RESUMEN

Objetivos:

La presente investigación tiene como objetivo conocer las condiciones de trabajo, seguridad y sa lud en el trabajo de la población urbana económicamente activa ocupada del Perú. Materiales y métodos: Se realizó un estudio transversal basado en una muestra probabilística de áreas y multietápica en la que partici paron 3122 personas mayores de 14 años distribuidas en todo el país.

Resultados

: La mayoría fueron hombres (53,6%) entre 30 y 59 años (50%). En cuanto a las condiciones de trabajo, la mayoría labora más de 48 horas semanales (39,8%) y de lunes a sábado (44,7%). Respecto a las condiciones de seguridad, higiene, ergonómicas y psicosociales, los resultados mostraron una menor exposición de riesgo. Sobre las condiciones de salud, la mayoría refiere que no se identifican ni se evalúan los riesgos laborales en su puesto de trabajo (35,9%); que no tienen servicios de salud ocupacional (40,7%) ni un delegado o un comité de seguridad y salud (39,4%); y que no se le realizan evaluaciones médico ocupacionales (39,3%).

Conclusiones:

La población económica mente activa urbana ocupada del Perú se expone con más frecuencia al ruido, la radiación solar, las posturas incómodas y los movimientos repetitivos; trabaja rápido con poco control y esconde sus emociones; además, en los lugares de trabajo no se gestiona la salud ocupacional. Estas condiciones pueden afectar la salud de los trabajadores y la calidad del trabajo.

Palabras clave:
Condiciones de Trabajo; Riesgos Laborales; Empleo; Salud Laboral

ABSTRACT

Objetives:

The present study aims to know the work, safety and health conditions at the jobs of the economically active urban population in Peru.

Materials and Methods:

A cross-sectional study was carried out based on a probabilistic sample of multistage areas in which 3122 people over 14 years of age distributed nationwide partici pated. Results: The majority were men (53.6%) between 30 and 59 years (50%). As for working conditions, most people work more than 48 hours per week (39.8%), and Monday through Saturday (44.7%). Regarding the safety, hygiene, ergonomic and psychosocial conditions, the results showed a lower risk exposure. Regarding health conditions, the majority report that the identification and evaluation of occupational hazards is not carried out in their workplace (35.9%), they do not have occupational health services (40.7%) or a delegate or a Health and sa fety committee (39.4%) and no occupational medical evaluations (39.3%).

Conclusions:

The economically active urban population of Peru is more frequently exposed to noise, solar radiation, awkward postures and repetitive movements, work at a fast pace with little control and hide their emotions; In addition, occupational health is not managed adequately in workplaces. These conditions may affect the health of workers and the quality of work.

Keywords:
Working Conditions; Occupational Risks; Employment; Occupational Health

INTRODUCTION

Employment generates economic and social growth and affects workers’ health and well-being, i.e. it can be a source of impro vement or harm. Paid work is the main source of income for most people, and it is a strong component of their social identity ¹1. Neffa JC. Los riesgos psicosociales en el trabajo: contribución a su estudio [Internet]. Buenos Aires: Centro de Estudios e Investigaciones Laborales CEIL-CONICET; 2015. 550 p. [citado el 19 junio 2019]. Disponible en: http://biblioteca.clacso.edu.ar/Argentina/fo-umet/20160212070619/Neffa.pdf..

Workers are exposed to conditions that affect their health, either positively or negatively. Such conditions involve the cha racteristics of the work organization, its environment and immediate surroundings, which can be considered physical, chemical, psychosocial, mechanical, and environmental risk factors, among others. Therefore, occupational health and safety conditions are established in organizations, these are related to the implementation of measures to eliminate or reduce the risk of suffering injuries, damaging health, material damage to equipment, machines or infrastructure. Similarly, workers’ health management, and preventive activities and resources involved within the organizations, are included ¹1. Neffa JC. Los riesgos psicosociales en el trabajo: contribución a su estudio [Internet]. Buenos Aires: Centro de Estudios e Investigaciones Laborales CEIL-CONICET; 2015. 550 p. [citado el 19 junio 2019]. Disponible en: http://biblioteca.clacso.edu.ar/Argentina/fo-umet/20160212070619/Neffa.pdf.^,22. Neffa JC. ¿Qué son las condiciones y medio ambiente de trabajo? Propuesta de una perspectiva [Internet]. Buenos Aires: Hvmanitas-Ceil; 2002. [citado el 5 junio 2019] Disponible en: http://www.referato.com/ubaproceso2/neffa_Condiciones_y_medio_ambiente_de_trabajo.pdf..

