications that could alter sleep or cause excessive daytime sleepiness&#44; were excluded&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Instruments</span><p id="par0040" class="elsevierStylePara elsevierViewall">Sociodemographic data&#44; general health and working conditions&#44; such as work schedule&#44; number of hours worked&#44; shift work and type of employment contract&#44; were collected by means of a questionnaire completed by all participants&#46; Excessive daytime sleepiness was evaluated on the Epworth sleepiness scale &#40;ESS&#41;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">26</span></a> and the subjective Pittsburgh Sleep Quality Index &#40;PSQI&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">27</span></a> Emotional disorders were evaluated using the Hospital Anxiety and Depression Scale &#40;HADS&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">28</span></a> The sum of the 2 subscales was considered&#44; and a cut-off point of 14 was used to determine psychological distress&#46; The survey included questions aimed at evaluating the number of days of sick leave and the number of work-related accidents in the last 18 months&#46; Impact of disease on productivity was evaluated on the IMPALA scale&#44;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">29</span></a> consisting of 7 items addressing different aspects of the occupational impact of health problems&#44; such as difficulty in following routine work schedules&#44; in working without rest breaks&#44; in avoiding mistakes&#44; and in meeting deadlines&#46; The response scale ranges from 1 &#40;work affected constantly or for most of the time&#41; to 4 &#40;no impact at any time&#41;&#46; The total transformed scale was scored from 0 &#40;poorest productivity possible&#41; to 100 &#40;maximum productivity&#41;&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Procedure</span><p id="par0045" class="elsevierStylePara elsevierViewall">OSAHS was diagnosed from a complete sleep study with conventional polysomnography&#46; The same methodology was used in both clinics&#58; 3 electroencephalogram channels &#40;F4-M1&#44; C4-M1 and O2-M1&#41;&#44; 2 electrooculogram channels&#44; 2 electromyography channels placed under the chin&#44; 1 placed on the anterior tibialis of each leg&#44; and 1 electrocardiogram channel&#46; SaO<span class="elsevierStyleInf">2</span>&#44; pulse and snoring rate were also analyzed&#46; Airflow was measured using a pressure catheter and a thermistor&#44; and chest and abdominal movements were recorded with elastic belts&#46; Sleep studies were analyzed manually by specialists&#44; according to the recommendations of the <span class="elsevierStyleItalic">American Academy of Sleep Medicine</span>&#46;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">30</span></a> SAHS diagnosis was determined using the apnea-hypopnea index &#40;AHI&#41;&#46; Any patient with a score &#8805;5 was considered to have OSAHS&#46; Study participants completed the questionnaire just before beginning their sleep study&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Educational levels were divided into 5 categories &#40;no studies&#44; primary&#44; secondary&#44; technical&#44; and university studies&#41;&#46; Types of occupation were classified according to the International Standard Classification of Occupations &#40;ISCO-08&#41;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">31</span></a> and divided into 10 groups of professions&#46; The presence of other diseases&#44; such as hypertension&#44; diabetes&#44; hypercholesterolemia&#44; and cardiovascular&#44; pulmonary&#44; endocrine and&#47;or neurological diseases&#44; was evaluated in some of the questionnaire items&#46; Co-morbidity was defined as the presence of at least 1 of the above-mentioned diseases&#46; Participants were also asked about their smoking and drinking habits and use of medications&#46; Somatic symptoms of stress were defined as manifestation of at least 1 symptom&#44; such as stomachache&#44; headache&#44; pain or chest tightness&#44; breathlessness or muscle tension&#46; Since the number of days missed from work due to illness did not show a normal distribution&#44; this item was transformed into a qualitative variable&#46; To do this&#44; absenteeism was defined as the number of periods of leave due to illness lasting 30 days or longer in the previous year&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Sample characteristics were expressed as mean and standard deviation&#46; The Pearson chi-squared test was used to compare the clinical group vs the control group for work-related accidents and absenteeism rates&#44; while the Student&#39;s <span class="elsevierStyleItalic">t</span>-test was used to measure the impact of the disease on productivity&#46; All comparisons were two-tailed&#44; with values of <span class="elsevierStyleItalic">P</span>&#60;&#46;05 being taken as significant&#46; To analyze the influence of diagnostic variables and OSAHS symptoms on the incidence of work-related accidents and absenteeism&#44; a logistic regression analysis was used and data were presented as odds ratios &#40;OR&#41; with 95&#37; confidence intervals &#40;CI&#41;&#46; A linear regression model was used to analyze the influence of the study variables on productivity&#46; All tests were performed using SPSS 20&#46;0 statistical software&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">The project was approved by the Clinical Research Ethics Committee of the healthcare areas that participated in the study&#46; Inclusion in the study was fully voluntary&#44; and patients were duly informed about the objectives and signed informed consent&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Results</span><p id="par0065" class="elsevierStylePara elsevierViewall">The characteristics of the 253 study participants&#44; classified according to diagnosis of OSAHS &#40;n&#61;182&#59; AHI&#61;42&#46;6&#177;28&#46;4&#41; or absence of OSAHS &#40;n&#61;71&#59; AHI&#61;2&#46;1&#177;1&#46;7&#41;&#44; are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; The only differences between the OSAHS group and the control group lay in the distribution of sex&#44; BMI and some of the job categories&#44; such as scientific or intellectual professions&#46; The type of working schedule was similar in both study groups&#46; Patients with OSAHS were more frequently hypertensive and had a higher degree of psychological distress than the non-OSAHS control group&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the characteristics of participants with OSAHS and their assessment of daytime sleepiness and perceived quality of sleep&#46; Patients with OSAHS had more excessive daytime sleepiness than the control group &#40;<span class="elsevierStyleItalic">P</span>&#61;&#46;021&#41;&#44; but Pittsburgh scores for poor quality of sleep were similar in both groups &#40;<span class="elsevierStyleItalic">P</span>&#61;&#46;238&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> compares repercussions in the workplace between the OSAHS group and the control group&#46; Both groups had similar rates of work-related accidents&#44; but it is interesting to observe that patients with OSAHS had a significantly higher rate of absenteeism and poorer productivity&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">A logistic regression model was constructed that included at least age&#44; sex&#44; excessive daytime sleepiness&#44; subjective quality of sleep&#44; and OSAHS or control subject&#46; The only variables of interest when evaluating workplace accidents were use of medications&#44; physically stressful work&#44; and social level&#59; the model produced an adjusted <span class="elsevierStyleItalic">R</span><span class="elsevierStyleSup">2</span> of 0&#46;126 &#40;<span class="elsevierStyleItalic">P</span>&#61;&#46;001&#41;&#44; and the only variable that showed an independent association with workplace accidents was physically stressful work &#40;OR&#61;0&#46;347&#59; CI&#58; 0&#46;167&#8211;0&#46;718&#59; <span class="elsevierStyleItalic">P</span>&#61;&#46;004&#41;&#46; With respect to absenteeism&#44; significant variables were&#58; OSAHS or control group subject&#44; and subjective quality of sleep &#40;adjusted <span class="elsevierStyleItalic">R</span><span class="elsevierStyleSup">2</span>&#61;0&#46;045&#59; <span class="elsevierStyleItalic">P</span>&#61;&#46;048&#41;&#46; Notwithstanding&#44; the only factor with an independent influence on work absenteeism was OSAHS subject &#40;OR&#61;2&#46;718&#59; CI&#58; 1&#46;004&#8211;7&#46;356&#59; <span