The impact of being the intermediate caring generation and intergenerational transfers on self-reported health of women in Ireland

Objectives

To investigate the associations with being the “sandwich generation” in older women in Ireland and its impact on self-reported health.

Methods

Analysis of 3,196 women from wave 1 of the Irish Longitudinal Study on Ageing (TILDA) was undertaken. Poisson regression was used to determine whether intergenerational transfers, were associated with self-rated physical health and depression, when controlling for other socio-demographic variables.

Results

Multivariate analysis found that women in the sandwich generation who financially supported their children had better self-rated physical health (poor/fair health relative to excellent; RR 0.84, 95 % CI 0.72–0.97). Conversely, the women who provided other care for their children showed evidence of poorer mental health (case-level depression, RR 1.35, 95 %CI 1.05–1.73). Providing financial support for parents was associated with case-level depression (RR 2.21, 95 %CI 1.26–3.86).

Conclusions

Supporting two generations was associated with both better self-rated health and poorer mental health, depending on the type and direction of the transfers. This generation of women have substantial caring responsibilities. Strategies to address the stresses associated with bi-directional intergenerational transfers are needed.     

Immigration, work and health in Spain: the influence of legal status and employment contract on reported health indicators

Objective

To analyze the relationship of legal status and employment conditions with health indicators in foreign-born and Spanish-born workers in Spain.

Methods

Cross-sectional study of 1,849 foreign-born and 509 Spanish-born workers (2008–2009, ITSAL Project). Considered employment conditions: permanent, temporary and no contract (foreign-born and Spanish-born); considered legal statuses: documented and undocumented (foreign-born). Joint relationships with self-rated health (SRH) and mental health (MH) were analyzed via logistical regression.

Results

When compared with male permanently contracted Spanish-born workers, worse health is seen in undocumented foreign-born, time in Spain ≤3 years (SRH aOR 2.68, 95% CI 1.09–6.56; MH aOR 2.26, 95% CI 1.15–4.42); in Spanish-born, temporary contracts (SRH aOR 2.40, 95% CI 1.04–5.53); and in foreign-born, temporary contracts, time in Spain >3 years (MH: aOR 1.96, 95% CI 1.13–3.38). In females, highest self-rated health risks are in foreign-born, temporary contracts (aOR 2.36, 95% CI 1.13–4.91) and without contracts, time in Spain >3 years (aOR 4.63, 95% CI 1.95–10.97).

Conclusions

Contract type is a health determinant in both foreign-born and Spanish-born workers. This study offers an uncommon exploration of undocumented migration and raises methodological issues to consider in future research.     

Health-related quality of life and body mass index among US adolescents

Purpose

To examine the magnitude of differences in health-related quality of life (HRQOL) by body mass index (BMI) in a population-based sample of United States adolescents overall and by sex, and to provide national prevalence estimates of reported HRQOL outcomes for not only obese and overweight but also underweight adolescents.

Methods

From the 2001 through 2010 cross-sectional National Health and Nutrition Examination Surveys, we estimated the percentages of four HRQOL outcomes—self-rated health, physically unhealthy days, mentally unhealthy days, and activity limitation days—in four BMI categories—obese, overweight, normal weight, and underweight—of approximately 6,000 US adolescents aged 12–17 years. We also estimated the percentages for boys and girls separately.

Results

Substantial gaps in self-rated health exist between normal-weight adolescents and those who are obese and overweight, but not underweight. Eighteen percent (95 % CI 15–22) of obese adolescents reported fair or poor health compared to only 5 % (95 % CI 4–7) of normal-weight adolescents. Thirty-seven percent (95 % CI 33–42) of obese adolescents reported excellent or very good health, compared to 65 % (94 % CI 63–67) of normal-weight adolescents. However, all BMI groups reported similar percentages of physically unhealthy days, mentally unhealthy days, and activity limitation days. The associations between HRQOL and BMI groups did not vary by sex. Boys generally reported significantly better self-rated health and mental health than girls. Specifically, obese boys reported better self-rated health, mental health, and fewer activity limitation days than obese girls.

Conclusions

Substantially, significant differences in some domains of HRQOL are found between above normal-weight and normal-weight US adolescents. This relationship between BMI and HRQOL is robust and observed among both boys and girls.     