Therefore, a worker with adequate working, safety and health conditions is strongly identified with the organization’s poli cies which are strengthened, as well as his or her motivation and productivity. On the contrary, if the workplace has precarious conditions, the workers’ health could be affected, in addition to the previously mentioned aspects, which generates a high social cost ²2. Neffa JC. ¿Qué son las condiciones y medio ambiente de trabajo? Propuesta de una perspectiva [Internet]. Buenos Aires: Hvmanitas-Ceil; 2002. [citado el 5 junio 2019] Disponible en: http://www.referato.com/ubaproceso2/neffa_Condiciones_y_medio_ambiente_de_trabajo.pdf..

According to the International Labor Organization, there is a high frequency of deaths caused by work accidents or disea ses, related to poor occupational safety and health practices. These health issues generate a high social and economic cost, due to losses related to working time, production development, medical care and rehabilitation of workers, as well as the payment of compensation ³3. Levaggi V. ¿Qué es el trabajo decente? [Internet]. Ginebra: Organización Internacional del Trabajo; 2004 [citado el 11 Sep 2015]. Disponible en: https://www.ilo.org/americas/sala-de-prensa/WCMS_LIM_653_SP/lang--es/index.htm.^,44. International Labour Organization. Safety and health at work: A vision for sustainable prevention. XX World Congress on Safety and Health at Work 2014 [Internet]. Geneva: ILO, 2014 [citado el 14 octubre 2019]. Disponible en: https://www.ilo.org/wcmsp5/groups/public/---ed_protect/---protrav/---safework/documents/publication/wcms_301214.pdf..

On the labor aspect, Peru maintained an economic growth that allowed a 2.4% increment of formal employment from April 2013 to March 2014 ⁵5. Instituto Nacional de Estadística e Informática. Informe técnico de la situación del mercado laboral en Lima Metropolitana [Internet]. Lima: INEI; 2019 [citado el 1 julio 2019]. Disponible en: https://www.inei.gob.pe/media/MenuRecursivo/boletines/04-informe-tecnico-n04_mercado-laboral-ene-feb-mar2019.pdf., and Metropolitan Lima showed a variation of 6.6% during first quarter 2019 ⁶6. Ministerio de Trabajo y Promoción del Empleo. Avance de los Resultados de la Encuesta Nacional de Variación Mensual del Empleo (ENVME), marzo 2014 [Internet]. Lima: MTPE; 2014. [citado el 20 mayo 2019] Disponible en: https://www.trabajo.gob.pe/archivos/file/publicaciones_dnpefp/2015/AVANCE_ENVME_Marzo_2014.pdf.. In addition, under the Occupational Safety and Health Act, employers must create means and conditions to protect workers’ health and safety ⁷7. Reglamento de la Ley No 29783, Ley de Seguridad y Salud en el Trabajo. Decreto Supremo N° 005-2012-TR [Internet]. Lima: Congreso de la Republica; 2012 [citado el 20 mayo 2019]. Disponible en: http://www.munlima.gob.pe/images/descargas/Seguridad-Salud-en-el-Trabajo/DecretoSupremo005_2012_TR_ReglamentodelaLey29783_LeydeSeguridadySaludenelTrabajo.pdf.⁾ by developing management systems according to their needs, and report to the Ministry of Labor any occupational accidents and diseases that occur in their organizations ⁸8. Ministerio de Trabajo y Promoción del Empleo. Política y Plan Nacional de Seguridad y Salud en el Trabajo 2017 - 2021 [Internet]. Lima: MTPE; 2018. [citado el 20/08/2019] Disponible en: https://www.trabajo.gob.pe/archivos/file/CNSST/politica_nacional_SST_2017_2021.pdf..

