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labour Markets and welfare states: a country perspective<br />

that workers' health problems differ substantially depending on<br />

employment status. Health inequalities at the macrosocial level may<br />

exist between urban and rural populations, and across geographic<br />

areas, and also between job sectors (services, production, public<br />

administration) and income levels. Discrimination on the basis of race,<br />

skin colour, sex, nationality, religious beliefs or any other offence to<br />

human dignity is forbidden and punishable by law (article 42 of the<br />

Constitution of the republic). Cuban people generally consider their<br />

Cuban identity as superseding any racial or ethnic identity, a cultural<br />

pattern that prevents discrimination in the work place or in access to<br />

health care or awareness. at the microsocial level, dangers and risks<br />

are attached to certain professions and working conditions, either<br />

environmental or organisational. moreover, psychosocial risk has<br />

increased in the growing services sector. The repercussions of health<br />

problems are a topic of research among experts in occupational health,<br />

including repercussions for the worker's family. although no national<br />

surveys have been conducted on job conditions and health in the<br />

working population, studies in specific sectors and territories have<br />

suggested that between 30 per cent and 50 per cent of interviewees,<br />

and in some cases more, claim occupational stress (román, 2003;<br />

2007; Hernández, 2003).<br />

The sistema nacional de Vigilancia de las Enfermedades<br />

profesionales (national occupational Diseases surveillance<br />

system), in operation since 1998, tracks occupational disease<br />

throughout the country. The fol<strong>low</strong>ing are some data related to<br />

occupational illness and injury. In 2006, 307 cases of occupational<br />

disease were diagnosed in Cuba, representing a rate of 15.9 per 105<br />

workers. This rate is the <strong>low</strong>est in the last five years; the highest was<br />

19.4 per 105 workers in 2002. Between January and september of<br />

2007, 245 cases of occupational disease were diagnosed: 101 cases<br />

of chronic nodular laryngitis (Cnl); 66 poisonings with insecticides;<br />

26 cases of hypoacusia; 10 cases each of pneumoconiosis; and 10<br />

cases of brucellosis. according to statistics from the "ministerio de<br />

salud pública" (ministry of public Health), between 1998 and 2003,<br />

841 cases of Cnl were diagnosed, representing incidence rates<br />

between 11.58 and 5.60 per 103 individuals exposed. The most<br />

affected groups in terms of sex were women (92.0, with incidence<br />

rates between 15.79 and 9.57 per 103) and, with respect to<br />

occupation, primary teachers (81.68, rates between 26.8 and 11.9<br />

per 103). Cnl persists as an occupational health problem, mainly in<br />

primary and kindergarten/creche teachers, appearing at <strong>low</strong>er ages<br />

and with shorter exposure times than among people making a living<br />

using their voices (reyes garcía, 2006). In 2006, according to the<br />

119

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