The role of lifestyle, health, and work in educational inequalities in sick leave and productivity loss at work

Purpose

To investigate the influence of lifestyle, health, and work conditions in the association between education and productivity loss at work and sick leave.

Methods

Employees of six companies filled out a questionnaire on demographics, lifestyle-related, health, and work-related factors, and productivity loss at work and sick leave at baseline (n = 915) and after 1-year (n = 647).

Results

Employees with a low education were more likely to report productivity loss at work (OR = 1.49, 95 % CI 0.98–2.26) and sick leave (OR = 1.81, 95 % CI 1.15–2.85). After adjustment for lifestyle, health, and work conditions, the association between education and productivity loss at work did not attenuate. Work conditions attenuated the association between low education and sick leave (OR = 1.62, 95 % CI 1.01–2.61), and additional adjustment for health and lifestyle-related factors further reduced the strength of the association (OR = 1.42, 95 % CI 0.86–2.34).

Conclusion

Work conditions and lifestyle-related factors partly explained the association between education and sick leave, but did not influence the association between education and productivity loss at work. The educational differences in sick leave prompt for interventions that address behavioral aspects as well as work-related and lifestyle-related factors.     

Skin symptoms in bakery and auto body shop workers: associations with exposure and respiratory symptoms

Purpose

Despite the importance of skin exposure, studies of skin symptoms in relation to exposure and respiratory symptoms are rare. The goals of this study were to describe exposure–response relationships for skin symptoms, and to investigate associations between skin and respiratory symptoms in bakery and auto body shop workers.

Methods

Data from previous studies of bakery and auto body shop workers were analyzed. Average exposure estimates for wheat allergen and isocyanates were used. Generalized linear models were constructed to describe the relationships between exposure and skin symptoms, as well as between skin and respiratory symptoms.

Results

Data from 723 bakery and 473 auto body shop workers were analyzed. In total, 5.3 % of bakery and 6.1 % of auto body shop workers were female; subjects’ mean age was 39 and 38 years, respectively. Exposure–response relationships were observed in auto body shop workers for itchy or dry skin (PR 1.55, 95 % CI 1.2–2.0) and work-related itchy skin (PR 1.97, 95 % CI 1.2–3.3). A possible exposure–response relationship for work-related itchy skin in bakery workers did not reach statistical significance. In both groups, reporting skin symptoms was strongly and significantly associated with reporting respiratory symptoms, both work-related and non-work-related.

Conclusions

Exposure–response relationships were observed for skin symptoms in auto body shop workers. The lack of significant exposure–response associations in bakery workers should be interpreted cautiously. Workers who reported skin symptoms were up to four times more likely to report respiratory symptoms. Improved awareness of both skin and respiratory outcomes in exposed workers is needed.     

The relationship between immigration and mental health: what is the role of workplace psychosocial factors

Background

To study the relationship between immigration and mental health considering the psychosocial factors in the workplace.

Methods

Multistage cluster sampling was used (final sample: 7,612 workers). Workers whose country of origin was unknown were excluded from the study (study population: 7,555). The information was collected between 2004 and 2005 using a standardized questionnaire, and interviews were conducted in respondents’ homes. The risk of poor mental health according to psychosocial factor, using the native, non-exposed workers as a reference, was calculated using log-binomial models. The prevalence ratio (PR) and confidence intervals (CI 95%) were estimated from crude data and from data adjusted for sex, age, and occupational category.

Results

Immigrants who experienced high quantitative demands (PR?=?1.46; CI 95%:1.34–1.59), high emotional demands (PR?=?1.42; CI 95%:1.301.56), high demands for hiding emotions (PR?=?1.35; CI 95%:1.21–1.50), low possibilities for development (PR?=?1.21; CI 95%:1.09–1.33), low levels of support from coworkers (PR?=?1.41; CI 95%:1.30–1.53), and low esteem (PR?=?1.53; CI 95%:1.42–1.66) perceived worse mental health. Equally, the study found that the immigrants with a high influence (PR?=?1.19; CI 95%:1.09–1.29) and high control over working times (PR?=?1.25; CI 95%:1.14–1.36) also reported worse mental health. We also found that native workers exposed to these factors also perceived worse mental health than those who were not exposed and that even, at times, they were at greater risk than exposed immigrants.

Conclusions

Differences in mental health between exposed and non-exposed wage earners, whether immigrant or native workers, indicate the importance of taking action to reduce psychosocial factors, as this would benefit both native and immigrant workers.     