class="elsevierStyleItalic">P</span>&#61;&#46;049&#41;&#46; A linear regression model was used for productivity&#44; and the variables accepted by the model were age&#44; subjective quality of sleep&#44; psychological distress&#44; OSAHS or control subject and AHI&#46; The model showed an adjusted <span class="elsevierStyleItalic">R</span><span class="elsevierStyleSup">2</span> of 0&#46;133&#44; <span class="elsevierStyleItalic">F</span>&#61;7&#46;412 &#40;<span class="elsevierStyleItalic">P</span>&#61;&#46;000&#41;&#44; and there was an independent association between productivity and a diagnosis of OSAHS &#40;<span class="elsevierStyleItalic">&#946;</span> coefficient&#61;0&#46;251&#59; <span class="elsevierStyleItalic">P</span>&#61;&#46;002&#41; and psychological distress &#40;<span class="elsevierStyleItalic">&#946;</span> coefficient&#61;&#8722;0&#46;249&#59; <span class="elsevierStyleItalic">P</span>&#61;&#46;001&#41;&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Discussion</span><p id="par0085" class="elsevierStylePara elsevierViewall">This study found that patients with OSAHS did not have a significantly higher number of work-related accidents&#44; although&#44; compared to the non-OSAHS group&#44; they did have a higher percentage of long-term absenteeism&#44; lower productivity levels&#44; and a high rate of psychological distress&#46; These findings are significant&#44; and confirm that OSAHS is a disease with considerable social and economic repercussions&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">The multivariate analysis corroborated the finding that patients with OSAHS had a lower level of productivity&#46; This result was previously reported by Swanson et al&#46;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">32</span></a> who used an OSAHS symptom questionnaire to show that individuals with a high risk of suffering this disease had problems concentrating and organizing themselves at work&#44; in addition to a loss of productivity&#46; Similarly&#44; Grunstein et al&#46;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">33</span></a> reported that sleepiness associated with the risk of sleep-disordered breathing was the main factor in loss of productivity and performance&#44; although the sample was composed of obese individuals who were consequently more likely to present other sleep disorders associated with obesity&#46; Nena et al&#46;<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">34</span></a> using the Endicott productivity scale&#44; did not find any relationship with severity of OSAHS or with sleep quality&#44; although it should be borne in mind that their sample contained only patients with OSAHS&#46; Thus&#44; very few studies have investigated productivity in OSAHS patients compared to a control group using standardized questionnaires&#46; Moreover&#44; we found that psychological distress led to poorer productivity in patients with OSAHS&#46; There is very little work on this aspect in the scientific literature&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">With regard to days off work due to illness&#44; a greater rate of long-term absenteeism was found in OSAHS patients&#44; in line with the findings of other authors&#46; Sivertsen et al&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">18</span></a> showed that subjects with OSAHS more often took periods of sick leave of longer than 8 weeks&#59; other authors have also suggested that OSAHS is associated with a greater risk of taking sick leave and receiving a disability allowance&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">17</span></a> Various studies have emphasized the importance of sleepiness as a determining factor for work absenteeism&#44;<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">18&#44;32&#44;35</span></a> although some of these have limitations&#46; For example&#44; Sivertsen et al&#46;<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">18&#44;35</span></a> used the Karolinska sleep questionnaire&#44; but did not perform an objective sleep study&#59; Accattoli et al&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">13</span></a> used only polygraph as their sleep study&#44; and only evaluated work performance on the basis of some questions related to difficulties encountered at work&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">The number of work-related accidents in our patients was not significantly higher than in the control group&#46; In line with this study&#44; Karimi et al&#46;<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">36</span></a> found similar work-related accident rates in OSAHS patients compared to healthy participants&#46; In another setting&#44; Accattoli et al&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">13</span></a> compared the rate of work-related accidents in healthy workers to those with a diagnosis of OSAHS and found that administrative workers with severe OSAHS had a higher percentage of work-related accidents compared to controls in the same sector&#44; but it must be emphasized that this group in general had a higher occupational accident rate than non-OSAHS workers in other areas&#46; Workers with respiratory disorders were also found to have a greater risk of work-related accidents&#59;<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">37</span></a> however subjects were classified on the basis of oximetry&#44; a test that is not recommended for a clear diagnosis of OSAHS&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">To conclude&#44; our study was conducted in a large cohort&#44; using rigorous methodology with validated questionnaires for studying work productivity and perceived quality of sleep&#46; Polysomnography was used as the reference test in sleep studies&#46; The most relevant findings are the relationship of OSAHS with low work productivity&#44; increased periods of sick leave lasting longer than 30 days&#44; and a greater degree of psychological distress&#46; These results have a clear application&#44; which should be studied in clinical practices&#44; and demonstrate the involvement of OSAHS in the working life of these patients&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Funding</span><p id="par0110" class="elsevierStylePara elsevierViewall">This study was possible thanks to funding from a Teaching and Research Personnel Training Grant from the <span class="elsevierStyleGrantSponsor" id="gs1">Regional Government of Andalusia</span>&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conflict of Interests</span><p id="par0115" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflict of interests&#46;</p></span></span>"
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            1 => "Workplace accident"
            2 => "Sick leave"
            3 => "Productivity"
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            0 => "S&#237;ndrome de apnea-hipopnea del sue&#241;o"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Obstructive sleep apnea-hypopnea syndrome &#40;OSAHS&#41; has health-related outcomes&#44; but the impact of OSAHS on occupational health has been scarcely studied&#46; The aim of this study was to evaluate the effect of OSAHS on workplace accidents&#44; absenteeism and productivity&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Method</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">One hundred eighty-two OSAHS patients and 71 healthy subjects completed the Epworth Sleepiness Scale&#44; the Pittsburgh Sleep Quality Index and the Spanish IMPALA <span class="elsevierStyleItalic">&#40;Impact of Disease on Work Productivity&#41;</span> index and answered various questions on workplace accidents and sick leave&#46; Participants were classified to an OSAHS group or a non-OSAHS group according to polysomnography results&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Patients with OSAHS had more sick leave lasting longer than 30<span class="elsevierStyleHsp" style=""></span>days &#40;16&#46;6&#37; vs 7&#37;&#44; <span class="elsevierStyleItalic">P</span>&#61;&#46;049&#41; and lower productivity &#40;63&#46;80&#37; vs 83&#46;20&#37;&#44; <span class="elsevierStyleItalic">P</span>&#61;&#46;000&#41; than subjects without OSAHS&#44; although the rate of workplace accidents was similar in both groups &#40;27&#46;4&#37; vs 25&#46;4&#37;&#59; <span class="elsevierStyleItalic">P</span>&#62;&#46;050&#41;&#46; None of the OSAHS-related variables were associated with workplace accidents&#46; A diagnosis of OSAHS was related with absenteeism&#46; Psychological distress and OSAHS were related with productivity&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">OSAHS