Occupational surveys on working conditions are valuable tools for obtaining information to develop strategies for promo ting health and preventing negative events for working groups. These surveys are useful for monitoring workers’ health ⁹9. Merino-Salazar P, Cornelio C, Lopez-Ruiz M, Benavides FG. Propuesta de indicadores para la vigilancia de la salud ocupacional en América Latina y el Caribe. Rev Panam Salud Pública. 2018;42:1-9 [citado el 6 mayo 2019]. Disponible en: https://doi.org/10.26633/RPSP.2018.125., and working, employment and health conditions worldwide.

As indicated in the National Plan for Occupational Safety and Health 2017-2021 ⁸8. Ministerio de Trabajo y Promoción del Empleo. Política y Plan Nacional de Seguridad y Salud en el Trabajo 2017 - 2021 [Internet]. Lima: MTPE; 2018. [citado el 20/08/2019] Disponible en: https://www.trabajo.gob.pe/archivos/file/CNSST/politica_nacional_SST_2017_2021.pdf., there are national statistics on occupa tional accidents and diseases; however, they do not express all of the occurrences, nor do they record the working conditions of the economically active population (EAP). For this reason, the aim of the present study was to determine the safety and health conditions at work of urban economically active occupied in Peru, by applying a population survey.

MATERIALS AND METHODS

Study Design

A cross-sectional design study based on a probability sample associated to geographical areas, in which the likelihood of being selected is associated with geographical areas in the scope of study, which is also multi-stage. The sample was designed to give reliable estimates at the national urban level.

Sample Framework

The sample framework was obtained from the statistical information of the National Institute of Statistics and Informatics (INEI in Spanish), from the 2007 Census and updated with information from the Household Targeting System (SISFOH in Spanish) 2012-2013, a system used by the INEI for conducting population surveys ¹⁰10. Instituto Nacional de Estadística e Informática. Encuesta Nacional de Programas Presupuestales 2011-2016 [Internet]. Lima: INEI; 2017 [citado el 31 enero 2020]. Disponible en: https://www.inei.gob.pe/media/MenuRecursivo/publicaciones_digitales/Est/Lib1442/libro.pdf.. The population comprises the habitual residents, over 14 years old, from urban private dwellings nationwide. The sample used was requested from the INEI, which included clus ters with information on blocks, dwellings, population and EAP from 252 districts of Peru.

Participants

Residents of urban areas of Peru, over 14 years old, who work or have worked, at least for one hour, the week before the survey or who are temporarily absent from work due to vacation, illness, leave, etc. ¹¹11. Instituto Nacional de Estadística e Informática. Características de la Población Económicamente Activa Ocupada [Internet]. Lima: INEI; 2012 [citado el 20/08/2019]. Disponible en: https://www.inei.gob.pe/media/MenuRecursivo/publicaciones_digitales/Est/Lib1105/cap02.pdf.. Children under 14 years old and those children whose surveys showed errors in completion were excluded.

Sample

The sample was probabilistic, area-based, stratified and multi-stage. With a known population and applying the proportion formula with a confidence level of 95%, a permissible error of 2.7%, a non-response rate of 10% and a design effect of 1.2. The calculated sample was 3,120 persons distributed in 520 clusters.

The sampling was carried out in several stages. First stage: selection of clusters with probability proportional to the size of the households (clusters: group of households defined by the INEI that include approximately 100 to 150 households). Second stage: selection of blocks within each cluster (systematic random sampling with random start). Third stage: random selection of house holds in the selected blocks (random sampling through a random number chart). Fourth stage: random selection of the person to be interviewed. The unit of analysis was the working person, selected among people who work in each household.

Variables

Socio-demographic variables, such as sex, age, education, job, economic activity of the company and number of workers. Wor king conditions, including employment conditions (weekly working hours, working days, type of relationship, contract, form of contract, type of workday, remuneration), other conditions such as safety, hygiene, ergonomic and psychosocial factors, resources and preventive activities (information or training on occupational risks, evaluations, measurements or controls of possible risks, access to occupational health services, occupational health and safety or hygiene committee, occupational medical examination, and workers participation). Health conditions, such as the perception of health, as well as injuries, and occupational diseases.

