Antonio Ramón Gómez-García

Agradecemos sinceramente el interés y los valiosos comentarios expresados en la carta a la editora relacionada con nuestro artículo “Incidencia de lesiones por accidentes de trabajo según edad y sector económico en hombres y mujeres en Ecuador”. Coincidimos plenamente con la perspectiva planteada por los autores al señalar que la relación entre la edad y los accidentes de trabajo no responde únicamente a factores biológicos, sino que resulta de una compleja interacción con la experiencia laboral, el nivel de competencia, la precariedad de la contratación y las condiciones organizativas en los entornos de trabajo. Como se discute en nuestro estudio, la mayor incidencia observada en trabajadores jóvenes suele estar estrechamente ligada a una menor antigüedad, una familiaridad limitada con los peligros del puesto, déficits en los programas de inducción y supervisión, y la prevalencia de condiciones de empleo precario.

Objetivo: La transición demográfica en Ecuador está reconfigurando la estructura etaria de la fuerza laboral. El análisis de registros administrativos permite identificar diferencias en la incidencia y necesidades preventivas según la edad de los trabajadores. El objetivo fue estimar diferencias en la incidencia de lesiones por accidentes de trabajo según edad, sexo y sector económico en Ecuador. Métodos: Se analizaron datos agregados del Instituto Ecuatoriano de Seguridad Social entre 2015 y 2024. Se incluyeron casos de lesiones por accidentes de trabajo calificadas, y empleo registrado de trabajadores afiliados a la seguridad social. Se calcularon las tasas de incidencia y razones de tasas de incidencia, y se realizó un análisis estratificado por sexo y sector económico. Resultados: La asociación entre edad e incidencia fue heterogénea según sector económico y sexo. En hombres, se observó un gradiente descendente con la edad y exceso relativo de incidencia del 51% en el grupo 15–24 años y del 28% en el de 25–34 años, respecto al de 35–44 años, y en la mayoría de sectores de producción. En mujeres, el exceso relativo de incidencia se concentró en las de 25–34 años (15%), con patrones variables, con mayor incidencia relativa en comercio, transporte y servicios en edades jóvenes, y en minería en edades más avanzadas. Conclusiones: Los hallazgos respaldan la priorización preventiva en trabajadores jóvenes y el fortalecimiento de la vigilancia con enfoque etario ante el envejecimiento de la fuerza laboral, aunque se requieren análisis más específicos para explicar estas diferencias.

Falls from heights (FFH) are a major cause of occupational fatalities in the construction industry. In developing countries, underreporting in social security records limits accurate knowledge of work-related mortality. This observational and descriptive study examined FFH deaths in Ecuador’s construction sector from 2013 to 2023 using data from the Statistical Registry of General Deaths. Cases were identified through ICD-10 codes (W11, W12, W13, W17, W19) with the place of occurrence classified as construction (.6). Descriptive and inferential analyses were conducted (Kruskal–Wallis test, p < 0.05), and working years of potential life lost (WYPLLs) were estimated. Fatal FFH incidents increased until 2017 (14.0%), decreased during 2020–2021, and rose again in 2022–2023. Most deaths occurred in Pichincha (48.2%), primarily from falls from scaffolding (W12, 65.5%). The mean age was 39.6 years (95% CI: 38.3–40.9). Significant differences in age by cause were observed (χ² = 9.74; p = 0.045), especially between W11 and W13 (p = 0.040). A total of 8,221 WYPLLs were estimated, mostly from scaffolding and building falls. These findings highlight a substantial mortality burden and the urgent need to reinforce preventive strategies, strengthen compliance and inspection systems, and promote safety culture within Ecuador’s construction industry.

Ecuador is facing an unprecedented public security crisis that has transformed violence into a structural determinant of everyday life. Although the education sector has implemented reactive measures to ensure pedagogical continuity, the accumulated psychological burden on educators remains insufficiently addressed. This editorial argues that community violence must be reframed as a chronic psychosocial occupational stressor, with profound implications for anxiety, emotional exhaustion, and workforce stability. We propose a bimodal research and policy agenda to bridge the gap between territorial insecurity and occupational health. This framework integrates the systematic assessment of mental health through validated instruments—such as the DASS-21—with geospatial mapping of exposure to violence at the cantonal level. By normalizing crime data against educational workforce statistics, it becomes possible to identify high-risk cohorts and prioritize institutional support where it is most needed. Recognizing community violence as a fundamental determinant of working conditions is essential to sustaining the education system in contexts of chronic social instability. Without evidence-based strategies that link territory, insecurity, and psychosocial burden, interventions will continue to overlook the systemic impact of violence on those who uphold the functioning of the nation’s schools.