Intergenerational educational mobility on general mental health and depressive symptoms in young women

Purpose

To investigate how intergenerational educational mobility between women and their parents influences mental health/depressive symptoms in women.

Method

We studied 5,619 women aged 31–36 years in 2009 from the Australian Longitudinal Study on Women’s Health. The short-form-36 Mental Component Summary Scores [MCS] measured mental health and the Centre for Epidemiologic Studies Depression Scale [CES-D] measured depressive symptoms. Multiple regression analyses, with adjustment for confounders, were used.

Results

Greater downward mobility from mothers (mother high to self low) [MCS regression estimate [β] ?3.35; 95 % confidence interval [CI] ?5.6,?1.1; CES-D β 1.94; 95 % CI, 0.7,3.2], and greater (father high to self low MCS β,-2.53; 95 % CI ?4.8,?0.3] and moderate (father high to self intermediate MCS β ?1.71; 95 % CI ?3.3,?0.1] downward mobility from fathers were associated with poorer mental health in women. Another strongly consistent influence on poor mental health was answering ‘don’t know/not applicable’ about parental education [mother–self MCS β ?1.34; 95 % CI, ?2.3,?0.4; mother–self CES-D β 0.52; 95 % CI 0.01,1.0; father–self MCS β ?1.19; 95 % CI ?2.1,?0.3].

Conclusions

There are subtle differences for same and opposite-sex parent–daughter relationships on the impact of downwards intergenerational educational mobility on mental health in young women. These results suggest the effect of own educational attainment on mental health depends on the degree of disparity between self and parent. Future studies should consider ‘don’t know’ as a separate category rather than treating it as a ‘missing’ response.     

From embouchure problems to embouchure dystonia? A survey of self-reported embouchure disorders in 585 professional orchestra brass players

Objectives

Data concerning embouchure problems in professional brass players are scarce. Embouchure problems can potentially lead to focal dystonia. The aim of this study was to investigate the frequency of distinct embouchure problems in professional brass players. Furthermore, the frequency of “cramping”, a distinct symptom of embouchure dystonia, was evaluated in the context of established embouchure dystonia risk factors.

Methods

Five hundred and eighty-five professional brass players participated in a cross-sectional study concerning embouchure problems. A self-administered questionnaire was developed to evaluate embouchure fatigue, embouchure disorders and their consequences. To study the association between risk factors and cramping (a symptom of embouchure dystonia), a log-binomial regression analysis was conducted, enabling estimation of prevalence ratios (PR) and 95 % confidence intervals (95 % CI).

Results

Thirty percent (95 % CI 25.9–33.3) reported embouchure fatigue. The relative frequency of embouchure disorders was 59 % (95 % CI 54.6–63.6), with 26 % (95 % CI 22.4–29.5) reporting embouchure cramping. Embouchure disorders resulted in sick leave in 16 % (95 % CI 12.7–20.6). Female brass players (PR 2.0, 95 % CI 0.98–3.98) and musicians with a prior change in their embouchure (PR 2.4, 95 % CI 1.38–4.05) or breathing technique (PR 2.2, 95 % CI 1.25–3.72) and musicians with embouchure fatigue (PR 1.9, 95 % CI 1.18–2.93) presented more frequently with embouchure cramping than musicians with other or without risk factors.

Conclusion

This study shows a high relative frequency of embouchure problems in professional brass players. Given that embouchure dystonia is often preceded by embouchure problems, these findings may assist in gaining further insight into the characteristics of embouchure dystonia and the development of preventive strategies.     

Organizational factors associated with work-related sleep problems in a nationally representative sample of Korean workers

Purpose

The purpose of this study was to assess the association of organizational factors with work-related sleep problems (WRSP) among Korean workers.

Methods

The data were derived from the First Korean Working Conditions Survey conducted in 2006 with a representative sample of the Korean working population (n = 10,039).

