Identifying workers at risk of sickness absence by questionnaire

BACKGROUND: Sickness absence is an important economic problem, because of high costs and lost productivity. Determining factors associated with increased risk of sickness absence may lead to the development of preventive measures. AIMS: To determine whether self-report questionnaires can identify those employees at risk of sickness absence METHODS: Prospective study of 238 healthy administrative workers. Participants completed a questionnaire proven to be valid and consistent. The questionnaire consisted of 116 items about health, work and working conditions. Sickness absence was followed-up for a period of 1 year. RESULTS: The questionnaires of 191 workers (80%) were suitable for analysis. The number of reported health complaints was significantly (P < 0.01) associated with sickness absence (OR 2.18; 95% CI 1.32-3.61). Concentration problems were correlated with more frequent absences, and both nervous complaints and coping problems with longer duration. Age (OR 0.96; 95% CI 0.93-0.99; P = 0.02) and job insecurity (OR 0.68; 95% CI 0.47-0.98; P = 0.04) were negatively associated with sickness absence. Psychosocial and physical work factors were not associated with sickness absence. CONCLUSIONS: Questionnaires on health and work can identify employees at future risk of sickness absence. Workers who report multiple health complaints, especially concentration problems, nervous complaints or coping problems, may be at increased risk of sickness absence.     

Morbidity in expatriates--a prospective cohort study

BACKGROUND: Expatriates comprise an important, but rarely studied subset of international travellers. This study was performed to assess the incidence of health events in an expatriate group and to evaluate factors affecting this incidence. METHODS: A cohort of 2020 Foreign and Commonwealth Office (FCO) staff and partners living abroad were followed-up over 1 year. The main outcome measure was incidence of illness or injury serious enough to require consultation with a doctor. Data collection was by means of a self-administered questionnaire. Poisson regression was used to estimate the rates of health events and to test for association between health events and a number of independent variables. RESULTS: The incidence of health events was 21%. Trauma (incidence 5%), musculoskeletal disorders (incidence 4%) and infectious disease (incidence 3%) were the principal causes of morbidity. The incidence of psychological disorders was low (1%). Of significance, employees were at increased risk of morbidity when compared to partners, with a higher incidence of health events [incidence rate ratio (IRR) 1.4, 95% CI 1.1-1.9] and psychological disorders (IRR 5.9, 95% CI 1.0-34.1). Moreover, unaccompanied employees were at increased risk of health events (IRR 1.3, 95% CI 1.0-1.7), and of traumatic injury (IRR 2.3, 95% CI 1.3-4.3) when compared to accompanied employees. CONCLUSION: While the morbidity in FCO personnel is low in comparison to other expatriate groups, the higher risk of morbidity in employees and unaccompanied individuals merits further research, particularly to ascertain whether work demands, isolation or risk-taking behaviour are contributory factors.     

Evaluation of occupational health service in the wood processing industry--determination of employee satisfaction

In order to define priorities for improvement of the occupationalhealth service (OHS) in one primary health care unit, employees'satisfaction was evaluated with a postal questionnaire. Thequestionnaire covered items on service reservation, personalhealth education received, quality of the OHS, and use of theOHS within six months by the employees. This evaluation wasone step of the quality system that was planned in accordancewith the ISO 9004-2 standard for continuous quality improvementof OHS. The study population was all of 1,050 employees workingfor five employers; 546 (52%) employees responded to the inquiry.However, only 377 of them had made use of the OHS within thelast six months before the inquiry. The mean age of the responderswas 42 years (SD=9 years) and 76%of the respondents were men.The percentages of employees with a high degree of satisfactionwith the quality of the OHS and personal health education inthe OHS were 76% and 69%, respectively. However, concerningthe quality of the OHS, the proportion of highly satisfied employeeswas 27% higher (95% Cl=19–35%) among those who had usedOHS within six months compared to the others. Furthermore, whenthe oldest (>48 years) and the youngest (<35 years) agegroups were compared, the difference between the proportionsof highly satisfied employees was 21% (95% Cl=11–31%).In conclusion, the high differences suggest a close linkagebetween the employee's satisfaction with the OHS, the use ofthe OHS and ageing.     

A cross-sectional study of employer and employee occupational health needs and priorities within the Irish Civil Service

BACKGROUND: This study aimed to establish how important an occupational health unit (OHU) is to its clients, and to identify the perceived needs and priorities for such a service. METHODS: A cross-sectional postal survey of a stratified, randomly selected group of employees (n = 760) and all human resources (HR) managers (n = 34) was conducted in the Irish Civil Service. Each participant was requested to rate the overall importance of the OHU and to prioritize eight proposed functions for the unit: medical surveillance, general health education, pre-employment/promotion medical assessments, ill-health retirement assessments, return-to-work (after sick leave) assessments, occupational health education, research, and general medical screening. The results were analysed according to age group, gender, grade and occupation. RESULTS: There was a response rate of 69% from employees and 74% from personnel managers. Significantly more HR managers than employees (92 versus 81%) thought an occupational health service was either important or very important. There were also differences in prioritization of functions by employees and HR managers. HR managers prioritized those functions concerned with assessing individuals' fitness for work, notably pre-employment/promotional health assessments, whereas employees consider group-directed 'preventative' functions to be more important, i.e. general medical screening, health education and medical surveillance. Both sets of opinions are not mutually exclusive, and considerable overlap exists, notably in the areas of occupational and general health education.     