Instrument

The Basic Questionnaire on Working, Employment and Health Conditions in Latin America and the Caribbean (CTESLAC in Spanish) ¹²12. Benavides FG, Merino-Salazar P, Cornelio C, Assunção AA, Agudelo-Suárez AA, Amable M, et al. Cuestionario básico y criterios metodológicos para las Encuestas sobre Condiciones de Trabajo, Empleo y Salud en América Latina y el Caribe. Cad Saude Publica. 2016;32(9):e00210715 [citado el 14 mayo 2019]. Disponible en: http://dx.doi.org/10.1590/0102-311X00210715.^,1313. Benavides F, Zimmermann M, Campos J, Carmenate L, Baez I, Nogareda C, et al. Conjunto mínimo básico de ítems para el diseño de cuestionarios sobre condiciones de trabajo y salud. Arch Prev Riesgos Labor. 2010;13(1):13-22.⁾ provides information on workers’ perceptions of working, employment and health conditions in their workplaces. It has 77 questions which include socio-demographic characteristics, employment conditions, work, health, resources, and preventive occupational health activities in the work centers, and family characteristics of the respondents. It was developed by the Network of Experts on Surveys of Working, Employment and Health Conditions (RED ECTS in Spanish), based on surveys of working con ditions used in Spain, Colombia, Argentina, Chile, Uruguay and Central America, in order to improve the comparability of survey results in Latin America and the Caribbean.

The answers to the questions include: frequency of the condition (always, several times, sometimes, very few times and never; or if it presents or not a certain condition), the completion time of the questionnaire is of 25 minutes and the results are expressed according to the answer options.

For this study, a group of 34 experts in occupational health (doctors, psychologists, nurses and medical technologists) re viewed and adapted the questionnaire. They discussed the relevance of each item, and the application of a pilot questionnaire to 34 workers in Lima, Ica and Arequipa. The partial response rate (i.e., the omission of information in some of the questions) ¹⁴14. Instituto Nacional de Estadística e Informática. Clasificacion Industrial Internacional Uniforme de todas las actividaes economicas CIIU Revisión 4 [Internet]. Lima: INEI; 2010. [citado el 10 mayo 2019]. Disponible en: https://www.inei.gob.pe/media/MenuRecursivo/publicaciones_digitales/Est/Lib0883/Libro.pdf. was 3.2%.

An acceptable correlation was found in safety (0.52-0.77), hygiene (0.29-0.50) and ergonomics (above 0.3). However, the psychosocial aspect showed a low correlation (less than 0.3). Overall, the questionnaire has a high reliability of the safety, hygiene and ergonomic aspects ¹⁵15. Sabastizagal I, Vives A, Astete J, Burgos M, Gimeno Ruiz de Porras D, et al. Fiabilidad y cumplimiento de las preguntas sobre condiciones de trabajo incluidas en el cuestionario CTESLAC: resultados del Estudio sobre Condiciones de trabajo, Seguridad y Salud en Perú. Arch Prev Riesgos Labor. 2018;21(4):196-202 [citado el 14 agosto 2019]. Disponible en: http://dx.doi.org/10.12961/aprl.2018.21.04.3.. It is important to point out that, regarding the correlation of psychosocial conditions, we consider that it does not affect the gathering of information, since the questionnaire is not a diagnostic instrument and therefore allows for the collection of relevant information on working conditions.

The final version of the questionnaire consists of three filter questions and 87 Likert-scale questions. An adequately trained interviewer applied the questionnaire to the participants in their homes, with an average duration of 20 minutes.

Procedure and statistical analysis

The information-gathering phase took place from November 2016 to June 2017. The process was gradual and on different dates, however, it was simultaneous at some points. For this purpose, experienced surveyors were called in, and the team of re searchers trained them in occupational health, working conditions, handling the questionnaire and selecting the respondents in the field. The questionnaire was printed on paper and applied to each participant.