causes limitations in the working lives of patients and leads to a higher incidence of sick leave and lower productivity&#46; A diagnosis of OSAHS was the variable with most influence on the working lives of patients&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">El s&#237;ndrome de apneas-hipopneas del sue&#241;o &#40;SAHS&#41; provoca consecuencias sobre la salud&#44; pero el impacto del SAHS sobre la salud laboral ha sido escasamente estudiado&#46; El objetivo fue evaluar la influencia del SAHS en la presencia de accidentes laborales&#44; absentismo y productividad laboral&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todo</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Un total de 182 pacientes con SAHS y 71 personas sin SAHS contestaron a la escala de somnolencia de Epworth&#44; el &#237;ndice de calidad de sue&#241;o de Pittsburgh&#44; el &#237;ndice de impacto de la enfermedad en la productividad laboral y algunas preguntas sobre la frecuencia de accidentes laborales y el n&#250;mero de d&#237;as de bajas laboral por enfermedad&#46; Los participantes fueron clasificados mediante polisomnograf&#237;a en un grupo con o sin SAHS&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Los pacientes con SAHS presentaron m&#225;s bajas laborales &#62; 30 d&#237;as &#40;16&#44;6&#37; vs 7&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;049&#41; y una menor productividad laboral &#40;63&#44;80&#37; vs 83&#44;20&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;000&#41; respecto a las personas sin SAHS&#44; aunque la proporci&#243;n de accidentes laborales fue similar &#40;27&#44;4&#37; vs 25&#44;4&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; Ninguna de las variables asociadas al SAHS se relacion&#243; con los accidentes laborales&#46; Se evidenci&#243; una asociaci&#243;n entre el absentismo y el diagn&#243;stico de SAHS&#44; y entre este &#250;ltimo&#44; el distr&#233;s psicol&#243;gico y la productividad laboral&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">El SAHS provoca limitaciones en la vida laboral de los pacientes&#44; con un n&#250;mero m&#225;s elevado de bajas laborales y una menor productividad&#46; El diagn&#243;stico de SAHS fue la variable con mayor influencia en la vida laboral de los pacientes&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Jurado-G&#225;mez B&#44; Guglielmi O&#44; Gude F&#44; Buela-Casal G&#46; Accidentes laborales&#44; absentismo y productividad en pacientes con apneas del sue&#241;o&#46; Arch Bronconeumol&#46; 2015&#59;51&#58;213&#8211;218&#46;</p>"
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          "leyenda" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">BMI&#44; body mass index&#59; NA&#44; not applicable&#59; NS&#44; not significant&#46;</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Data are expressed as absolute numbers and percentages for qualitative variables and as mean&#177;standard deviation for quantitative variables&#46;</p><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Permission has been granted by the publisher&#44; Elsevier B&#46;V&#46;&#44; for the reproduction of this table&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col">Characteristics&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Group</th><th class="td" title="table-head  " align="left" valign="top" scope="col"><span class="elsevierStyleItalic">P</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OSAHS &#40;No&#46;&#61;182&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Controls &#40;No&#46;&#61;71&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Age&#44; years</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">47&#177;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">46&#177;10&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;263&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Sex&#44; men&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">157 &#40;86&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">47 &#40;66&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">BMI</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30&#46;5&#177;5&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&#46;88&#177;4&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Education&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;405&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No studies&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;2&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;2&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Primary&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">55 &#40;30&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20 &#40;28&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Secondary&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42 &#40;23&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;21&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Technical training&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">43 &#40;23&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;16&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>University studies&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36 &#40;19&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22 &#40;31&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Type of work&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Managers&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Professionals&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10 &#40;5&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14 &#40;20&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Technicians and associate professionals&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28 &#40;16&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;11&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Clerical support workers&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;0&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Services and sales workers&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32 &#40;18&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;21&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Skilled agricultural&#44; forestry and fishery workers&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;3&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Craft and related trade workers&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;1&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Plant and machine operators&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">71 &#40;40&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20 &#40;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Elementary occupations&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;9&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11 &#40;15&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Armed forces occupations&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;4&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;1&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Working schedule&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;262&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Full time&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">98 &#40;54&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">44 &#40;62&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Part time&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">57 &#40;31&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18 &#40;25&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Shift work&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25 &#40;13&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;11&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>High alcohol consumption&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19 &#40;10&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;8&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;595&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Smoking habit&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28 &#40;15&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;12&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;120&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Comorbidities&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hypertension&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50 &#40;27&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10 &#40;14&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;024&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Diabetes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;6&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;4&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;474&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hyper-cholesterolemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">51 &#40;28&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19 &#40;26&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;840&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Cardiovascular disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10 &#40;5&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;4&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;681&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Lung disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;3&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;8&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;136&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Endocrine disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;4&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;512&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Neurological disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;2&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;4&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;551&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Habitual use of medications&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">97 &#40;53&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32 &#40;45&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;208&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Psychological distress&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">87 &#40;48&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23 &#40;32&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                0 => "xTab767370.png"
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          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Sociodemographic and Clinical Characteristics of Study Participants&#46;</p>"
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      1 => array:7 [
        "identificador" => "tbl0010"
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        "tipo" => "MULTIMEDIATABLA"
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        "tabla" => array:2 [
          "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Data are expressed as absolute numbers and percentages for qualitative variables and as mean&#177;standard deviation for quantitative variables&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col">Variables&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Group</th><th class="td" title="table-head  " align="left" valign="top" scope="col"><span class="elsevierStyleItalic">P</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OSAHS &#40;No&#46;&#61;182&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Control &#40;No&#46;&#61;71&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Physically stressful work&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">99 &#40;60&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40 &#40;57&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;608&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">51 &#40;33&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;22&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;095&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Excessive daytime sleepiness&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#46;3&#177;5&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#46;55&#177;4&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;021&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Subjective quality of sleep &#40;Pittsburgh index&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;9&#177;3&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;3&#177;3&#46;72&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;238&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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        "tipo" => "MULTIMEDIATABLA"
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        "tabla" => array:2 [
          "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Data are expressed as absolute numbers and percentages for qualitative variables and as mean&#177;standard deviation for quantitative variables&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col">Variables&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Control &#40;No&#46;&#61;71&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Work-related accidents&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">49 &#40;27&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18 &#40;25&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;745&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Absenteeism due to disease&#44; number of sick leaves&#62;30 days&#47;year&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30 &#40;16&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;049&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Impact of disease on work productivity &#40;IMPALA scale&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">63&#177;33&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">83&#177;21&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Comparison of Work-related Accidents&#44; Absenteeism and Work Productivity of Subjects With and Without OSAHS&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
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                  "contribucion" => array:1 [
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            3 => array:3 [
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            4 => array:3 [
              "identificador" => "bib0210"
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              "referencia" => array:1 [
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                            1 => "M&#46;C&#46; Fernandez-Marin"
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              "etiqueta" => "6"
              "referencia" => array:1 [
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                  "contribucion" => array:1 [
                    0 => array:2 [
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                      "autores" => array:1 [
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                            0 => "A&#46;I&#46; S&#225;nchez"
                            1 => "P&#46; Mart&#237;nez"
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                            3 => "W&#46;A&#46; Bardwell"
                            4 => "G&#46; Buela-Casal"
                          ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.smrv.2008.07.002"
                      "Revista" => array:6 [
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                        "paginaInicial" => "223"
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Original Article
Workplace Accidents, Absenteeism and Productivity in Patients With Sleep Apnea
Accidentes laborales, absentismo y productividad en pacientes con apneas del sueño
Bernabé Jurado-Gámeza,b, Ottavia Guglielmic,
Corresponding author
, Francisco Guded, Gualberto Buela-Casalc
a Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
b Unidad del Sueño, UGC Neumología, Hospital Universitario Reina Sofía, Córdoba, Spain
c Laboratorio de Psicofisiología, Centro de Investigación Mente, Cerebro y Comportamiento (CIMCYC), Facultad de Psicología, Universidad de Granada, Granada, Spain
