[Interterritorial inequalities in compensation for occupational diseases in Spain from 1990-2007]

To determine the reporting pattern and trends for occupational diseases by autonomous communities in Spain between 1990 and 2007.

Cases were obtained from the Ministry of Labor and Social Affairs, and the number of workers was obtained from the National Institute of Statistics. A principal components analysis was used to explain the data structure. Adjusted annual incidence rates were computed and relative risk is shown in maps.

The number of reported occupational diseases remained constant from 1990 to 2005 in all the autonomous communities, except for minor occupational diseases not leading to sick leave (accounting for 99% of the total), which increased. From 2006-07, reported rates decreased to almost half: 17,061 cases in 2007 versus 30,030 in 2005. Both the increase and the decrease in incidence were observed in all autonomous communities, but with distinct values and slopes. As revealed by the principal components analysis, all the autonomous communities showed the same time pattern, except Asturias. Northern Spain showed the highest rates, which cannot be explained by factors such as age, sex, economic activity or occupation.

The social security system is not compensating the complex and chronic diseases that are prevalent today. Despite improvements in disease reporting from 1990-2005, the decrease observed from 2006-07 and, above all, the gap among autonomous communities show that provision is not working with equity, generating inequality and lack of cohesion and posing a challenge for the definition of efficient prevention policies.