For the selection of the household, in each cluster (according to the criteria of the INEI, as a

subpopulation, which has characteristics present in the population, with attributes such as geographical location, being over 14 years old, worker ¹⁶16. Instituto Nacional de Estadística e Informática. Glosario de términos [Internet]. En: Compendio estadistico Perú 2016. Lima: INEI; 2016 [citado el 20/08/2019]. Disponible en: https://www.inei.gob.pe/media/MenuRecursivo/publicaciones_digitales/Est/Lib1375/glosario2.pdf), the following procedure was taken into account: at random, in each block, the households were selected (nine households, of which three were replacement households, in the event that a possible participant was not identified), and then, for the random selection of the occupied EAP member, within the households, the Kish (or random) chart was used.

To calculate the confidence intervals (sampling errors), the statistical program SPSS 20, complex samples section, was used, which provides the sample variability estimators for population parameters (the elaborated frequency plan contained: the file plan, the frame stratum, the cluster and the expansion factor by district, for the construction of the expansion factors, the se lection probabilities in each stage were taken into consideration), such as totals, means, ratios and proportions for the different estimation domains, and the algorithm used by SPSS is based on the method of the variance estimators of the final clusters ¹⁷17. Instituto Nacional de Estadística e Informática. Aspectos metodológicos [Internet]. Lima: INEI; 2012. [citado el 05/11/2019]. Disponible en: https://www.inei.gob.pe/media/MenuRecursivo/publicaciones_digitales/Est/Lib1106/cap01.pdf..

Ethical aspects

The study was approved by the Institutional Committee of Ethics and Research of the National Institute of Health. Informed consent (assent for those under 18 years old) was applied, which was codified and guarded by the research team.

RESULTS

Out of 3,126 questionnaires applied, 4 were eliminated because of errors in the filling process. As can be seen in Table 1, men had the highest participation (56.6%), between 30 and 59 years of age (50%), and of secondary level education (32.9%).

In terms of employment, most were service workers and shop and market assistants (30.8%), from wholesale and retail trade sector, in the repair of motor vehicles and motorcycles (31.0%), and worked in small centers, that is, between 1 and 10 persons (66.7%).

Regarding working conditions (Table 2), 39.8% worked 49 hours or more per week; 44.7% worked from Monday to Saturday; and 61.1% worked split shifts, morning and afternoon. Regarding the net monthly income of the participants, the highest percen tage received remuneration between 851 soles and 1,700 soles (40%); 51.8% were dependent workers; and regarding the form and type of contract, 26.8% had a written contract and 33.1% a temporary contract. With respect to the social protection coverage of the interviewees, 67.2% said that they did not contribute to any retirement system and 53.5% did not have any health insurance (Figure 1).

With respect to exposure to occupational risk factors, less than 6.5% of those surveyed indicated that they are often or always exposed to falls at the same or lower levels; more than 7% of workers reported that they are often or always exposed to a level of noise that forces them to raise their voice to talk to another person and more than 8% reported that they are oftenor always exposed to solar radiation for a minimum period of one hour per day. Their tasks make them keep uncomfortable or forced postures (12.9%) or to make repetitive movements (21.6%). Psychosocially, they must work very fast (13.9%) and hide their emotions or feelings when doing their work (12.9%) (Table 3).

With regard to resources and preventive activities, 7.7% of the workers reported having received poor information about occupational risks. With regard to the identification and eva luation of occupational risks, 35.9% of the dependent workers did not have a risk evaluation for their job in the last 12 months; 40.7% did not have an occupational health service or area in their work center; 39.4% did not have a prevention delegate or supervisor or an occupational health and safety or hygiene committee; 39.3% did not have an occupational health examination in the last 24 months, and 36.5% indicated that their work center did not hold regular meetings to discuss health and safety issues (Table 4).

Finally, regarding the participants’ perception of their health in general, the majority (49.9%) responded that their health was good. A total of 9.1% reported that they had suffered some injury or damage due to an accident at work, and 4.5% reported that they had suffered from one or more diseases caused by work (Table 5).