d Unidad de Epidemiologia Clínica, Hospital Universitario de Santiago de Compostela, Santiago de Compostela, La Coruña, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Obstructive sleep apnea-hypopnea syndrome &#40;OSAHS&#41; is a very common respiratory disorder in industrialized societies&#44; and occurs in 24&#37; of men and 9&#37; of women in middle age&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">1</span></a> It consists of repeated episodes of limited airflow or airflow blockage during sleep causing micro-awakenings and intermittent hypoxemia&#46; It has a serious impact on health&#44;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">2</span></a> causing hypertension<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">3</span></a> and cardiovascular disease&#46;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">4&#44;5</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">OSAHS patients often present significant cognitive limitations<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">6</span></a> and a generally poorer quality of life&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">7</span></a> Obesity and poor quality of rest&#44; which are often seen with this disorder&#44; are associated with mood disorders such as anxiety and depression&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">8</span></a> However&#44; one of the most debilitating symptoms of this syndrome is excessive daytime sleepiness&#46; Tiredness&#44; together with loss of alertness and attention deficit&#44; not only makes it difficult for OSAHS patients to function on a daily basis&#44; but also contributes to a general increase in mortality&#44; due to the increased risk of road traffic accidents&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">9</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Only 5&#37;&#8211;9&#37; of patients with OSAHS are diagnosed<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">10</span></a> and the burden on public health services in Western societies is considerable&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">11</span></a> Moreover&#44; OSAHS involves indirect costs that are very difficult to calculate&#44; such as limited ability to work&#44; accidents at work&#44; and loss of productivity&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">12</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Some studies have evaluated work performance in patients with OSAHS&#44; but results have been disputed&#46; The syndrome has been shown to have a negative impact on patients&#8217; ability to concentrate&#44; to organize time&#44; to learn new tasks and to carry out monotonous tasks&#46;<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">13&#44;14</span></a> Another study found that OSAHS&#44; when associated with excessive daytime sleepiness&#44; was detrimental to work performance&#46;<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">15&#44;16</span></a> Despite some methodological limitations&#44; cohort studies have found a higher rate of absenteeism in patients with symptoms of OSAHS&#46;<a class="elsevierStyleCrossRefs" href="#bib0270"><span class="elsevierStyleSup">17&#44;18</span></a> However&#44; no solid conclusions have been drawn regarding the relationship between OSAHS and absenteeism&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">19</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Some authors have reported a relationship between OSAHS symptoms and increased risk of work-related accidents&#46; In a prospective study&#44; Lindberg et al&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">20</span></a> showed a 2-fold increase in the risk of workplace accidents in patients who snored and who had daytime sleepiness vs patients without those symptoms&#46; Other large population studies&#44;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">21</span></a> including professional drivers<a class="elsevierStyleCrossRefs" href="#bib0295"><span class="elsevierStyleSup">22&#44;23</span></a> or rural workers&#44;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">24</span></a> found that some OSAHS symptoms&#44; such as snoring&#44; sleep apneas or daytime sleepiness&#44; evaluated by direct questioning or questionnaires&#44; were associated with a greater risk of accidents in the workplace&#46; However&#44; very few studies have evaluated the rate of work-related accidents in patients with a definitive diagnosis of OSAHS&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">In view of the lack of consensus between studies investigating productivity and work accidents in patients with OSAHS&#44; we designed a cross-sectional&#44; descriptive <span class="elsevierStyleItalic">ex postfacto</span> study of productivity and work accidents in a sample of OSAHS patients vs a group of non-OSAHS individuals&#46; A sleep study was performed in both the clinical group and the control group using the gold standard test&#44; polysomnography&#46; The study hypothesis was that participants in the clinical group would have a higher rate of work-related accidents and absenteeism than the control group&#44; and that OSAHS patients would have poorer productivity than healthy subjects&#46; This article was written following the Hartley guidelines&#46;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">25</span></a></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><p id="par0035" class="elsevierStylePara elsevierViewall">Data for this study were collected between 2010 and 2012 in 2 sleep units in hospitals in the north and in the south of Spain&#46; The sample comprised 259 individuals who attended the sleep unit and underwent consecutive polysomnography studies&#46; Participants were actively employed or had been unemployed for up to 6 months&#46; All participants signed informed consent&#59; only 6 individuals refused to take part in the study&#46; Of the remaining 253 subjects&#44; 204 were men and 49 were women&#44; with ages ranging from 22 to 65 years&#44; mean 46&#46;85&#177;9&#46;5 years&#46; The clinical group consisted of 182 patients with a diagnosis of OSAHS&#44; and 71 non-OSAHS subjects were included in the control group&#46; Patients with a diagnosis of other sleep disorders&#44; serious debilitating diseases&#44; alcohol or other drug addictions&#44; or who were receiving treatment with neuroleptics&#44; tranquilizers or other medications that could alter sleep or cause excessive daytime sleepiness&#44; were excluded&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Instruments</span><p id="par0040" class="elsevierStylePara elsevierViewall">Sociodemographic data&#44; general health and working conditions&#44; such as work schedule&#44; number of hours worked&#44; shift work and type of employment contract&#44; were collected by means of a questionnaire completed by all participants&#46; Excessive daytime sleepiness was evaluated on the Epworth sleepiness scale &#40;ESS&#41;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">26</span></a> and the subjective Pittsburgh Sleep Quality Index &#40;PSQI&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">27</span></a> Emotional disorders were evaluated using the Hospital Anxiety and Depression Scale &#40;HADS&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">28</span></a> The sum of the 2 subscales was considered&#44; and a cut-off point of 14 was used to determine psychological distress&#46; The survey included questions aimed at evaluating the number of days of sick leave and the number of work-related accidents in the last 18 months&#46; Impact of disease on productivity was evaluated on the IMPALA scale&#44;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">29</span></a> consisting of 7 items addressing different aspects of the occupational impact of health problems&#44; such as difficulty in following routine work schedules&#44; in working without rest breaks&#44; in avoiding mistakes&#44; and in meeting deadlines&#46; The response scale ranges from 1 &#40;work affected constantly or for most of the time&#41; to 4 &#40;no impact at any time&#41;&#46; The total transformed scale was scored from 0 &#40;poorest productivity possible&#41; to 100 &#40;maximum productivity&#41;&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Procedure</span><p id="par0045" class="elsevierStylePara elsevierViewall">OSAHS was diagnosed from a complete sleep study with conventional polysomnography&#46; The same methodology was used in both clinics&#58; 3 electroencephalogram channels &#40;F4-M1&#44; C4-M1 and O2-M1&#41;&#44; 2 electrooculogram channels&#44; 2 electromyography channels placed under the chin&#44; 1 placed on the anterior tibialis of each leg&#44; and 1 electrocardiogram channel&#46; SaO<span class="elsevierStyleInf">2</span>&#44; pulse and snoring rate were also analyzed&#46; Airflow was measured using a pressure catheter and a thermistor&#44; and chest and abdominal movements were recorded with elastic belts&#46; Sleep studies were analyzed manually by specialists&#44; according to the recommendations of the <span class="elsevierStyleItalic">American Academy of Sleep Medicine</span>&#46;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">30</span></a> SAHS diagnosis was determined using the apnea-hypopnea index &#40;AHI&#41;&#46; Any patient with a score &#8805;5 was considered to have OSAHS&#46; Study participants completed the questionnaire just before beginning their sleep study&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Educational levels were divided into 5 categories &#40;no studies&#44; primary&#44; secondary&#44; technical&#44; and university studies&#41;&#46; Types