Peru has one of the highest informal employment rates in Latin America (73%). Previous studies have shown a higher prevalence of poor self-perceived health (P-SPH) in informal than in formal workers. The aim of this study was to analyze the role of working conditions in the association between informality and SPH in an urban working population in Peru. We conducted a cross-sectional study based on 3098 workers participating in the working conditions survey of Peru 2017. The prevalence of P-SPH and exposure to poor working conditions were calculated separately for formal and informal employment and were stratified by sex. Poisson regression models were used to assess the association between P-SPH and informal employment, with crude and adjusted prevalence ratios (PR) for working conditions. Informal employment affected 76% of women and 66% of men. Informal workers reported higher exposition to poor working conditions than formal workers and reported worse SPH. Informal workers had a higher risk of P-SPH than formal workers: PR 1.38 [95% CI: 1.16–1.64] in women and PR 1.27 [95% CI: 1.08–1.49] in men. Adjustment by working conditions weakened the association in both sexes. In women, this association was only partially explained by worse working conditions; PR 1.23 [95% CI: 1.04–1.46]. Although some of the negative effect of informal employment on workers´ health can be explained by the characteristics of informality per se, such as poverty, a substantial part of this effect can be explained by poor working conditions.

Cancer incidence and survival rates have increased in the last decades and as a result, the number of working age people diagnosed with cancer who return to work. In this study the probability of accumulating days of employment and employment participation trajectories (EPTs) in a sample of salaried workers in Catalonia (Spain) who had a sickness absence (SA) due to cancer were compared to salaried workers with SA due to other diagnoses or without SA. Each individual with SA due to cancer between 2012 and 2015 was matched by age, sex, and onset of time at risk to a worker with SA due to other diagnoses and another worker without SA. Accumulated days of employment were measured, and negative binomial models were applied to assess differences between comparison groups. Latent class models were applied to identify EPTs and multinomial regression models to analyse the probability of belonging to one EPT of each group. Men and women without SA or with SA due to other diagnoses had at least a 9% higher probability of continuing in employment compared to workers who had a SA due to cancer, especially among men without SA (adjusted IRR 1.27, 95% CI 1.06‒1.53). Men without SA had the highest probability of having high stable EPT compared to workers who had a SA due to cancer (adjusted RRR 3.21, 95% CI 1.87‒5.50). Even though workers with SA due to cancer continue working afterwards, they do it less often than matched controls and with a less stable employment trajectory. Health and social protection systems should guaranty cancer survivors the opportunity to continue voluntary participation in the labour market.

Objectives: This study aims to assess the association between daily temperature and sickness absence episodes in the Mediterranean province of Barcelona between 2012 and 2015, according to sociodemographic and occupational characteristics.Methods: Ecological study of a sample of salaried workers affiliated to the Spanish social security, resident in Barcelona province between 2012 and 2015. The association between daily mean temperature and risk of new sickness absence episodes was estimated with distributed lag non-linear models. The lag effect up to 1 week was considered. Analyses were repeated separately by sex, age groups, occupational category, economic sector and medical diagnosis groups of sickness absence.Results: The study included 42,744 salaried workers and 97,166 episodes of sickness absence. The risk of sickness absence increased significantly between 2 and 6 days after the cold day. For hot days there was no association with risk of sickness absence. Women, young, non-manual and workers in the service sector had a higher risk of sickness absence on cold days. The effect of cold on sickness absence was significant for respiratory system diseases (RR: 2.16; 95%CI: 1.68–2.79) and infectious diseases (RR: 1.31; 95%CI: 1.04–1.66).Conclusion: Low temperatures increase the risk of having a new episode of sickness absence, especially due to respiratory and infectious diseases. Vulnerable groups were identified. These results suggest the importance of working in indoor and possibly poorly ventilated spaces in the spread of diseases that eventually lead to an episode of sickness absence. It is necessary to develop specific prevention plans for cold situations.