Results

The overall prevalence of WRSP was 5.1  % (95  % confidence interval (CI) 4.7–5.5). Those who experienced sexual harassment at work (adjusted odds ratio (aOR) 3.47: 95 % CI 1.77–6.81), discrimination due to sex (aOR 2.44: 95 % CI 1.36–4.36) or age (aOR 2.22: 95 % CI 1.52–3.23), violence at work (aOR 1.98: 95 % CI 1.06–3.68), threat of violence (aOR 1.96: 95 % CI 1.05–3.66), poor work-life balance (aOR 1.78: 95 % CI 1.44–2.20), low job satisfaction (aOR 1.69: 95 % CI 1.37–2.09), high cognitive (OR 1.64: 95 % CI 1.32–2.03) and emotional (aOR 1.53: 95 % CI 1.22–1.91) demands, job insecurity (aOR 1.32: 95 % CI 1.07–1.63), and high work intensity (aOR 1.55: 95 % CI: 95 % CI 1.25–1.92) had an increased risk of WRSP compared to their respective counterparts (p < 0.01). Low social support was not significantly associated with WRSP (aOR 0.88: 95 % CI 0.67–1.15).

Conclusion

The results revealed that poor psychosocial working conditions may be related to a high prevalence of WRSP among representative Korean workers.     

Organizational and psychosocial risk factors for carpal tunnel syndrome: a cross-sectional study of French workers

Purpose

The aim of the study was to examine the organizational and psychosocial risk factors for carpal tunnel syndrome (CTS) in workers exposed to various levels of work-related constraints, with a special focus on factors related to the work organization.

Methods

From 3,710 workers, representative of a French region’s working population, trained occupational physicians diagnosed a total of 156 cases of CTS between 2002 and 2005. Diagnoses were established by standardized physical examination, while personal factors and work exposure were assessed by self-administered questionnaires. Statistical associations between CTS and personal and work-related factors were analyzed for each gender using logistic regression modeling.

Results

Among the factors related to work organization, working with temporary workers was associated with CTS for women (OR = 1.99, 95 % CI 1.23–3.25), but not for men. Task rotation during the job (OR = 2.45 95 % CI 1.41–4.24) and work pace dependent on quantified targets (OR = 1.93 95 % CI 1.08–3.46) were associated with CTS only for men. The work-related psychosocial factors highlighted by the logistic modeling were high psychological demand for women (OR = 1.90, 95 % CI 1.17–3.09) and low skill discretion (OR = 1.77, 95 % CI 1.01–3.11) for men.

Conclusion

This study has identified some psychosocial factors and factors related to work organization associated with clinically diagnosed and symptom-only cases of CTS as well as personal and biomechanical factors. However, due to the cross-sectional design of the study, no causal conclusion could be drawn and longitudinal studies are necessary to confirm these results.     

Social capital dynamics and health in mid to later life: findings from Australia

Purpose

The influence of social capital has been shown to improve health and wellbeing. This study investigates the relationship between changes in social capital and health outcomes during a 6-year follow-up in mid to later life in Australia.

Methods

Nationally representative data from the Household, Income and Labour Dynamics in Australia (HILDA) survey included participants aged 45 years and over who responded in 2006, 2010 and 2012 (N = 3606). Each of the three components of social capital (connectedness, trust and participation) was measured in Waves 2006 and 2010 and categorised as: ‘never low’, ‘transitioned to low’, ‘transitioned out of low’ and ‘consistently low’. Health outcomes in 2012 included self-rated overall health, physical functioning, and mental health based on the Short Form 36-item health survey (SF-36). Multivariable logistic regression assessed changes in social capital (measured in 2006 and 2010) predicted poor health (measured in 2012), adjusting for covariates.

Results

Consistently low trust was significantly associated with higher odds of transitions into poor physical functioning (AOR 1.54; 95% Confidence Interval 1.06–1.22), poor mental health (AOR 1.59; 95% CI 1.08–2.36) and poor self-rated health (AOR 1.86; 95% CI 1.27–2.72). Transition into low trust was also a predictor of poor self-rated health after adjusting for covariates (AOR 1.74; 95% CI 1.11–2.73). Changes in social connectedness in both directions (transitioned out of and into low) were statistically associated with poor self-rated health (AORs 1.40; 95% CI 1.00–1.97 and 1.61; 95% CI 1.11–2.34, respectively) after adjusting for confounders as well as other social capital components.

Conclusions

Our longitudinal findings reveal social capital dynamics and effects on health in mid to later life. Social trust and connectedness could be important enablers for older persons to be more active in the community and potentially benefit their health and wellbeing over time.

