Long-term psychosocial work environment and cardiovascular mortality among Swedish men.

OBJECTIVES. This study examined the effect of cumulative exposure to work organization--psychological demands, work control, and social support on prospectively measured cardiovascular disease mortality risk. METHODS. The source population was a national sample of 12517 subjects selected from the Swedish male population by Statistics Sweden in annual surveys between 1977 and 1981. Over a 14-year follow-up period, 521 deaths from cardiovascular disease were identified. A nested case-control design was used. Work environment exposure scores were assigned to cases and controls by linking lifetime job histories with a job exposure matrix. RESULTS. Conditional logistic regression analysis was used in examining cardiovascular mortality risk in relation to work exposure after adjustment for age, year last employed, smoking, exercise, education, social class, nationality, and physical job demands. In the final multi-variable analysis, workers with low work control had a relative risk of 1.83 (95% confidence interval [CI] = 1.19, 2.82) for cardiovascular mortality. Workers with combined exposure to low control and low support had a relative risk of 2.62 (95% CI=1.22, 5.61). CONCLUSIONS. These results indicate that long-term exposure to low work control is a risk factor for cardiovascular disease mortality.     

Musculoskeletal symptoms, work ability, and disability among nursing personnel

Nursing personnel are at risk for developing musculoskeletal symptoms, which can result in persistent pain and inability to work. This study was designed to investigate the occurrence of musculoskeletal symptoms and their association with work role as well as to verify the relationship between pain intensity and disability among symptomatic individuals. Three hundred one nursing personnel, of whom 80.7% had musculoskeletal symptoms in at least one body part, participated in the study. The mean work ability score of symptomatic personnel was lower for physical demands. A significant difference between symptomatic and asymptomatic personnel was found for each demand measured by the Work Role Functioning Questionnaire, except social demand. Correlations were moderate but significant between pain intensity and disability. The results suggest that musculoskeletal symptoms interfere with work life.     

Musculoskeletal symptoms among electricians

This study ascertained the presence of musculoskeletal symptoms among electricians, in order to evaluate the prevalence of cumulative trauma disorders (CTD) in this population. We adapted the CTD surveillance questionnaire used by National Institute for Occupational Safety and Health (NIOSH) to assess the prevalence of neck, shoulder, elbow, hand/wrist, back, and knee symptoms in the year prior to the survey. Questionnaires were completed by 308 apprentices and journeymen enrolled in training classes at the local union hall. The participants were relatively young individuals, and 86% of the participants were currently working as electricians. Participants reported a high prevalence of symptoms which occurred more than three times during the past year or which lasted more than 1 week. Back symptoms and hand/wrist symptoms were experienced most frequently, by about half the population, while elbow symptoms were reported by only 15% of participants. Symptom prevalence was lower, but still notable, when defined as symptoms which had occurred at least once a month or lasted more than a week in the past year. Eighty-two percent of participants reported at least one musculoskeletal symptom using the most inclusive definition, while 57% reported two or more symptoms. This survey highlights that: 1) low back discomfort is common in young construction workers, and resulted in medical care, missed work, or light duty for almost 35% of the participants; 2) neck discomfort is also very common and required doctor visits or work modification for almost one quarter of the participants; 3) these construction workers continued to work with symptoms that are classifiable as a CTD; and 4) history of injury is correlated with the subsequent prevalence of musculoskeletal symptoms. © 1994 Wiley-Liss, Inc.     

Prevalence of fatigue among commercial pilots

BACKGROUND: Short-haul pilots have largely been neglected in studies of fatigue, sleep loss and circadian disruption created by flight operations, but anecdotal evidence from pilots suggests that with the increasing amount of low-cost air travel, commercial pilots working short-haul operations may be becoming seriously fatigued. AIMS: This study attempted to ascertain how much subjective fatigue short-haul pilots reported, and makes comparisons between low-cost and scheduled airline pilots. METHODS: Pilots completed anonymous questionnaires (encompassing aviation factors, flight experience and a fatigue scale) posted on the Professional Pilots' Rumours Network website. RESULTS: Data were collected from 162 short-haul pilots and statistical adjustment for operational factors was made. Seventy-five percent reported severe fatigue and 81% reported the fatigue to be worse than 2 years ago. Eighty percent considered their thought processes were reduced while flying. Severe fatigue was reported more frequently by low-cost airline pilots than scheduled airline pilots (P = 0.05) and fatigue ratings were higher in this group (P = 0.03). Pilots who reported regularly flying into their 'discretion' hours had lower physical and psychological health, and overall fatigue scores, and poorer self-rated general health. Flying into discretion time occurred no more frequently in low-cost airline pilots than scheduled airline pilots. CONCLUSIONS: Identifiable fatigue problems are reported by short-haul pilots, but this cannot be attributed solely to the work schedules of low-cost airlines as regular use of discretion time appears to be associated with fatigue regardless of airline.     

Musculoskeletal symptoms among hospital cleaners

Studies have indicated that cleaners are at risk for musculoskeletal symptoms (MSS). In 2001, the Norwegian Labor Inspectorate suggested improvements in cleaners' work environment to reduce MSS. We estimate prevalence of MSS among cleaners in a Norwegian hospital that had implemented improvements to reduce risk of MSS and calculate relative risk of MSS among cleaners compared to a group of office workers. Data were collected from 255 participants. MSS were investigated using the Nordic Questionnaire for Analysis of Musculoskeletal Symptoms. Cleaners reported a significantly higher prevalence of MSS compared to office workers but a lower prevalence compared to similar studies among cleaners in other countries. This may indicate that working conditions in Norway are better than in other countries; further studies are needed to compare MSS and working conditions in different settings.     