Background: The consequences of cancer on working until retirement age remain unclear. This study aimed to analyse working life considering all possible labour market states in a sample of workers after sickness absence (SA) due to cancer and to compare their working life paths to those of a sample of workers without SA and with an SA due to other diseases. Methods: This was a retrospective dynamic cohort study among social security affiliates in Catalonia from 2012–2018. Cases consisted of workers with an SA due to cancer between 2012–2015 (N = 516) and were individually age- and sex-matched with those of affiliates with an SA due to other diagnoses and workers without an SA. All workers (N = 1,548, 56% women) were followed up from entry into the cohort until the end of 2018 to characterise nine possible weekly labour states. Sequence analysis, optimal matching, and multinomial logistic regression were used to identify and assess the probability of future labour market participation patterns (LMPPs). All analyses were stratified by sex. Results: Compared with workers with an SA due to cancer, male workers with no SA and SA due to other causes showed a lower probability of being in the LMPP of death (aRRR 0.02, 95% CI: 0.00‒0.16; aRRR 0.17, 95% CI: 0.06‒0.46, respectively) and, among women, a lower probability of permanent disability and death (aRRR 0.24, 95% CI: 0.10‒0.57; aRRR 0.39, 95% CI: 0.19‒0.83, respectively). Compared to workers with SA due to cancer, the risk of early retirement was lower among workers with no SA (women, aRRR 0.60, 95% CI: 0.22‒1.65; men, aRRR 0.64, 95% CI: 0.27‒1.52), although these results were not statistically significant. Conclusions: Workplaces, many of which have policies common to all diagnoses, should be modified to the needs of cancer survivors to prevent an increasing frequency of early retirement and permanent disability when possible. Future studies should assess the impact of cancer on premature exit from the labour market among survivors, depending on cancer localisation and type of treatment.

Purpose: The aim of this study was to examine the factors acting as barriers or facilitators, from diagnosis and sickness absence (SA) to RTW and work retention, after a cancer-related SA from the perspectives of all stakeholders in the Spanish setting. Methods: Descriptive qualitative approach with a socio-constructivist perspective. Theoretical sampling was carried out until saturation. Six discussion groups (4-8 people/group) were conducted: three groups of people with a cancer-related SA in Catalonia (Spain), one with oncology care professionals, and two with company representatives. An additional individual interview was conducted with a primary care physician. The sessions were held virtually and were recorded, transcribed verbatim, and analyzed using thematic analysis and mixed coding. Results: Barriers to RTW and work retention detected by stakeholders included insufficient information and guidance on the impact of cancer on work and SA management, lack of general knowledge and recognition of side effects, lack of consideration of job tasks by medical tribunals, and working in precarious employment. Facilitators included workplace support, psycho-oncologists, patient associations, and working for a public company. Conclusions: Both work interruption due to an SA and RTW, are key moments for determining cancer survivors’ work retention. We found a general perception of lack of involvement of the social security system, companies, and health professionals in Spain in the impact of cancer on work. Implications for Cancer Survivors: Integrating the work sphere in cancer care from the beginning of cancer treatment, and by all stakeholders, could facilitate successful future RTW.

: People who have suffered from cancer find it difficult to return to work after a sickness absence (SA). Previous evidence indicates that people who survive a cancer have a higher risk than general population of leaving the labor market prematurely or being unemployed due to sequelae of both treatment and disease. Our objective is to identify barriers and facilitators associated with the return and permanence in the workplace of salaried workers after a SA due to cancer in Catalonia. The research used a descriptive qualitative approach with socio-constructivist perspective. A theoretical sampling was carried out until saturation. Three discussion groups (7 people/group) were conducted with people who had suffered a SA due to cancer in Catalonia. The sessions were held virtually and were recorded, transcribed verbatim, and analyzed using thematic analysis and mixed coding with Atlas.ti. Most of the people had returned to work after SA or were looking for a job that was suitable for their health status. Among the barriers to reincorporation to their job detected: (1) coping with the same workload they had before the SA, (2) sequelae associated with cancer treatment that affected their ability to work (stress, low ability to concentrate, chronic fatigue, mobility limitations), (3) having jobs with a high physical load, (4) expectations of colleagues and bosses. Among the facilitating factors: (1) sessions with psycho-oncologists, (2) availability of holidays to adapt their return after SA, (3) teleworking, and (4) job adaptation. Regarding proposals to improve this process, the most outstanding were the implementation of policies that allow a gradual return to work adjusted to the people who want to adhere to it and generalize the possibility of doing psycho-oncological therapy. End of SA after cancer is a key moment for people who go through it, they suffer many difficulties during the process that could be prevented with measures such as a gradual return to work. Key messages: • Workers who suffer a SA due to cancer face difficulties on their return to work. • Initiatives of adaptation and gradual reincorporation to the workplace could improve return to work process after a SA due to cancer.