DISCUSSION

Peru’s urban occupied active population has a profile characterized by a high percentage of workers with long working hours, low social protection coverage (the highest percentages of workers were not registered in any retirement plan or health system), and in dependent workers have long working hours, low pension coverage and low economic income. These situations can affect workers’ health and performance, as well as the quality of their work, which could be related to informality or precariousness of employment. These results are different from those reported in Colombia ¹⁸18. Ministerio de la Protección Social. Primera Encuesta Nacional de Condiciones de Salud y Trabajo en el Sistema General de Riesgos Profesionales [Internet]. Bogotá: Ministerio de Protección Social; 2007. Disponible en: https://www.minsalud.gov.co/Documentos%20y%20Publicaciones/ENCUESTA%20SALUD%20RP.pdf., Argentina ¹⁹19. Ministerio de Trabajo, Empleo y Seguridad Social. Primera Encuesta Nacional a Trabajadores sobre Empleo, Trabajo, Condiciones y Medio Ambiente Laboral [Internet]. Buenos Aires: MTEySS; 2009 [citado el 10 mayo 2019]. Disponible en: https://www.argentina.gob.ar/sites/default/files/primera_encuesta_nacional_trabajadores.pdf., Chile ²⁰20. Ministerio de Salud, Instituto de Seguridad Laboral y la Dirección del Trabajo. Primera Encuesta Nacional de Condiciones de Empleo, Trabajo, Salud y Calidad de Vida de los Trabajadores (ENETS 2009-2011) [Internet]. Santiago: MINSAL; 2009 [citado el 8 mayo 2019]. Disponible en: https://www.dt.gob.cl/portal/1629/articles-99630_recurso_1.pdf.⁾ and Central America ²¹21. Benavides FG, Wesseling I, Delclós G, Felknor S, Pinilla J, Rodrigo F, et al. I Encuesta Centroamericana sobre Condiciones de Trabajo y Salud (I ECCTS). [Internet]. Organización Iberoamericana de Seguridad Social (OISS); 2012 [citado el 19 mayo 2019]. Disponible en: http://www.oiss.org/estrategia/encuestas/lib/iecct/ESTUDIO_CUANTITATIVO_ECCTSSALTRA9.pdf., where most workers do have these systems.

A total of 9.2% of participants always work in noisy environments, a frequency of exposure lower

than the observed in other countries of the region ¹⁹19. Ministerio de Trabajo, Empleo y Seguridad Social. Primera Encuesta Nacional a Trabajadores sobre Empleo, Trabajo, Condiciones y Medio Ambiente Laboral [Internet]. Buenos Aires: MTEySS; 2009 [citado el 10 mayo 2019]. Disponible en: https://www.argentina.gob.ar/sites/default/files/primera_encuesta_nacional_trabajadores.pdf.

20. Ministerio de Salud, Instituto de Seguridad Laboral y la Dirección del Trabajo. Primera Encuesta Nacional de Condiciones de Empleo, Trabajo, Salud y Calidad de Vida de los Trabajadores (ENETS 2009-2011) [Internet]. Santiago: MINSAL; 2009 [citado el 8 mayo 2019]. Disponible en: https://www.dt.gob.cl/portal/1629/articles-99630_recurso_1.pdf.^-2121. Benavides FG, Wesseling I, Delclós G, Felknor S, Pinilla J, Rodrigo F, et al. I Encuesta Centroamericana sobre Condiciones de Trabajo y Salud (I ECCTS). [Internet]. Organización Iberoamericana de Seguridad Social (OISS); 2012 [citado el 19 mayo 2019]. Disponible en: http://www.oiss.org/estrategia/encuestas/lib/iecct/ESTUDIO_CUANTITATIVO_ECCTSSALTRA9.pdf., which in general exceed 15%. This differs to the report made in 2017, when 59.2% of the occupational illnesses notified to the Ministry of Labor and Employment Promotion (MTPE in Spanish) of Peru ²²22. Ministerio de Trabajo y Promoción del Empleo. Anuario estadístico sectorial 2017. [Internet]. Lima: MTPE; 2018. [citado el 20/09/2019] Disponible en: https://cdn.www.gob.pe/uploads/document/file/229919/Anuario_2017_opt.pdf. were due to hearing loss or deafness caused by noise. However, this higher percentage of hearing-related illnesses may be explained by a lower quantity of reported cases from other pathologies.

