<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0213-9111</journal-id>
<journal-title><![CDATA[Gaceta Sanitaria]]></journal-title>
<abbrev-journal-title><![CDATA[Gac Sanit]]></abbrev-journal-title>
<issn>0213-9111</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Española de Salud Pública y Administración Sanitaria (SESPAS)]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0213-91112021000500502</article-id>
<article-id pub-id-type="doi">10.1016/j.gaceta.2020.03.005</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Causalidad y responsabilidad en salud laboral]]></article-title>
<article-title xml:lang="en"><![CDATA[Causality and responsibility in occupational health]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Benavides]]></surname>
<given-names><![CDATA[Fernando G]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universitat Pompeu Fabra IMIM Parc Salut Mar Centro de Investigación en Salud Laboral (CiSAL]]></institution>
<addr-line><![CDATA[Barcelona ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,CIBER de Epidemiología y Salud Pública (CIBERESP)  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>España</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>10</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>10</month>
<year>2021</year>
</pub-date>
<volume>35</volume>
<numero>5</numero>
<fpage>502</fpage>
<lpage>505</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S0213-91112021000500502&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S0213-91112021000500502&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S0213-91112021000500502&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen El objetivo de este trabajo es revisar la relación imperfecta entre causalidad y responsabilidad, desde la mirada de la salud laboral. En este espacio académico y profesional se produce frecuentemente esta tensión al abordar la prevención de enfermedades y lesiones laborales. Desde la epidemiología somos muy exigentes en nuestras observaciones, tanto respecto a la validez interna como a la validez externa, al establecer relaciones causales; un rigor imprescindible en el análisis de la causalidad, que no nos previene de la miopía cuando se adopta una visión puramente biomédica, olvidando las causas a diferentes niveles y de naturaleza económica y política algunas de ellas. A su vez, necesitamos una gobernanza (Administraciones, empresas y gobiernos) que a veces muestra hipoacusia y no asume la responsabilidad a través del establecimiento de políticas, basadas o no en normas legales. Unas normas fruto de procesos participativos, que en ocasiones se prolongan excesivamente en el tiempo como resultado de intereses contrapuestos, lo que puede llevar a situaciones inaceptables de sufrimiento evitable. El debate es ilustrado con dos ejemplos: la exposición al amianto y una lesión mortal por un accidente de trabajo. Así pues, con la ayuda de alguna prótesis, la ciencia de unas gafas para proporcionar evidencias que nos explican desde lo macro a lo micro el proceso de la salud a la enfermedad, y la política de unos audífonos para asumir la responsabilidad de adoptar medidas preventivas escuchando los intereses de las personas más vulnerables, todos podríamos disfrutar de una vida larga y saludable.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract The objective of this work is to review the imperfect relationship between causality and responsibility, from the perspective of occupational health, where this tension occurs so frequently when addressing the prevention of illnesses and occupational injuries. From epidemiology, we are very demanding in our observations, both in terms of internal and external validity, when establishing causal relationships. An essential rigor in the analysis of causality, which does not prevent us from myopia when a purely biomedical vision is adopted, forgetting the causes at different levels and of an economic and political nature. In turn, we need a governance (administrations, companies and governments) that assumes responsibility through the establishment of policies, many of them based on legal norms. Rules resulting from participatory processes, broad in democratic societies, in which conflicting interests intervene, and sometimes extends for years, which can lead to unacceptable situations of unrecognized suffering. So, helping us with some prosthesis, a glasses for science, to provide evidence that explains from macro to micro the process that takes us from health to disease, and a hearing aids for politics, to assume with all consequences their responsibility for taking preventive measures listening to the interests of the most vulnerable people, we could enjoy a long and healthy life.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Salud laboral]]></kwd>
<kwd lng="es"><![CDATA[Derecho Inferencia causal]]></kwd>
<kwd lng="es"><![CDATA[Principio de precaución]]></kwd>
<kwd lng="en"><![CDATA[Occupational health]]></kwd>
<kwd lng="en"><![CDATA[Law Causal inference]]></kwd>
<kwd lng="en"><![CDATA[Precautionary principle]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Benavides]]></surname>
<given-names><![CDATA[FG]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Vocación científica, vocación política en la salud pública]]></article-title>
<source><![CDATA[Gac Sanit]]></source>
<year>2008</year>
<volume>22</volume>
<page-range>81-2</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Weber]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<source><![CDATA[El político y el científico]]></source>
<year>1984</year>
<edition>8</edition>
<publisher-loc><![CDATA[Madrid ]]></publisher-loc>
<publisher-name><![CDATA[Alianza]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hill]]></surname>
<given-names><![CDATA[AB]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The environment and disease: association or causation?]]></article-title>
<source><![CDATA[Proc R Soc Med]]></source>
<year>1965</year>
<volume>58</volume>
<page-range>295-300</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hernán]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The C-word: scientific euphemisms do not improve causal inference from observational data]]></article-title>
<source><![CDATA[Am J Public Health]]></source>
<year>2018</year>
<volume>108</volume>
<page-range>616-9</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[García]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
<name>
<surname><![CDATA[Benavides]]></surname>