Shift work, health, the working time regulations and health assessments.

Shift work and night work in particular have been associated with sleep difficulties, general malaise, fatigue, peptic ulceration, ischaemic heart disease, cigarette smoking and adverse pregnancy outcome. The medical conditions previously regarded as making individuals unsuitable for shift work show wide ranging patho-physiological activity and there is no published evidence for any such condition to be regarded an absolute reason to exclude an individual from shift work. The fulfilment of the legal obligations of the Working Time Regulations 1998 is neither prescribed nor constrained in any way. It is advisable therefore to build on existing health procedures where they are in effect. Periodic health questionnaires can offer health professionals an opportunity to detect any disorder likely to be aggravated by shift work or by a combination of shift work, job demands and workplace conditions. A further purpose of the questionnaire is the assessment of ability to undertake shift work duties. However, health questionnaires are neither sensitive nor specific enough to be used to select applicants or employees for shift work, since they do not consistently predict tolerance of shift work or subsequent health problems. Whether employers should offer anything more than a simple questionnaire will depend on the culture of the company and accessibility of health services. Screening programmes affect many people relative to the few who benefit and with existing knowledge, periodic general health examinations performed in asymptomatic subjects have limited predictive or preventive value.     

Organizational practices, work demands and the well-being of employees: a follow-up study in the metal industry and retail trade

BACKGROUND: Rapid technological change and increased international competition have changed working life and work organizations. These changes may not be considered when researching employee work ability and well-being. AIM: This study investigates the impact of organizational practices, work demands and individual factors on work ability, organizational commitment and mental well-being of employees in the metal industry and retail trade. METHOD: A follow-up study was conducted to examine these connections among 1389 employees (mean age 42 years at baseline) in 91 organizations. The first survey was conducted in 1998 and was repeated in 2000. RESULTS: Changes in organizational practices and the demands of work were strongly associated with changes in employee well-being. Work ability, organizational commitment and the mental well-being of employees were increased most if the opportunities for development and influence and the promotion of employee well-being were increased and if the supervisory support and organization of work were improved. Well-being also improved with less uncertainty at work and with decreasing mental and physical work demands. In addition physical exercise and affluence also had favourable effects. CONCLUSIONS: The results confirm that several features of organizational practices are strongly associated with employees' well-being. Organizational development is an important method of improving employees' work ability, commitment and well-being.     

Use of prescribed medication at work in employees with chronic illness

BACKGROUND: This study examined factors associated with the use of prescribed medication at work. METHODS: Questionnaire survey of employees with diagnosed chronic illnesses from four UK organizations. Data were collected on type of chronic illness, health status, health beliefs, work limitations, occupational health support, general practitioner (GP) and line manager support. Data were analysed using univariate logistic regression. RESULTS: A total of 1474 employees with chronic illness participated. Medication use at work (yes versus no) was predicted by age, pain, diagnosis of heart disease, medication use at home, benefit of prescribed medication to health, ease of using medication at work, practical support from families and practical and emotional support from GP and line manager. In a multivariate logistic regression model, medication use at work was predicted by medication use at home and ease of using medication at work only. CONCLUSIONS: The ease of taking medication at work was found to be a key predictor of medication use at work, suggesting occupational health may play a vital role in finding ways to support employees in their usage of medication. This may be for example by providing help and guidance in storing medication at work and encouraging employees to disclose medication use to employers and managers where necessary. Occupational health services can help create a workplace culture that places a high value on health, educating staff on the value of looking after their health and the benefits of following advice.     

Validity of the HSE stress tool: an investigation within four organizations by the Corporate Health and Performance Group

AIM: To examine the validity and accuracy of the HSE Management Standards Stress Tool. METHODS: A cross-sectional questionnaire was administered to employees of the occupational health and human resource departments of four of the Corporate Health and Performance Group organizations. The relationship between the six first-pass stress filter questions and self-rated health were examined using the General Health Questionnaire (GHQ12) and the Short Form. The relationship between the filter questions and objective work characteristics such as sickness absence, self-rated performance and job satisfaction was also examined. RESULTS: Two hundred and thirty-five employees participated, giving an overall response rate of 68%. The study sample met the proposed HSE of 85 and 65% pass rates and would not normally progress to further analysis. Almost 40% of the group were above threshold on the GHQ12; 19% rated their work as very or extremely stressful. While the filters were highly specific, they were insensitive and at best detected for less than 40% of those with psychological or work stress. All but one of the filters had less than 50% positive predictive value for work stress and the majority of those identified by the filters did not consider themselves stressed, either overall or by work. Five of the filter questions were significantly associated with self-rated performance, three with absence and two with other objective work indicators. CONCLUSIONS: Further developmental work on these filter questions is indicated. Use of work absence as a measure of the impact or 'cost' of stress may lead to a significant underestimation of the 'true cost' of psychosocial hazards in the workplace.