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[Application of the self-evaluation questionnaire of the WHO multimodal strategy to improve the practice of hand hygiene in a tertiary hospital]. [世卫组织多模式战略自评问卷在某三级医院手部卫生实践改进中的应用]
Q4 Medicine Pub Date : 2021-10-15 DOI: 10.12961/aprl.2021.24.04.03
Alejando De Arriba Fernández, Jesús Molina-Cabrillana, Lluís Serra-Majem

Objective: Hand hygiene (HH) is the single most important and effective measure to reduce the risk of healthcare-related infections. However, low compliance with HH indications among healthcare professionals is often low. The objective of this study was to evaluate the implementation of a multimodal strategy to promote HH among healthcare professionals.

Methods: We used the "Application guide of the multimodal strategy of the World Health Organization for the improvement of hand hygiene", which consists of: changes to the system, education and training, evaluation and feedback, workplace reminders, organizational safety climate and monitoring of compliance with HH. The strategy was designed as an intervention study to promote HH in the Maternal and Child Insular University Hospital Complex in the period 2012-2020.

Results: Overall compliance with the HH indications at the end of the study period was 59.2%. The use of alcoholic-based products increased with respect to previous years (p <0.05), reaching 70 liters/1000 hospital admissions in the final year. Healthcare professionals perceived training and accessibility to an alcohol-based preparation at each point of care as the most effective measures for promoting good HH practice.

Conclusions: The implementation of a multimodal intervention significantly improved compliance with handwashing and the use of alcohol-based products among healthcare professionals. Despite having previous training on hand hygiene, HH knowledge among professionals remains incomplete. Prior training followed by time worked are the most important determinants of knowledge and perceptions about hand hygiene.

目的:手部卫生(HH)是降低卫生保健相关感染风险的最重要和最有效的措施。然而,卫生保健专业人员对HH适应症的依从性往往很低。本研究的目的是评估多模式策略在医疗保健专业人员中促进HH的实施情况。方法:采用《世界卫生组织改善手卫生多模式战略应用指南》,包括:制度变革、教育培训、评价反馈、工作场所提醒、组织安全氛围、卫生合规监测等内容。该战略被设计为一项干预研究,旨在促进2012-2020年期间母婴岛大学综合医院的HH。结果:在研究结束时,HH适应症的总体依从性为59.2%。与前几年相比,酒精产品的使用有所增加(p结论:多模式干预的实施显著提高了卫生保健专业人员洗手和使用酒精产品的依从性。尽管以前接受过手部卫生方面的培训,但专业人员的卫生知识仍然不完整。先前的培训之后的工作时间是手卫生知识和观念的最重要决定因素。
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引用次数: 0
[Methodology to evaluate occupational exposure to chemical contaminants at high altitude]. [评价高海拔职业接触化学污染物的方法学]。
Q4 Medicine Pub Date : 2021-10-15 DOI: 10.12961/aprl.2021.24.04.06
Margarita Zamora Saa, Jilberto Zamora-Saa

This study reviews the current method for assessing exposure to chemical contaminants at high altitude, which is based on the use of Threshold Limit Values (TLV). These TLVs were originally established for work performed at sea level, for 8-hour shifts over a 40-hour work week. Our study analyzes the problem for a specific group of Chilean miners working at altitudes above 3000, and for shifts of up to 12 hours a day. We examined different approaches for the evaluation of exposure to chemical contaminants: adjusting the TLV for work at high altitude and calculating inhaled dose. Since minute ventilation changes at different altitudes, we propose using calculated inhaled dose of the chemical contaminant as the method of choice.