of occupation were classified according to the International Standard Classification of Occupations &#40;ISCO-08&#41;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">31</span></a> and divided into 10 groups of professions&#46; The presence of other diseases&#44; such as hypertension&#44; diabetes&#44; hypercholesterolemia&#44; and cardiovascular&#44; pulmonary&#44; endocrine and&#47;or neurological diseases&#44; was evaluated in some of the questionnaire items&#46; Co-morbidity was defined as the presence of at least 1 of the above-mentioned diseases&#46; Participants were also asked about their smoking and drinking habits and use of medications&#46; Somatic symptoms of stress were defined as manifestation of at least 1 symptom&#44; such as stomachache&#44; headache&#44; pain or chest tightness&#44; breathlessness or muscle tension&#46; Since the number of days missed from work due to illness did not show a normal distribution&#44; this item was transformed into a qualitative variable&#46; To do this&#44; absenteeism was defined as the number of periods of leave due to illness lasting 30 days or longer in the previous year&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Sample characteristics were expressed as mean and standard deviation&#46; The Pearson chi-squared test was used to compare the clinical group vs the control group for work-related accidents and absenteeism rates&#44; while the Student&#39;s <span class="elsevierStyleItalic">t</span>-test was used to measure the impact of the disease on productivity&#46; All comparisons were two-tailed&#44; with values of <span class="elsevierStyleItalic">P</span>&#60;&#46;05 being taken as significant&#46; To analyze the influence of diagnostic variables and OSAHS symptoms on the incidence of work-related accidents and absenteeism&#44; a logistic regression analysis was used and data were presented as odds ratios &#40;OR&#41; with 95&#37; confidence intervals &#40;CI&#41;&#46; A linear regression model was used to analyze the influence of the study variables on productivity&#46; All tests were performed using SPSS 20&#46;0 statistical software&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">The project was approved by the Clinical Research Ethics Committee of the healthcare areas that participated in the study&#46; Inclusion in the study was fully voluntary&#44; and patients were duly informed about the objectives and signed informed consent&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Results</span><p id="par0065" class="elsevierStylePara elsevierViewall">The characteristics of the 253 study participants&#44; classified according to diagnosis of OSAHS &#40;n&#61;182&#59; AHI&#61;42&#46;6&#177;28&#46;4&#41; or absence of OSAHS &#40;n&#61;71&#59; AHI&#61;2&#46;1&#177;1&#46;7&#41;&#44; are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; The only differences between the OSAHS group and the control group lay in the distribution of sex&#44; BMI and some of the job categories&#44; such as scientific or intellectual professions&#46; The type of working schedule was similar in both study groups&#46; Patients with OSAHS were more frequently hypertensive and had a higher degree of psychological distress than the non-OSAHS control group&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the characteristics of participants with OSAHS and their assessment of daytime sleepiness and perceived quality of sleep&#46; Patients with OSAHS had more excessive daytime sleepiness than the control group &#40;<span class="elsevierStyleItalic">P</span>&#61;&#46;021&#41;&#44; but Pittsburgh scores for poor quality of sleep were similar in both groups &#40;<span class="elsevierStyleItalic">P</span>&#61;&#46;238&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> compares repercussions in the workplace between the OSAHS group and the control group&#46; Both groups had similar rates of work-related accidents&#44; but it is interesting to observe that patients with OSAHS had a significantly higher rate of absenteeism and poorer productivity&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">A logistic regression model was constructed that included at least age&#44; sex&#44; excessive daytime sleepiness&#44; subjective quality of sleep&#44; and OSAHS or control subject&#46; The only variables of interest when evaluating workplace accidents were use of medications&#44; physically stressful work&#44; and social level&#59; the model produced an adjusted <span class="elsevierStyleItalic">R</span><span class="elsevierStyleSup">2</span> of 0&#46;126 &#40;<span class="elsevierStyleItalic">P</span>&#61;&#46;001&#41;&#44; and the only variable that showed an independent association with workplace accidents was physically stressful work &#40;OR&#61;0&#46;347&#59; CI&#58; 0&#46;167&#8211;0&#46;718&#59; <span class="elsevierStyleItalic">P</span>&#61;&#46;004&#41;&#46; With respect to absenteeism&#44; significant variables were&#58; OSAHS or control group subject&#44; and subjective quality of sleep &#40;adjusted <span class="elsevierStyleItalic">R</span><span class="elsevierStyleSup">2</span>&#61;0&#46;045&#59; <span class="elsevierStyleItalic">P</span>&#61;&#46;048&#41;&#46; Notwithstanding&#44; the only factor with an independent influence on work absenteeism was OSAHS subject &#40;OR&#61;2&#46;718&#59; CI&#58; 1&#46;004&#8211;7&#46;356&#59; <span class="elsevierStyleItalic">P</span>&#61;&#46;049&#41;&#46; A linear regression model was used for productivity&#44; and the variables accepted by the model were age&#44; subjective quality of sleep&#44; psychological distress&#44; OSAHS or control subject and AHI&#46; The model showed an adjusted <span class="elsevierStyleItalic">R</span><span class="elsevierStyleSup">2</span> of 0&#46;133&#44; <span class="elsevierStyleItalic">F</span>&#61;7&#46;412 &#40;<span class="elsevierStyleItalic">P</span>&#61;&#46;000&#41;&#44; and there was an independent association between productivity and a diagnosis of OSAHS &#40;<span class="elsevierStyleItalic">&#946;</span> coefficient&#61;0&#46;251&#59; <span class="elsevierStyleItalic">P</span>&#61;&#46;002&#41; and psychological distress &#40;<span class="elsevierStyleItalic">&#946;</span> coefficient&#61;&#8722;0&#46;249&#59; <span class="elsevierStyleItalic">P</span>&#61;&#46;001&#41;&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Discussion</span><p id="par0085" class="elsevierStylePara elsevierViewall">This study found that patients with OSAHS did not have a significantly higher number of work-related accidents&#44; although&#44; compared to the non-OSAHS group&#44; they did have a higher percentage of long-term absenteeism&#44; lower productivity levels&#44; and a high rate of psychological distress&#46; These findings are significant&#44; and confirm that OSAHS is a disease with considerable social and economic repercussions&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">The multivariate analysis corroborated the finding that patients with OSAHS had a lower level of productivity&#46; This result was previously reported by Swanson et al&#46;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">32</span></a> who used an OSAHS symptom questionnaire to show that individuals with a high risk of suffering this disease had problems concentrating and organizing themselves at work&#44; in addition to a loss of productivity&#46; Similarly&#44; Grunstein et al&#46;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">33</span></a> reported that sleepiness associated with the risk of sleep-disordered breathing was the main factor in loss of productivity and performance&#44; although the sample was composed of obese individuals who were consequently more likely to present other sleep disorders associated with obesity&#46; Nena et al&#46;<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">34</span></a> using the Endicott productivity scale&#44; did not find any relationship with severity of OSAHS or with sleep quality&#44; although it should be borne in mind that their sample contained only patients with OSAHS&#46; Thus&#44; very few studies have investigated productivity in OSAHS patients compared to a control group using standardized questionnaires&#46; Moreover&#44; we found that psychological distress led to poorer productivity in patients with OSAHS&#46; There is very little work on this aspect in the scientific literature&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">With regard to days off work due to illness&#44; a greater rate of long-term absenteeism was found in OSAHS patients&#44; in line with the findings of other authors&#46; Sivertsen et