     

Poor self-rated health associated with an increased risk of subsequent development of lung cancer

Purpose

Self-rated health has shown to be a strong predictor of mortality and some major chronic diseases. The purpose of this study was to investigate whether poor self-rated health also was related to an increased risk of subsequent development of cancer.

Methods

Information on self-rated health, life-style factors, and other health-related risk factors was ascertained in a cohort of 25,532 persons participating in the Hordaland Health Study in 1997–1999. Information on development of cancer during 10 years of follow-up was obtained from the Norwegian Cancer Registry. The relationship between self-rated health and development of cancer was examined using Cox regression analysis adjusting for smoking and other life-style factors.

Results

Respondents reporting a poor health showed a non-significant increased risk of overall cancer. Sub-analysis of the four most common types of cancer showed a statistically significant association between self-rated health and lung cancer. The adjusted hazard ratio was 3.88 (95 % CI; 0.99, 15.8) for those rating their health as poor compared to very good (p for trend = 0.038). For the other types of cancer, we found a non-significant elevated risk associated with poor self-rated health.

Conclusion

Respondents who perceive their health as poor had an increased risk of developing lung cancer also after adjusting for smoking. This suggests that self-rated health reflects a broad range of factors important for development of this cancer type. Nevertheless, due to the explorative analysis of the specific cancer types, these findings need to be repeated before elaborate interpretations can be made.     

Occupational respiratory and skin diseases among Finnish machinists: findings of a large clinical study

Purpose

Machinists are exposed to many sensitizing and irritant substances, but no previous study has assessed the occurrence of clinically verified occupational diseases in an unselected large workforce of machinists. Our aim was to study the occurrence of clinically verified occupational respiratory and skin diseases cross-sectionally in a large sample of machinists in southern Finland.

Methods

A computer-assisted telephone interview on occupational exposures and health was carried out in a sample of 961 machining workers from 64 metalworking companies. Of these, 757 (79 %) answered the interview. A total of 245 subjects reported work-related respiratory or skin symptoms and were invited to clinical examinations; 138 of these underwent a clinical interview and examination by an occupational health physician. On the basis of this examination, 32 subjects were further examined at the Finnish Institute of Occupational Health (FIOH) for occupational skin or respiratory diseases.

Results

One case of occupational asthma (OA) and seven cases of occupational dermatoses (OD) were diagnosed, giving a prevalence of 0.13 % (95 % CI 0–0.39) for OA, and 0.92 % (95 % CI 0.24–1.16) for OD. The OA was induced by the patient’s own MWF. Additional five cases of newly diagnosed non-occupational asthma (0.79 %, 95 % CI = 0.16–1.42) were detected. No cases of occupational rhinitis or COPD were diagnosed. The dermatoses diagnoses consisted of four cases of allergic contact dermatitis and three cases of irritant contact dermatitis. The most common causes of the ODs were MWFs.

Conclusion

This large clinical study of machinists representing metalworking in South Finland showed a prevalence of 0.13 % of OA and 0.92 % of OD. This relatively low occurrence of occupational diseases may reflect the strict Finnish criteria for the diagnosis of these occupational diseases and the relatively good level of occupational hygiene in machining workshops in Finland. Reported respiratory and skin symptoms were common, and these milder conditions may be linked to irritant rather than sensitizing exposures.     

Work-related psychosocial and mechanical risk factors for neck/shoulder pain: a 3-year follow-up study of the general working population in Norway

Purpose

This study examines the impact of work-related psychosocial and mechanical exposure on the development of neck/shoulder pain in the general working population.

Methods

A randomly drawn cohort from the general population in Norway aged 18–66 was followed up for 3 years (n = 12,550, response rate = 67 %). Eligible respondents were in paid work during the reference week in 2006 and 2009, or temporarily absent from such work (n = 6,745). Four work-related psychosocial factors and six mechanical exposures were measured. Outcomes of interest were moderate or severe neck/shoulder pain at follow-up adjusted for baseline neck/shoulder pain.

Results

In total, 16.9 % (1,138 individuals) reported neck/shoulder pain during the last month at follow-up. Work related psychosocial predictors of neck/shoulder pain were high job demands (highest OR 1.41, 95 % CI 1.11–1.78) and low levels of supportive leadership (highest OR 1.66, 95 % CI 1.08–2.54). Mechanical factors were neck flexion (highest OR 1.77, 95 % CI 1.31–2.39) and lifting in awkward postures (highest OR 1.81, 95 % CI 1.21–2.71). The estimated population risk attributable to these factors was about 23 %. The relative risk for neck/shoulder pain associated with psychosocial exposure was slightly influenced by adjustment for physical risk factors, and vice versa. There was no substantial confounding related to age, gender, education, occupation or psychological distress.