<given-names><![CDATA[FG]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Causalidad en salud laboral: el caso de Ardystil]]></article-title>
<source><![CDATA[Gac Sant]]></source>
<year>1995</year>
<volume>51</volume>
<page-range>371-9</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Segura]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Reflexiones sobre la causalidad de las epidemias de asma]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Agustín]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<source><![CDATA[Las epidemias de asma de Barcelona]]></source>
<year>1990</year>
<page-range>85-108</page-range><publisher-loc><![CDATA[Madrid ]]></publisher-loc>
<publisher-name><![CDATA[Ministerio de Sanidad y Consumo]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Krieger]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Epidemiology and the web of causation: has anyone seen the spider?]]></article-title>
<source><![CDATA[Soc Sci Med]]></source>
<year>1994</year>
<volume>39</volume>
<page-range>887-903</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rose]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<source><![CDATA[La estrategia de la medicina preventiva]]></source>
<year>1994</year>
<publisher-loc><![CDATA[Barcelona ]]></publisher-loc>
<publisher-name><![CDATA[Masson-Salvat]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Benavides]]></surname>
<given-names><![CDATA[FG]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[La epidemiologia "moderna" y la "nueva" salud pública]]></article-title>
<source><![CDATA[Rev San Hig Pub]]></source>
<year>1994</year>
<volume>68</volume>
<page-range>101-5</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hernán]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Robins]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<source><![CDATA[Causal inference]]></source>
<year>2019</year>
<publisher-loc><![CDATA[Boca Raton ]]></publisher-loc>
<publisher-name><![CDATA[Chapman &amp; Hall/CRC]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hoffmeister]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Benavides]]></surname>
<given-names><![CDATA[FG]]></given-names>
</name>
<name>
<surname><![CDATA[Jodar]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Responsabilidad social corporativa en salud y seguridad en el trabajo: dimensiones, realidad y perspectivas]]></article-title>
<source><![CDATA[Cuadernos de Relaciones Laborales]]></source>
<year>2006</year>
<volume>24</volume>
<page-range>183-98</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Murray]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Asbestos: a chronology of its origins and health effects]]></article-title>
<source><![CDATA[Br J Ind Med]]></source>
<year>1990</year>
<volume>47</volume>
<page-range>361-5</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Doll]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Mortality from lung cancer in asbestos workers]]></article-title>
<source><![CDATA[Br J Ind Med]]></source>
<year>1955</year>
<volume>12</volume>
<page-range>81-6</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Selikoff]]></surname>
<given-names><![CDATA[IJ]]></given-names>
</name>
<name>
<surname><![CDATA[Churg]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Hammond]]></surname>
<given-names><![CDATA[EC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Asbestos exposure and neoplasia]]></article-title>
<source><![CDATA[JAMA]]></source>
<year>1964</year>
<volume>188</volume>
<page-range>22-6</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Selikoff]]></surname>
<given-names><![CDATA[IJ]]></given-names>
</name>
<name>
<surname><![CDATA[Hammond]]></surname>
<given-names><![CDATA[EC]]></given-names>
</name>
<name>
<surname><![CDATA[Churg]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Asbestos exposure, smoking, and neoplasia]]></article-title>
<source><![CDATA[JAMA]]></source>
<year>1968</year>
<volume>204</volume>
<page-range>106-12</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Landrigan]]></surname>
<given-names><![CDATA[PJ]]></given-names>
</name>
<name>
<surname><![CDATA[Kazemi]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The third wave of asbestos disease: exposure to asbestos in place. Public health control]]></article-title>
<source><![CDATA[Ann N Y Acad Sci]]></source>
<year>1991</year>
<volume>643</volume>
<page-range>1-628</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[McCulloch]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Tweedale]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Science is not sufficient: Irving J Selikoff and the asbestos tragedy]]></article-title>
<source><![CDATA[New Solut]]></source>
<year>2007</year>
<volume>17</volume>
<page-range>293-310</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Benavides]]></surname>
<given-names><![CDATA[FG]]></given-names>
</name>
<name>
<surname><![CDATA[Menéndez-Navarro]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Delclos]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Evidencia científica y responsabilidad social: recargo de prestaciones por falta de medidas de seguridad e higiene tras la muerte por mesotelioma de un trabajador]]></article-title>
<source><![CDATA[Arch Prev Riesgos Labor]]></source>
<year>2012</year>
<volume>15</volume>
<page-range>86-9</page-range></nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pitarque]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Clèries]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Martínez]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Mesothelioma mortality in men: trends during 1977-2001, and projections for 2002-2016 in Spain]]></article-title>
<source><![CDATA[Occup Environ Med]]></source>
<year>2008</year>
<volume>65</volume>
<page-range>279-82</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sánchez]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[El principio de precaución: implicaciones para la salud pública]]></article-title>
<source><![CDATA[Gac Sanit]]></source>
<year>2002</year>
<volume>16</volume>
<page-range>371-3</page-range></nlm-citation>
</ref>
<ref id="B21">
<label>21</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fernández]]></surname>
<given-names><![CDATA[MF]]></given-names>
</name>
<name>
<surname><![CDATA[Olea]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Disruptores endocrinos ¿suficiente evidencia para actuar?]]></article-title>
<source><![CDATA[Gac Sanit]]></source>
<year>2014</year>
<volume>28</volume>
<page-range>93-5</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