al&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">18</span></a> showed that subjects with OSAHS more often took periods of sick leave of longer than 8 weeks&#59; other authors have also suggested that OSAHS is associated with a greater risk of taking sick leave and receiving a disability allowance&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">17</span></a> Various studies have emphasized the importance of sleepiness as a determining factor for work absenteeism&#44;<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">18&#44;32&#44;35</span></a> although some of these have limitations&#46; For example&#44; Sivertsen et al&#46;<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">18&#44;35</span></a> used the Karolinska sleep questionnaire&#44; but did not perform an objective sleep study&#59; Accattoli et al&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">13</span></a> used only polygraph as their sleep study&#44; and only evaluated work performance on the basis of some questions related to difficulties encountered at work&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">The number of work-related accidents in our patients was not significantly higher than in the control group&#46; In line with this study&#44; Karimi et al&#46;<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">36</span></a> found similar work-related accident rates in OSAHS patients compared to healthy participants&#46; In another setting&#44; Accattoli et al&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">13</span></a> compared the rate of work-related accidents in healthy workers to those with a diagnosis of OSAHS and found that administrative workers with severe OSAHS had a higher percentage of work-related accidents compared to controls in the same sector&#44; but it must be emphasized that this group in general had a higher occupational accident rate than non-OSAHS workers in other areas&#46; Workers with respiratory disorders were also found to have a greater risk of work-related accidents&#59;<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">37</span></a> however subjects were classified on the basis of oximetry&#44; a test that is not recommended for a clear diagnosis of OSAHS&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">To conclude&#44; our study was conducted in a large cohort&#44; using rigorous methodology with validated questionnaires for studying work productivity and perceived quality of sleep&#46; Polysomnography was used as the reference test in sleep studies&#46; The most relevant findings are the relationship of OSAHS with low work productivity&#44; increased periods of sick leave lasting longer than 30 days&#44; and a greater degree of psychological distress&#46; These results have a clear application&#44; which should be studied in clinical practices&#44; and demonstrate the involvement of OSAHS in the working life of these patients&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Funding</span><p id="par0110" class="elsevierStylePara elsevierViewall">This study was possible thanks to funding from a Teaching and Research Personnel Training Grant from the <span class="elsevierStyleGrantSponsor" id="gs1">Regional Government of Andalusia</span>&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conflict of Interests</span><p id="par0115" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflict of interests&#46;</p></span></span>"
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    "fechaRecibido" => "2014-01-02"
    "fechaAceptado" => "2014-07-02"
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          "clase" => "keyword"
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            0 => "Obstructive sleep apnea-hypopnea syndrome"
            1 => "Workplace accident"
            2 => "Sick leave"
            3 => "Productivity"
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          "palabras" => array:4 [
            0 => "S&#237;ndrome de apnea-hipopnea del sue&#241;o"
            1 => "Accidentes laborales"
            2 => "D&#237;as de baja"
            3 => "Productividad laboral"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Obstructive sleep apnea-hypopnea syndrome &#40;OSAHS&#41; has health-related outcomes&#44; but the impact of OSAHS on occupational health has been scarcely studied&#46; The aim of this study was to evaluate the effect of OSAHS on workplace accidents&#44; absenteeism and productivity&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Method</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">One hundred eighty-two OSAHS patients and 71 healthy subjects completed the Epworth Sleepiness Scale&#44; the Pittsburgh Sleep Quality Index and the Spanish IMPALA <span class="elsevierStyleItalic">&#40;Impact of Disease on Work Productivity&#41;</span> index and answered various questions on workplace accidents and sick leave&#46; Participants were classified to an OSAHS group or a non-OSAHS group according to polysomnography results&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Patients with OSAHS had more sick leave lasting longer than 30<span class="elsevierStyleHsp" style=""></span>days &#40;16&#46;6&#37; vs 7&#37;&#44; <span class="elsevierStyleItalic">P</span>&#61;&#46;049&#41; and lower productivity &#40;63&#46;80&#37; vs 83&#46;20&#37;&#44; <span class="elsevierStyleItalic">P</span>&#61;&#46;000&#41; than subjects without OSAHS&#44; although the rate of workplace accidents was similar in both groups &#40;27&#46;4&#37; vs 25&#46;4&#37;&#59; <span class="elsevierStyleItalic">P</span>&#62;&#46;050&#41;&#46; None of the OSAHS-related variables were associated with workplace accidents&#46; A diagnosis of OSAHS was related with absenteeism&#46; Psychological distress and OSAHS were related with productivity&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">OSAHS causes limitations in the working lives of patients and leads to a higher incidence of sick leave and lower productivity&#46; A diagnosis of OSAHS was the variable with most influence on the working lives of patients&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">El s&#237;ndrome de apneas-hipopneas del sue&#241;o &#40;SAHS&#41; provoca consecuencias sobre la salud&#44; pero el impacto del SAHS sobre la salud laboral ha sido escasamente estudiado&#46; El objetivo fue evaluar la influencia del SAHS en la presencia de accidentes laborales&#44; absentismo y productividad laboral&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todo</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Un total de 182 pacientes con SAHS y 71 personas sin SAHS contestaron a la escala de somnolencia de Epworth&#44; el &#237;ndice de calidad de sue&#241;o de Pittsburgh&#44; el &#237;ndice de impacto de la enfermedad en la productividad laboral y algunas preguntas sobre la frecuencia de accidentes laborales y el n&#250;mero de d&#237;as de bajas laboral por enfermedad&#46; Los participantes fueron clasificados mediante polisomnograf&#237;a en un grupo con o sin SAHS&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Los pacientes con SAHS presentaron m&#225;s bajas laborales &#62; 30 d&#237;as &#40;16&#44;6&#37; vs 7&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;049&#41; y una menor productividad laboral &#40;63&#44;80&#37; vs 83&#44;20&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;000&#41; respecto a las personas sin SAHS&#44; aunque la proporci&#243;n de accidentes laborales fue similar &#40;27&#44;4&#37; vs 25&#44;4&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; Ninguna de las variables asociadas al SAHS se relacion&#243; con los accidentes laborales&#46; Se evidenci&#243; una asociaci&#243;n entre el absentismo y el diagn&#243;stico de SAHS&#44; y entre este &#250;ltimo&#44; el distr&#233;s psicol&#243;gico y la productividad laboral&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">El SAHS provoca limitaciones en la vida laboral de los pacientes&#44; con un n&#250;mero m&#225;s elevado de bajas laborales y una menor productividad&#46; El diagn&#243;stico de SAHS fue la variable con mayor influencia en la vida laboral de los pacientes&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Jurado-G&#225;mez B&#44; Guglielmi O&#44; Gude F&#44; Buela-Casal G&#46; Accidentes laborales&#44; absentismo y productividad en pacientes con apneas del sue&#241;o&#46; Arch Bronconeumol&#46; 2015&#59;51&#58;213&#8211;218&#46;</p>"