Conclusions

Highly demanding jobs, neck flexion and awkward lifting appear as the most important predictors of neck/shoulder pain.     

Contact allergy to thiurams: multifactorial analysis of clinical surveillance data collected by the IVDK network

Purpose

To analyse the association between occupation (represented by job title) and contact allergy to thiuram vulcanising agents based on data of a clinical registry (IVDK, www.ivdk.org).

Methods

Clinical, demographic and allergy patch test data of all patients tested between 1992 and 2006 with the thiuram mix (1% in petrolatum) as part of the baseline series was analysed (n = 121,051). Poisson regression analysis was used to quantify the association between different occupations (and other relevant factors) and a positive patch test reaction to the thiuram mix. Furthermore, the time trend of sensitisation prevalence was analysed in high-risk occupational subgroups identified.

Results

In comparison to a largely unexposed reference group (office workers and teachers), rubber manufacturers had a significantly elevated risk (prevalence ratio (PR): 5.1, 95% confidence interval (CI) 2.0–10.5). However, health care workers such as physicians and dentists (PR: 3.8, 95% CI: 3.0–4.8) or nursing staff (PR: 3.0, 95% CI: 2.5–3.6) as well as meat and fish processors (PR 3.5, 95% CI: 2.2–5.3) and cleaners (PR 3.1, 95% CI: 2.5–3.8) were found to have a high sensitisation risk as well. In case of health care workers, a significant downward trend during the study period was observed; while in food processors and cleaners, sensitisation prevalence remained largely stable.

Conclusion

The adjusted multifactorial analysis identified occupations yet unknown to be associated with elevated thiuram contact allergy risk, e.g., food processors and cleaners. Thus, (i) further in-depth research can be targeted and (ii) efforts to prevent sensitisation to thiurams focussed, e.g., by limiting thiuram concentrations in products to a residual level which is technically inevitable.     

The association of self-rated health and lifestyle behaviors among foreign-born Chinese, Korean, and Vietnamese Americans

Purpose

This study employed the 2009 California Health Interview Survey to examine the association of self-rated heath status and lifestyle behavior variables such as smoking at least 100 cigarettes or more in an entire lifetime, alcohol consumption, and physical activity level among foreign-born Chinese, Korean, and Vietnamese Americans aged 18 and older.

Methods

The total study sample consisted of 3,023 foreign-born adult Chinese (n = 812), Korean (n = 857), and Vietnamese (n = 1,354) Americans. Logistic regression via Stata 12 was employed. Odds ratios (OR) along with confidence intervals (CI) were reported in the results.

Results

Results revealed that smoking at least 100 cigarettes or more in an entire lifetime had a negative association with good health status (OR = 0.74, 95 % CI = 0.59, 0.94), while alcohol consumption had a positive association with good health status (OR = 1.20, 95 % CI = 1.00, 1.44). Moderate physical activity (OR = 1.26, 95 % CI = 1.05, 1.50) and vigorous physical activity (OR = 1.68, 95 % CI = 1.31, 2.15) had a similar positive association with good self-rated health status. The results also revealed that the predicted probability of self-rated health status based on ethnicity and lifestyle variables was more favorable for foreign-born Chinese Americans than their Korean and Vietnamese American counterparts.

Conclusions

This study’s results corroborated the findings reported in previous research on the association of lifestyle behaviors and health status. Regardless of racial or ethnic backgrounds, good lifestyles have an important role in the prevention of poor health status. However, health education and lifestyle intervention programs should take cultural differences among racial and ethnic populations into consideration.     

Stigma related to sex work among men who engage in transactional sex with men in Ho Chi Minh City,Vietnam

Objectives

Male sex workers (MSW) in Vietnam face high levels of stigma related to sex work, which may be associated with depression and increased vulnerability to HIV.

Methods

In 2010, 300 MSW completed a behavioral and psychosocial survey. Multivariable models assessed factors associated with sex work-related stigma and the association between stigma and depression.