本研究回顾了目前基于阈值限制(TLV)的高海拔化学污染物暴露评估方法。这些tlv最初是为在海平面上工作而建立的,每周工作40小时,轮班8小时。我们的研究分析了在海拔3000以上、每天轮班长达12小时的一组智利矿工的问题。我们研究了评估化学污染物暴露的不同方法:调整高海拔工作的TLV和计算吸入剂量。由于不同海拔高度的微小通风变化,我们建议使用计算吸入剂量的化学污染物作为选择方法。
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引用次数: 0
[Vaccine response to SARS-CoV-2 in hospital workers]. [医院工作人员对SARS-CoV-2的疫苗反应]。
Q4 Medicine Pub Date : 2021-10-15 DOI: 10.12961/aprl.2021.24.04.05
Susana Sabater Vidal, Mª Carmen Bellido-Cambrón, Alberto Arnedo-Pena, Mª Isabel Palomares-Gallego, Rosa María Larrea-González, Mario Carballido-Fernández, Rosario Moreno-Muñoz

Introduction: The aim of this study was to measure anti-SARS-CoV-2 immunity of hospital workers after a completed 2-dose Pfizer-BionTech vaccination, and to examine factors potentially associated with immunity status. Side effects of the vaccine were also studied.

Method: This was a cross-sectional study of a representative sample of General University Hospital of Castellon workers, vaccinated with two doses in January and February 2021. We measured IgG antibodies against protein N (IgG-NP), IgM against protein S (IgM-S), and quantitative levles of IgG against protein S (IgG-Quant) one month after the last dose. We obtained information on demographic, risk factors, and vaccine side effects via a self-completed questionnaire. For the statistical analysis we used multiple regression models.

Results: Two hundred seventy-five workers participated (96.8%, 275/284). Positive IgG-Quant, IgM-S, and IgG-NP were 99.6%, 14.9% and 4.4%, respectively. Adjusted IgG-Quant levels increased significantly with obesity, nonsmoking status, positive IgM-S, and/or IgG-NP. The prevalence of IgM-S was higher in males, and associated with the same factors as those for IgG-Quant. Among those with a history of COVD-19 infection, 42.9% did not have IgG-NP. Overall 86.5% of participants had side effects, which were associated with positive IgG-NP, high IgG-Quant levels, younger age, and being female.

Conclusions: All but one participant developed immunity. Those who had suffered from COVID-19 infection had higher antibody levels. A high proportion of participants had mild secondary effects, especially those with previous COVID-19 infection.

本研究的目的是测量医院工作人员在完成2剂辉瑞- biontech疫苗接种后的抗sars - cov -2免疫力,并检查可能与免疫状态相关的因素。还研究了疫苗的副作用。方法:这是一项对卡斯特隆综合大学医院工人代表性样本的横断面研究,这些工人于2021年1月和2月接种了两剂疫苗。最后一次给药一个月后,我们检测了抗蛋白N IgG抗体(IgG- np)、抗蛋白S IgG抗体(IgM-S)和抗蛋白S IgG抗体(IgG- quant)的定量水平。我们通过一份自我填写的问卷获得了人口统计学、危险因素和疫苗副作用的信息。统计分析采用多元回归模型。结果:参与调查的职工275人(96.8%,275/284)。IgG-Quant、IgM-S和IgG-NP阳性率分别为99.6%、14.9%和4.4%。调整后的IgG-Quant水平随着肥胖、不吸烟、IgM-S阳性和/或IgG-NP显著升高。IgM-S的患病率在男性中较高,与IgG-Quant的相关因素相同。在有covid -19感染史的人群中,42.9%的人没有IgG-NP。总体而言,86.5%的参与者有副作用,这些副作用与IgG-NP阳性、IgG-Quant水平高、年龄较小和女性有关。结论:除一人外,所有参与者均产生免疫。感染过新冠病毒的人抗体水平更高。很高比例的参与者有轻微的继发性反应,特别是那些以前感染过COVID-19的人。
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引用次数: 4
[Risk Factors for COVID-19 transmission among healthcare workers]. [COVID-19在医护人员中传播的危险因素]。
Q4 Medicine Pub Date : 2021-10-15 DOI: 10.12961/aprl.2021.24.04.04
Florin Ciorba Ciorba, Javier Flores Benítez, Raul Hernandez Iglesias, Joan Inglés Torruella, Mª Montserrat Olona Cabases

Objective: Frontline healthcare workers are the first line of defense against Covid-19, resulting in a higher risk of infection. The objective of this study was to describe the impact of the SARS-CoV-2 infection and its associated risk factors among professionals working in a healthcare consortium that includes different centers.