Between 9.1% and 21.6% of surveyed subjects suffer from uncomfortable postures, they lift or move loads, or make re petitive movements. These figures are lower than those observed in the surveys carried out in Colombia, Argentina, Chile, Central America and Uruguay ²³23. Merino-Salazar P, Artazcoz L, Cornelio C, Iñiguez MJI, Rojas M, Martínez-Iñigo D, et al. Work and health in Latin America: results from the working conditions surveys of Colombia, Argentina, Chile, Central America and Uruguay. Occup Environ Med. 2017;74(6):432-9. [citado el 2 setiembre 2019]. Disponible en: http://dx.doi.org/10.1136/oemed-2016-103899.. However, no musculoskeletal diseases related to such exposure were reported in the MTPE ²²22. Ministerio de Trabajo y Promoción del Empleo. Anuario estadístico sectorial 2017. [Internet]. Lima: MTPE; 2018. [citado el 20/09/2019] Disponible en: https://cdn.www.gob.pe/uploads/document/file/229919/Anuario_2017_opt.pdf. during 2017. Regarding psychosocial conditions, between 12% and 41% of the population surveyed said that they always work too fast or hide their emotions, or that they never influence the amount of work assigned to them, similar to that found in surveys in other countries ⁽¹⁹19. Ministerio de Trabajo, Empleo y Seguridad Social. Primera Encuesta Nacional a Trabajadores sobre Empleo, Trabajo, Condiciones y Medio Ambiente Laboral [Internet]. Buenos Aires: MTEySS; 2009 [citado el 10 mayo 2019]. Disponible en: https://www.argentina.gob.ar/sites/default/files/primera_encuesta_nacional_trabajadores.pdf.

20. Ministerio de Salud, Instituto de Seguridad Laboral y la Dirección del Trabajo. Primera Encuesta Nacional de Condiciones de Empleo, Trabajo, Salud y Calidad de Vida de los Trabajadores (ENETS 2009-2011) [Internet]. Santiago: MINSAL; 2009 [citado el 8 mayo 2019]. Disponible en: https://www.dt.gob.cl/portal/1629/articles-99630_recurso_1.pdf.^-2121. Benavides FG, Wesseling I, Delclós G, Felknor S, Pinilla J, Rodrigo F, et al. I Encuesta Centroamericana sobre Condiciones de Trabajo y Salud (I ECCTS). [Internet]. Organización Iberoamericana de Seguridad Social (OISS); 2012 [citado el 19 mayo 2019]. Disponible en: http://www.oiss.org/estrategia/encuestas/lib/iecct/ESTUDIO_CUANTITATIVO_ECCTSSALTRA9.pdf..

It should also be noted that this is the first time that Peru gets information on prevention and resources from companies, which, according to the regulations ⁽⁷7. Reglamento de la Ley No 29783, Ley de Seguridad y Salud en el Trabajo. Decreto Supremo N° 005-2012-TR [Internet]. Lima: Congreso de la Republica; 2012 [citado el 20 mayo 2019]. Disponible en: http://www.munlima.gob.pe/images/descargas/Seguridad-Salud-en-el-Trabajo/DecretoSupremo005_2012_TR_ReglamentodelaLey29783_LeydeSeguridadySaludenelTrabajo.pdf., they are the ones that must carry out these preventive activities. The surveyed subjects report that their work organizations do not identify nor evaluate occupational risks at workplace, provide occupational health service, consider a prevention delegate or supervisor at the workplace, provide annual occupational medical evaluations. These reported information by the subjects can be explained by the fact that not all employers have implemented the guidelines of the Occupational Safety and Health law in their organizations, or, that workers are not correctly informed about it.