Results

Factors associated with increased stigma included having disclosed sexual orientation to healthcare workers (b 1.75, 95 % CI 0.69–2.80), meeting clients in the street/park (b 1.42, 95 % CI 0.32–2.52), and having been forced to have sex without a condom (b 2.36, 95 % CI 1.27–3.45). Factors associated with decreased stigma included meeting clients via the telephone or internet (b ?1.26, 95 % CI ?2.39 to ?0.12) and receiving financial support from family or friends (b ?1.31, 95 % CI ?2.46 to ?0.17). Stigma was significantly associated with increased odds of depression (AOR 1.07, 95 % CI 1.01–1.15).

Conclusions

Addressing stigma and depression in HIV prevention interventions is crucial for tailoring these programs to MSWs’ needs, and may result in decreased HIV spread.     

Exacerbation of symptoms in agricultural pesticide applicators with asthma

Purpose

Exacerbation is a critical event in asthma management. We investigated whether exacerbation of symptoms is associated with farming exposures among agricultural pesticide applicators with asthma.

Methods

Participants were pesticide applicators with active asthma (wheezing and breathing problems in past 12 months) who completed enrollment questionnaires for the Agricultural Health Study (AHS). Exacerbation of asthma was defined as having visited a hospital emergency room or doctor for an episode of wheezing or whistling in the past 12 months. Exposures of interest were using 36 specific pesticides in the past 12 months and conducting various agricultural activities. Adjusted odds ratios (ORs) were estimated by logistic regression while controlling for potential confounders.

Results

The 926 AHS adult pesticide applicators with active asthma included 202 (22 %) with exacerbation. Inverse associations with exacerbation were observed for two herbicides [glyphosate, odds ratio (OR) = 0.5, 95 % confidence interval (CI) 0.3, 0.8, and paraquat, OR = 0.3, 95 % CI 0.1, 0.9] and several agricultural activities (repairing engines, grinding metal, driving diesel tractors, and performing veterinary procedures). Only asthma cases with allergies (i.e., doctor-diagnosed hay fever or eczema, 46 %) had positive exacerbation–pesticide associations, with OR = 2.1 (95 % CI 1.1, 4.1) for the herbicide pendimethalin and OR = 10.2 (95 % CI 1.9, 55) for the insecticide aldicarb.

Conclusions

The inverse associations with two pesticides and specific farm activities are consistent with the possibility that asthma cases prone to exacerbation may avoid exposures that trigger symptoms. Although limited by small sample size and a cross-sectional design, our study suggests that use of specific pesticides may contribute to exacerbation of asthma among individuals with allergies.     

Musculoskeletal symptoms and psychosocial work environment,among Swedish commercial pilots

Purpose

The associations between psychosocial work conditions and health in pilots are understudied, and therefore, the associations between the psychosocial work conditions and musculoskeletal problems among Swedish commercial pilots were investigated.

Methods

In 2010, a self-administered questionnaire study was performed among pilots in one Swedish commercial airline: 354 pilots participated (61 %). Musculoskeletal symptoms and the psychosocial work conditions measured by the demand control social support model were investigated. Odds ratios (OR) with 95 % confidence interval (95 % CI) were expressed per change of one unit on the interquartile score scale.

Results

Pilots on long-haul flights had less elbow symptoms (OR 0.34, 95 % CI 0.14–0.85), and women had more hand symptoms (OR 2.90, 95 % CI 1.11–7.52). There were associations between high work demands and symptoms from the neck (OR 2.04, 95 % CI 1.45–2.88), shoulders (OR 1.46, 95 % 1.05–2.03), elbows (OR 1.79, 95 % CI 1.10–2.90) and low back (OR 1.42, 95 % CI 1.02–1.96) in pilots. Low social support was associated with symptoms from the neck (OR 1.87, 95 % 1.35–2.58), shoulders (OR 1.56, 95 % CI 1.14–2.14) and low back (OR 1.63, 95 % CI 1.18–2.24). Low supervisor support was associated with neck (OR 1.67, 95 % CI 1.22–2.27), shoulders (OR 1.38, 95 % CI 1.02–1.87) and low back symptoms (OR 1.48, 95 % CI 1.09–2.01). The associations were mainly found among first officers.

Conclusions

Musculoskeletal symptoms in pilots can be affected by poor psychosocial work conditions such as high demands and low social support, especially for first officers. The psychosocial aspects of organisational changes in commercial airlines should be taken into consideration.