Methods: This was a retrospective analytical observational study of 2620 healthcare workers; the project period began with the declaration of the state of alarm in Spain (March 15, 2020) and ended on June 21, 2020. We estimated associations between the independent variables sex, age, seniority, professional category and work location and confirmed COVID-19 as the outcome variable. Bivariate study analysis was based on chi-square test and simple logistic regression with calculation of the odds ratio (OR) and 95% confidence interval (95%CI). Multivariate analysis was performed using multiple logistic regression. Statistical significance was set at p ≤0.05.

Results: All frontline healthcare worker categories were at higher risk than non-patient-facing personnel. Nurses had the highest risk [OR, 14.03 (3.19-61.66)]. With respect to work location, and as compared to non-patient-facing personnel, working in the surgical-medical-hospitalization-clinic [OR 13.43 (1.7-106.12)] and socio-health center [OR 17.77 (2.19-144.04) posed the greatest risks.

Conclusions: The greatest risk of acquiring COVID-19 was among patient-facing healthcare professionals working in areas where COVID-19 was detected among patients admitted for other pathologies. This risk was higher than in those areas designated for the care of COVID-19 patients, possibly due to differences in the use of personal protective equipment.

目的:一线医护人员是防控新冠肺炎的第一道防线,感染风险较高。本研究的目的是描述在包括不同中心的医疗保健联盟中工作的专业人员中SARS-CoV-2感染及其相关危险因素的影响。方法:对2620名医护人员进行回顾性分析观察性研究;项目期间从西班牙宣布进入警戒状态(2020年3月15日)开始,至2020年6月21日结束。我们估计了自变量性别、年龄、资历、专业类别和工作地点之间的关联,并确认COVID-19为结果变量。双变量研究分析基于卡方检验和简单逻辑回归,计算优势比(OR)和95%置信区间(95% ci)。采用多元逻辑回归进行多因素分析。p≤0.05为差异有统计学意义。结果:所有一线医护人员类别的风险均高于非面向患者的人员。护士的风险最高[OR, 14.03(3.19-61.66)]。就工作地点而言,与非面向患者的人员相比,在外科-医疗-住院-诊所[OR 13.43(1.7-106.12)]和社会卫生中心[OR 17.77(2.19-144.04)]工作的风险最大。结论:感染COVID-19的风险最大的是在其他病理入院的患者中检测到COVID-19的地区工作的面向患者的医护人员。这种风险高于那些指定用于照顾COVID-19患者的区域,可能是由于个人防护装备的使用差异。
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引用次数: 1
Herramienta para predecir la gravedad y secuelas de la COVID-19 en sanitarios del entorno de hospitales. El "COVID-19 Occupational Vulnerability Index" 预测COVID-19在医院环境卫生人员中的严重程度和后果的工具。COVID-19职业脆弱性指数
Q4 Medicine Pub Date : 2021-10-15 DOI: 10.12961/aprl.2021.24.04.07
María Teófila Vicente Herrero, A. Fernández-Montero
Este trabajo es un comentario del artículo: Navarro-Font X, Kales SN, Vicente-Herrero MT, Rueda-Garrido JC, Del Campo MT, Reinoso-Barbero L, Fernandez-Montero A. Association Between the "COVID-19 Occupational Vulnerability Index" and COVID-19 Severity and Sequelae Among Hospital Employees. J Occup Environ Med. 2021;63(10):895-900. doi: 10.1097/JOM.0000000000002253.
本文是对文章的评论:Navarro-Font X, Kales SN, Vicente-Herrero MT, Rueda-Garrido JC, del Campo MT, Reinoso-Barbero L, Fernandez-Montero A.“COVID-19职业脆弱性指数”与医院员工COVID-19严重程度和后效之间的关联。约占医学2021;63(10):895-900。doi: 10.1097 / JOM.0000000000002253。
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引用次数: 0
[Lumbar biomechanical risk factors due to manual handling of loads in the distribution of meat products]. [肉类产品配送中人工搬运负荷引起的腰椎生物力学风险因素]。
Q4 Medicine Pub Date : 2021-10-15 DOI: 10.12961/aprl.2021.24.04.02
Carlos Ibarra Villanueva, Pamela Astudillo-Cornejo

Introduction: Identify risk factors for lumbar musculoskeletal disorders (MSD) associated with manual handling (MHL) of meat products in truck loading and unloading activities.