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          "leyenda" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">BMI&#44; body mass index&#59; NA&#44; not applicable&#59; NS&#44; not significant&#46;</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Data are expressed as absolute numbers and percentages for qualitative variables and as mean&#177;standard deviation for quantitative variables&#46;</p><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Permission has been granted by the publisher&#44; Elsevier B&#46;V&#46;&#44; for the reproduction of this table&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col">Characteristics&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Group</th><th class="td" title="table-head  " align="left" valign="top" scope="col"><span class="elsevierStyleItalic">P</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OSAHS &#40;No&#46;&#61;182&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Controls &#40;No&#46;&#61;71&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Age&#44; years</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">47&#177;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">46&#177;10&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;263&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Sex&#44; men&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">157 &#40;86&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">47 &#40;66&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">BMI</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30&#46;5&#177;5&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&#46;88&#177;4&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Education&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;405&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No studies&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;2&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;2&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Primary&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">55 &#40;30&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20 &#40;28&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Secondary&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42 &#40;23&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;21&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Technical training&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">43 &#40;23&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;16&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>University studies&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36 &#40;19&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22 &#40;31&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Type of work&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Managers&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Professionals&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10 &#40;5&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14 &#40;20&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Technicians and associate professionals&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28 &#40;16&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;11&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Clerical support workers&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;0&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Services and sales workers&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32 &#40;18&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;21&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Skilled agricultural&#44; forestry and fishery workers&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;3&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Craft and related trade workers&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;1&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Plant and machine operators&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">71 &#40;40&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20 &#40;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Elementary occupations&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;9&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11 &#40;15&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Armed forces occupations&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;4&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;1&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Working schedule&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;262&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Full time&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">98 &#40;54&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">44 &#40;62&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Part time&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">57 &#40;31&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18 &#40;25&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Shift work&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25 &#40;13&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;11&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>High alcohol consumption&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19 &#40;10&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;8&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;595&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Smoking habit&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28 &#40;15&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;12&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;120&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Comorbidities&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hypertension&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50 &#40;27&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10 &#40;14&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;024&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Diabetes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;6&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;4&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;474&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hyper-cholesterolemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">51 &#40;28&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19 &#40;26&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;840&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Cardiovascular disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10 &#40;5&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;4&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;681&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Lung disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;3&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;8&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;136&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Endocrine disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;4&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;512&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Neurological disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;2&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;4&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;551&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Habitual use of medications&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">97 &#40;53&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32 &#40;45&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;208&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Psychological distress&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">87 &#40;48&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23 &#40;32&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col">Variables&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Group</th><th class="td" title="table-head  " align="left" valign="top" scope="col"><span class="elsevierStyleItalic">P</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OSAHS &#40;No&#46;&#61;182&#41;&nbsp;\t\t\t\t\t\t\n
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        "texto" => "<p id="par0125" class="elsevierStylePara elsevierViewall">This study was performed thanks to a predoctoral Research Personnel Training Grant in underdeveloped areas of knowledge from the Department of Economics&#44; Science and Employment of the Regional Government of Andalusia&#44; awarded to Ottavia Guglielmi from the Department of Personality&#44; Evaluation and Psychological Treatment of the Faculty of Psychology&#44; Universidad de Granada&#44; Spain&#46;</p>"
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Article information
ISSN: 15792129
Original language: English
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