Introduction. Work-related injuries (WRIs) generate substantial functional and economic burdens, yet evidence on their duration and direct costs remains scarce in middle-income countries. Objective. This study aimed to characterize the duration and direct salary-related costs of WRIs and to identify predictors of return to work (RTW) in the financial and insurance sector of the Metropolitan District of Quito (DMQ), Ecuador. Method. An analytical cross-sectional study was conducted using secondary administrative microdata from the General Insurance for Work Risks (SGRT) of the Ecuadorian Social Security Institute, covering 409 certified non-fatal WRIs with at least one day of temporary work incapacity (TWI) recorded between 2023 and 2024. TWI duration was compared across sociodemographic, occupational, and place of occurrence categories using the Mann–Whitney U and Kruskal–Wallis H tests. Time to RTW was estimated using Kaplan–Meier methods and compared using the log-rank test; observations exceeding 90 days of TWI were right-censored. Unadjusted and adjusted Cox proportional hazards regression models were used to identify independent predictors of time to RTW. Direct salary-related costs were estimated using the human capital method, disaggregated by responsible payer. Results. Of the 409 WRIs analysed, 256 (62.6%) resulted in ≥4 days of TWI. Commuting accidents represented 67.7% of all injuries and were significantly associated with longer TWI duration (median: 44.0 vs. 6.0 days for workplace accidents; p < 0.001). Place of occurrence was the only statistically significant independent predictor of time to RTW, with workers injured at the workplace having a 6.6 times higher probability of RTW at any given time compared to those involved in commuting accidents (AHR = 6.589, 95% CI: 4.520–9.607; p < 0.001). The SGRT bore 97.0% of total direct salary-related costs (US$479,617 out of US$494,379), with commuting accidents generating the highest mean cost per case (US$2,421 vs. US$264 for workplace accidents). Conclusion. Commuting accidents are the primary driver of prolonged TWI and the dominant source of direct salary-related costs in the financial and insurance sector of the DMQ. The current workers' compensation framework, which limits employer liability to the first three days of TWI, is associated with a marked structural asymmetry in the financial burden between employers and the social security system. Occupational health and safety strategies should be broadened to include commuting risk reduction measures, and potential reforms to the workers' compensation framework warrant further evaluation.

Ecuador is currently experiencing an unprecedented deterioration in public safety, with homicide rates rising drastically in recent years; however, national-level analyses often obscure the specific local dynamics of violence. This study analyzes the relationship between adverse socioeconomic indicators, specifically poverty and inequality, and homicide rates at a highly disaggregated territorial level: the administrative "circuits" (micro-territories) of Zone 8, which includes Guayaquil, Durán, and Samborondón. An exploratory ecological study was conducted across 67 of these micro-territories, utilizing administrative homicide records (2014–2024) and socioeconomic census data. The methodology involved Pearson correlation analyses and the classification of territories into prioritization quadrants to guide policy. Results reveal significant territorial heterogeneity and a strong positive correlation between homicide rates and both the poverty rate (r=0.785) and the Gini coefficient (r=0.768). Crucially, priority intervention quadrants were identified where high social exclusion and lethal violence converge. These findings demonstrate a structural link between socioeconomic precariousness and interpersonal violence in the coastal region. Consequently, the study concludes that effective security strategies must transcend exclusive reliance on police control to integrate targeted environmental, educational, and economic interventions, fostering a multisectoral social dialogue essential for recovering the social fabric.

Background: Initiatives for workplace health promotion (WHP) has gained increasing importance in the face of changing workplace dynamics and new corporate health policies. Understanding how this field has evolved allows us to identify knowledge gaps, guide new research, and strengthen evidence-based organizational interventions. This study aimed to identify existing research gaps, predominant thematic trends, and emerging ideas related to health promotion in the workplace. Methods: A descriptive bibliometric review was conducted on a retrospective database, analyzing relevant scientific literature using quantitative techniques that allow assessing the impact and influence of publications in this field. The database used was Scopus, and data extraction was performed on December 13, 2024. Results: The findings reveal a steady increase in WHP research since 1983, In the field of WHP, 76 countries have participated, reflecting an extensive and diverse global collaboration network. Of these, 29 countries stand out for having produced more than 5 publications each, underscoring their significant contribution to the field. The most frequently used terms, “health promotion,” “occupational health,” and “workplace,” reflect the central focus of this area of study. Conclusions: The study identifies regional gaps and highlights the need for differentiated approaches based on population and context. Furthermore, it confirms the positive impact of occupational health promotion on individuals, organizations, and societies, reinforcing its strategic value globally. Based on the trends detected, future lines of research are proposed to strengthen scientific evidence and practical action in this area.

This viewpoint examines the inadequate protection of informal workers against climate change hazards under new legislation in Ecuador. The recent Executive

INTRODUCTION. Commuting accidents, defined as those occurring during the usual journey between home and the workplace or vice versa, may cluster or vary across working days. However, in Ecuador, evidence on these temporal patterns remains limited. OBJECTIVE. To assess the presence of the 'Monday effect' and the 'Weekday effect' in commuting accident injuries in Ecuador, and to explore heterogeneity by sex and age group. METHOD. Exploratory study based on administrative records from 2023–2024 (n = 3,469). Daily proportions (95% CI), relative index (Monday = 100), and linear trends (β, R²) of commuting accidents during peak commuting hours (Monday to Friday) were estimated. Differences between consecutive days were assessed using the Z statistic (p < 0.05). RESULTS. Men accounted for the majority of accidents (61%). Among women ≤29 years, a significant increase was observed on Tuesday compared with Monday (p < 0.05), while among men ≥50 years, a significant downward trend from Monday to Friday was detected (β = −7.67; R² = 0.871; p = 0.020). In other groups, variations were not statistically significant. DISCUSSION AND CONCLUSIONS. Commuting accidents in Ecuador show a homogeneous distribution across the working week, with no confirmation of the temporal patterns analyzed, though vulnerable subgroups were identified. Longitudinal studies are needed to further examine these findings and support targeted preventive measures focused on mobility during peak hours.