Method: Cross-sectional descriptive observational study with a mixed approach, based on ergonomic analysis of work activity. The 4 workers from the loader and loader-driver positions participated. Kinematic and dynamometric analyzes were performed to determine compression and shear forces and musculoskeletal risk in the lumbar area. Interviews and observations were conducted to analyze tasks and determine the times involved in each operation, type of exposure and the determinants of work activity.

Results: The work context is highly variable during the loading and unloading of the truck, considering the variability at each delivery point the characteristics of the parking lots, weather conditions, the presence of animals and other obstacles during manual transport of the load. The MHL produces forces over 4000 N of disc compression at levels L4-L5 and L5-S1, the initial push and pull forces were 51.2 kg*f and 27.3 kg*f respectively, which shows the risk of MSD. The work activity is determined by the type of working day, the organization of the distribution and the lack of mechanical means to support the loading and unloading of trucks.

Conclusions: The manual handling tasks in this industry are physically very demanding and improving these working conditions represents a significant challenge for prevention.

介绍:确定与卡车装卸肉制品的手工处理(MHL)相关的腰椎肌肉骨骼疾病(MSD)的危险因素。方法:基于工作活动的人体工程学分析,采用混合方法进行横断面描述性观察研究。装载机和装载机司机岗位的4名工人参加。进行运动学和动力学分析以确定腰椎区域的压缩和剪切力以及肌肉骨骼风险。进行了访谈和观察,以分析任务并确定每项操作所涉及的时间、暴露类型和工作活动的决定因素。结果:在卡车装卸过程中,工作环境是高度可变的,考虑到每个交货点的可变性,停车场的特征,天气条件,人工运输过程中动物和其他障碍的存在。MHL在L4-L5和L5-S1水平产生超过4000 N的椎间盘压缩力,初始推力和拉力分别为51.2 kg*f和27.3 kg*f,显示出MSD的风险。工作活动是由工作日的类型、分配的组织和缺乏机械手段来支持卡车装卸决定的。结论:该行业的手工操作任务对体力要求很高,改善这些工作条件是预防的重大挑战。
{"title":"[Lumbar biomechanical risk factors due to manual handling of loads in the distribution of meat products].","authors":"Carlos Ibarra Villanueva,&nbsp;Pamela Astudillo-Cornejo","doi":"10.12961/aprl.2021.24.04.02","DOIUrl":"https://doi.org/10.12961/aprl.2021.24.04.02","url":null,"abstract":"<p><strong>Introduction: </strong>Identify risk factors for lumbar musculoskeletal disorders (MSD) associated with manual handling (MHL) of meat products in truck loading and unloading activities.</p><p><strong>Method: </strong>Cross-sectional descriptive observational study with a mixed approach, based on ergonomic analysis of work activity. The 4 workers from the loader and loader-driver positions participated. Kinematic and dynamometric analyzes were performed to determine compression and shear forces and musculoskeletal risk in the lumbar area. Interviews and observations were conducted to analyze tasks and determine the times involved in each operation, type of exposure and the determinants of work activity.</p><p><strong>Results: </strong>The work context is highly variable during the loading and unloading of the truck, considering the variability at each delivery point the characteristics of the parking lots, weather conditions, the presence of animals and other obstacles during manual transport of the load. The MHL produces forces over 4000 N of disc compression at levels L4-L5 and L5-S1, the initial push and pull forces were 51.2 kg*f and 27.3 kg*f respectively, which shows the risk of MSD. The work activity is determined by the type of working day, the organization of the distribution and the lack of mechanical means to support the loading and unloading of trucks.</p><p><strong>Conclusions: </strong>The manual handling tasks in this industry are physically very demanding and improving these working conditions represents a significant challenge for prevention.</p>","PeriodicalId":38326,"journal":{"name":"Archivos de prevención de riesgos laborales","volume":"24 4","pages":"342-354"},"PeriodicalIF":0.0,"publicationDate":"2021-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39771048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Trastornos musculoesqueléticos y riesgos psicosociales de los técnicos de prevención de riesgos laborales 职业风险预防技术人员的肌肉骨骼疾病和心理社会风险
Q4 Medicine Pub Date : 2021-07-15 DOI: 10.12961/aprl.2021.24.03.09
Fermín Torrano, G. García González
Entrevista con el Dr. Fermín Torrano
采访费尔明·托拉诺博士
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引用次数: 1
[Occupational safety and health management of COVID-19 at a company in the Peruvian fishing sector]. [秘鲁渔业部门一家公司COVID-19职业安全和健康管理]。
Q4 Medicine Pub Date : 2021-07-15 DOI: 10.12961/aprl.2021.24.03.02
Daniel Anderson Solorzano-Aquino, Williams Esteward Castillo-Martínez, Guillermo Segundo Miñan Olivos, Wilson Daniel Símpalo-López