As for the perception of health, this is similar to that found in the surveys of Colombia, Chile and Central America, which perceive, in a high percentage, that their workers are healthy, and have a low percentage of accidents and occupational diseases. Similar to what was found in the National Socio-economic Survey about Access to Health from EsSalud Insured Persons in Peru ²⁴24. EsSalud. Presentación de los principales Resultados de la encuesta nacional socioeconómica y de acceso a la salud de los asegurados de EsSalud 2015 [Internet]. Lima: EsSalud; 2016. [citado el 14 octubre 2019]. Disponible en: http://www.essalud.gob.pe/downloads/encuesta_nacional_socioeconomica/., which indicates that 64.1% of the insured population refers having no symptoms, illness or accident.

Among the advantages of this study, it should be mentioned that, in order to obtain the information, the surveys were applied in the households, having as a common filter people who had worked, at least one hour, in the week prior to the interview. Unlike the surveys carried out in Colombia ¹⁸18. Ministerio de la Protección Social. Primera Encuesta Nacional de Condiciones de Salud y Trabajo en el Sistema General de Riesgos Profesionales [Internet]. Bogotá: Ministerio de Protección Social; 2007. Disponible en: https://www.minsalud.gov.co/Documentos%20y%20Publicaciones/ENCUESTA%20SALUD%20RP.pdf., Argentina ¹⁹19. Ministerio de Trabajo, Empleo y Seguridad Social. Primera Encuesta Nacional a Trabajadores sobre Empleo, Trabajo, Condiciones y Medio Ambiente Laboral [Internet]. Buenos Aires: MTEySS; 2009 [citado el 10 mayo 2019]. Disponible en: https://www.argentina.gob.ar/sites/default/files/primera_encuesta_nacional_trabajadores.pdf., Chile ²⁰20. Ministerio de Salud, Instituto de Seguridad Laboral y la Dirección del Trabajo. Primera Encuesta Nacional de Condiciones de Empleo, Trabajo, Salud y Calidad de Vida de los Trabajadores (ENETS 2009-2011) [Internet]. Santiago: MINSAL; 2009 [citado el 8 mayo 2019]. Disponible en: https://www.dt.gob.cl/portal/1629/articles-99630_recurso_1.pdf. and Uruguay ²³23. Merino-Salazar P, Artazcoz L, Cornelio C, Iñiguez MJI, Rojas M, Martínez-Iñigo D, et al. Work and health in Latin America: results from the working conditions surveys of Colombia, Argentina, Chile, Central America and Uruguay. Occup Environ Med. 2017;74(6):432-9. [citado el 2 setiembre 2019]. Disponible en: http://dx.doi.org/10.1136/oemed-2016-103899., where the interviews took place in the formal workplaces.

Among the limitations, it should be mentioned that the information collected has not been verified. That is, the instrument collects the perceptions of the workers and this information is based on their honesty (we do not verify the conditions in their workplaces), which is common in this kind of study. Similar surveys were conducted in the European Union since 1990, every five years ²⁵25. Eurofound. Sixth European Working Conditions Survey-Overview report (2017 update) [Internet]. Luxembourg: Publications Office of the European Union; 2017 [citado el 14 octubre 2019]. Disponible en: https://www.eurofound.europa.eu/sites/default/files/ef_publication/field_ef_document/ef1634en.pdf.. However, and despite the fact that information was not verified, this study provides for the first time a description of the working, employment and health conditions in a representative sample of the occupied active population in urban areas of Peru.

In conclusion, there is ample room for occupational risk prevention among Peru’s urban occupied economically active population, especially among dependent workers with long working hours, low social protection coverage and low economic income, poor occupational health management in their workplaces; situations that might affect their health and performance, as well as the quality of their work.

This first task provides the basis for monitoring and surveillance of the working, employment and health conditions of the urban occupied active population in Peru. Similar studies should be carried out periodically. In addition, occupational health information should be disseminated to raise awareness in the workers (independent and dependent) and their employers in order to reduce exposure to occupational risks and prevent work-related accidents and diseases.

Acknowledgements:

To the district authorities and to the EAP participating in the study. To Miguel Burgos, for his support in editing the manuscript and to the postgraduate collaborators in Occupational Health, Occupational Medicine and Environment of the Universidad Peruana Cayetano Heredia and the Universidad Nacional Mayor de San Marcos, for their support in the process of adaptation and application of the questionnaire

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