RESUMENLa violencia contra profesionales y el síndrome de burnout, o desgaste profesional del personal sanitario, ha adquirido una enorme importancia en los últimos años, especialmente en los servicios de urgencias. Sólo una pequeña proporción de las agresiones al personal sanitario sale a la luz, pero hay un gran volumen de incidentes violentos sumergidos que no constan en ninguna parte. Se han creado protocolos y registros de agresiones en diversas comunidades para contar con datos precisos y poder tomar las decisiones más adecuadas y oportunas.Las agresiones sufridas por los trabajadores se encuentran dentro del amplio abanico de riesgos que afectan a la seguridad y salud de los trabajadores sanitarios, ya de por sí sometidos a factores de estrés laboral elevados que conducen a altos niveles de desgaste profesional (burnout).Por otra parte, los «profesionales quemados» incrementan, con sus actitudes en el trabajo, el riesgo de agresiones contra sí mismos y contra sus compañeros. Las autoridades sanitarias tienen entre sus prioridades no sólo ofrecer un servicio de calidad a todas las personas usuarias del sistema sanitario, sino también que todo profesional sanitario pueda trabajar en las mejores condiciones laborales y con unos niveles de satisfacción, motivación y seguridad adecuados.Palabras clave. Agresividad. Síndrome de burnout. Servicios de urgencias. Violencia laboral. ABSTRACTViolence against professionals and the syndrome of burnout, or the professional exhaustion of health personnel, has acquired enormous significance in recent years, especially in emergency care. Only a small proportion of the aggressions against the health personnel come to light, but there is a great volume of submerged violent incidents that are not recorded anywhere. Protocols and registers of aggressions have been created in different autonomous communities to make precise data available so that more suitable and opportune decisions can be taken. The aggressions suffered by the workers fall within a wide range of risks that affect the safety and health of health workers, who are already subjected to high stress that lead to high levels of professional exhaustion (burnout). On the other hand, "burnt-out professionals", with their attitudes at work, increase the risk of aggressions against themselves and against their colleagues. The priorities of the health authorities include not only offering a quality service to all the users of the health system, but also ensuring that every health professional can work in optimum working conditions, with suitable levels of satisfaction, motivation and safety.

Factors underlying metabolic phenotypes, such as the metabolically healthy but obese phenotype, remain unclear. Differences in metabolic phenotypes-particularly, among individuals with a similar body mass index-could be related to concentrations of persistent organic pollutants (POPs). To our knowledge, no studies have analyzed POPs and metabolic phenotypes in normal-weight persons. We investigated the relationships between serum concentrations of POPs and metabolic phenotypes in 860 normal-weight, overweight, and obese participants in the 2002 Catalan Health Interview Survey (Spain). POP concentrations were significantly higher in metabolically unhealthy than in metabolically healthy individuals. In models adjusting for body mass index and other confounders, hexachlorobenzene, β-hexachlorocyclohexane, and polychlorinated biphenyls were associated with the unhealthy metabolic phenotype and metabolic syndrome. Among normal-weight individuals, the adjusted prevalence ratio of having an unhealthy phenotype for the upper category of the sum of orders of the 6 mentioned POPs (all individually associated with metabolic phenotypes) was 4.1 (95% confidence interval: 1.7, 10.0). Among overweight and obese individuals, the corresponding prevalence ratio for the sum of polychlorinated biphenyls was 1.4 (95% confidence interval: 1.0, 1.8). Our results supported the hypothesis that POP concentrations are associated with unhealthy metabolic phenotypes, not only in obese and overweight individuals but also (and probably more strongly) in normal-weight individuals.

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