Objective: To evaluate the occupational safety and health management of COVID-19 at a company in the Peruvian fishing sector Methods: The independent variable was occupational safety and health management, defined as the implementation of preventive and control measures in response to COVID-19. The dependent variable was defined as the number of detected COVID-19 cases and test positivity rate. We used a pre- (implementation phase) and post-test (following the implementation phase) study design. We performed a non-parametric inferential analysis to identify any significant pre- and post-test differences and any associations between the variables.

Results: The company initiated a strategy to detect positive cases through the use of serological tests. During the first stage, 2329 tests were conducted, yielding a positivity rate of 71%. Once prevention and control actions were implemented, the positivity rate in August 2020 had decreased to 15.65%,, a statistically significant decrease (p<0.05), as well as its relationship to the measures implemented.

Conclusions: This occupational safety and health intervention significantly reduced the number of COVID-19 cases and positivity rate in this group of workers in the Peruvian fishing sector.

目的:评价秘鲁某渔业企业COVID-19职业安全卫生管理情况方法:以职业安全卫生管理为自变量,定义为COVID-19防控措施的实施情况。因变量定义为新冠肺炎确诊病例数和检测阳性率。我们采用了前(实施阶段)和后测试(实施阶段之后)研究设计。我们进行了非参数推理分析,以确定任何显著的前后测试差异和变量之间的任何关联。结果:该公司启动了一项战略,通过使用血清学测试来检测阳性病例。在第一阶段,进行了2329次检测,阳性率为71%。实施防控措施后,2020年8月的阳性率降至15.65%,有统计学意义的下降(结论:这项职业安全卫生干预措施显著降低了秘鲁渔业部门这组工人的COVID-19病例数和阳性率。
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引用次数: 0
[Safety and Health at Work in Ecuador]. [厄瓜多尔的工作安全与健康]。
Q4 Medicine Pub Date : 2021-07-15 DOI: 10.12961/aprl.2021.24.03.01
Antonio Ramón Gómez García
La República del Ecuador (en adelante Ecuador) puede ser considerada como uno de los países latinoamericanos más privilegiados por sus contrastes geográficos, variedad climática y amplia biodiversidad. La Cordillera de los Andes divide al Ecuador en tres regiones (Amazonía, Sierra y Costa del Pacífico) con marcadas diferencias culturales. Además, existen el conjunto de las Islas Galápagos como cuarta región. La población (2020) es de 17,5 millones de habitantes (51% son mujeres) y la esperanza de vida aumentará significativamente en los próximos años (2010 fue de 75 años y para el 2030 será de 80,5 años). En contraste, los indicadores de salud, económicos y laborales muestran un paronarma preocupante. La tasa de mortalidad en los últimos años ha aumentado ligeramente, en 2014 fue de 4,1 por cada 1000 habitantes y en 2019 fue de 4,3 por cada 1000 habitantes. En 2019, la primera causa de muerte fueron las enfermedades isquémicas del corazón, tanto en mujeres y hombres, y en adultos de 30 a 64 años los accidentes de transporte. Aunque la economía de Ecuador ha mostrado un crecimiento hasta mediados de la última década, la caída del precio internacional del petróleo provocó una recesión económica, con pérdidas de plazas de empleo adecuado desde 2015 y que se mantienen progresivamente en la actualidad. El empleo informal ha crecido rápidamente, situándose en el 46,7% en 2019, y en condiciones precarias de trabajo y ausencia derechos de protección social. Desafortunadamente, la crisis sanitaria por el SARS-CoV-2 ha provocado aún más un entorno desfavorable y retroceso en los objetivos marcados para reducir las desigualdades sociales….
{"title":"[Safety and Health at Work in Ecuador].","authors":"Antonio Ramón Gómez García","doi":"10.12961/aprl.2021.24.03.01","DOIUrl":"https://doi.org/10.12961/aprl.2021.24.03.01","url":null,"abstract":"La República del Ecuador (en adelante Ecuador) puede ser considerada como uno de los países latinoamericanos más privilegiados por sus contrastes geográficos, variedad climática y amplia biodiversidad. La Cordillera de los Andes divide al Ecuador en tres regiones (Amazonía, Sierra y Costa del Pacífico) con marcadas diferencias culturales. Además, existen el conjunto de las Islas Galápagos como cuarta región. La población (2020) es de 17,5 millones de habitantes (51% son mujeres) y la esperanza de vida aumentará significativamente en los próximos años (2010 fue de 75 años y para el 2030 será de 80,5 años). En contraste, los indicadores de salud, económicos y laborales muestran un paronarma preocupante. La tasa de mortalidad en los últimos años ha aumentado ligeramente, en 2014 fue de 4,1 por cada 1000 habitantes y en 2019 fue de 4,3 por cada 1000 habitantes. En 2019, la primera causa de muerte fueron las enfermedades isquémicas del corazón, tanto en mujeres y hombres, y en adultos de 30 a 64 años los accidentes de transporte. Aunque la economía de Ecuador ha mostrado un crecimiento hasta mediados de la última década, la caída del precio internacional del petróleo provocó una recesión económica, con pérdidas de plazas de empleo adecuado desde 2015 y que se mantienen progresivamente en la actualidad. El empleo informal ha crecido rápidamente, situándose en el 46,7% en 2019, y en condiciones precarias de trabajo y ausencia derechos de protección social. Desafortunadamente, la crisis sanitaria por el SARS-CoV-2 ha provocado aún más un entorno desfavorable y retroceso en los objetivos marcados para reducir las desigualdades sociales….","PeriodicalId":38326,"journal":{"name":"Archivos de prevención de riesgos laborales","volume":"24 3","pages":"232-239"},"PeriodicalIF":0.0,"publicationDate":"2021-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39771469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Exámenes europeos. Unión Europea de Médicos Especialistas (UEMS). Sección de Medicina del Trabajo de la UEMS. 欧洲测试。欧洲医学专家联盟(UEMS)。UEMS的职业健康科。
Q4 Medicine Pub Date : 2021-07-15 DOI: 10.12961/aprl.2021.24.03.06
Maria Cruz Rodríguez-Jareño
{"title":"Exámenes europeos. Unión Europea de Médicos Especialistas (UEMS). Sección de Medicina del Trabajo de la UEMS.","authors":"Maria Cruz Rodríguez-Jareño","doi":"10.12961/aprl.2021.24.03.06","DOIUrl":"https://doi.org/10.12961/aprl.2021.24.03.06","url":null,"abstract":"","PeriodicalId":38326,"journal":{"name":"Archivos de prevención de riesgos laborales","volume":"24 3","pages":"300-303"},"PeriodicalIF":0.0,"publicationDate":"2021-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39771474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Archivos de prevención de riesgos laborales
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