Incidence of cancer among commercial airline pilots

OBJECTIVES—To describe the cancer pattern in a cohort of commercial pilots by follow up through the Icelandic Cancer Registry.
METHODS—This is a retrospective cohort study of 458 pilots with emphasis on subcohort working for an airline operating on international routes. A computerised file of the cohort was record linked to the Cancer Registry by making use of personal identification numbers. Expected numbers of cancer cases were calculated on the basis of number of person-years and incidences of cancer at specific sites for men provided by the Cancer Registry. Numbers of separate analyses were made according to different exposure variables.
RESULTS—The standardised incidence ratio (SIR) for all cancers was 0.97 (95% confidence interval (95% CI) 0.62 to 1.46) in the total cohort and 1.16 (95% CI 0.70 to 1.81) among those operating on international routes. The SIR for malignant melanoma of the skin was 10.20, 95% CI 3.29 to 23.81 in the total cohort and 15.63, 95% CI 5.04 to 36.46 in the restricted cohort. Analyses according to number of block-hours and radiation dose showed that malignant melanomas were found in the subgroups with highest exposure estimates, the SIRs were 13.04 and 28.57 respectively. The SIR was 25.00 for malignant melanoma among those who had been flying over five time zones.
CONCLUSIONS—The study shows a high occurrence of malignant melanoma among pilots. It is open to discussion what role exposure of cosmic radiation, numbers of block-hours flown, or lifestyle factors—such as possible excessive sunbathing—play in the aetiology of cancer among pilots. This calls for further and more powerful studies. The excess of malignant melanoma among those flying over five time zones suggests that the importance of disturbance of the circadian rhythm should be taken into consideration in future studies.


Keywords: cancer registry; malignant melanoma of the skin; cosmic radiation; block-hours; time zones     

Depressive symptoms and psychosocial stress at work among older employees in three continents

ABSTRACT: BACKGROUND: To assess whether an association of psychosocial stress at work with depressive symptoms among older employees is evident in a set of comparable empirical studies from Europe, North America and Asia. METHODS: Cross-sectional and longitudinal multivariate regression analyses of data from 4 cohort studies with elder workers (2004 and 2006) testing associations of psychosocial stress at work ('effort-reward imbalance'; 'low control') with depressive symptoms. RESULTS: Cross-sectional analyses from 17 countries with 14.236 participants reveal elevated odds ratios of depressive symptoms among people experiencing high work stress compared to those with low or no work stress. Adjusted odds ratios vary from 1.64 (95% CI 1.02-2.63) in Japan to 1.97 (95% CI 1.75-2.23) in Europe and 2.28 (95% CI 1.59-3.28) in the USA. Odds ratios from additional longitudinal analyses (in 13 countries) controlling for baseline depression are smaller, but remain in part significant. CONCLUSION: Findings indicate that psychosocial stress at work might be a relevant risk factor for depressive symptoms among older employees across countries and continents. This observation may call for global policy efforts to improve quality of work in view of a rapidly aging workforce, in particular in times of economic globalization.     

Myocardial infarction risk and psychosocial work environment: An analysis of the male Swedish working force

The project was designed to test the assumption that certain psychosocial characteristics of occupational groups are associated with elevated myocardial infarction risk.All cases of myocardial infarction below the age of 65 in men living in the region of greater Stockholm during the years 1974–1976 were identified (deaths as well as survivals) in the official registries of hospitalizations and deaths. For each case two controls without infarction (in younger ages four) matched for age, area of residence and sex were selected randomly from the parish registries. For each case and control (n=334 and 882, respectively) information was available regarding occupation.The psychosocial characteristics of each one of the 118 occupations were recorded by means of a nation wide interview survey (3876 working men) in 1977.Relative age-adjusted risks of developing a myocardial infarction were calculated for occupations in which many vs occupations in which few subjects reported a given characteristic (50% with most vs 50% with least).Shift work and monotony were associated with significant excess risk. Hectic work was not associated with excess risk by itself but in combination with variables associated with low decision latitude and/or few possibilities for growth it was associated with significant excess risk.     

Associations between psychosocial work environment and hypertension among non-Western immigrant and Danish cleaners

Introduction

Non-Western cleaners have reported better psychosocial work environment but worse health compared with their Danish colleagues. The aim of this study was to compare the association between psychosocial work environment and hypertension among non-Western immigrant cleaners and Danish cleaners.

Methods

Two hundred and eighty-five cleaners from nine workplaces in Denmark participated in this cross-sectional study. The cleaners were identified as non-Western immigrants (n?=?137) or Danes (n?=?148). Blood pressure was measured in a seated position, and psychosocial work environment was assessed by the Copenhagen Psychosocial Questionnaire (COPSOQ). In each population, multivariate logistic regressions were applied testing for an association between each of the COPSOQ scales and hypertension.

Results

Models adjusted for age, sex, BMI, smoking, workplace and physical work exertion showed that high Trust regarding management (OR?=?0.50) and high Predictability (OR?=?0.63) were statistically significantly associated with low prevalence of hypertension in the Danish population. In the immigrant population, no significant associations were found. Analyses on interaction effects showed that associations between Meaning of work and hypertension were significantly different among the two populations (p?Conclusions Psychosocial work factors were associated with hypertension among Danes, but not among non-Western immigrants. This divergent association between psychosocial work environment and hypertension between Danes and non-Western immigrant cleaners may be explained by different perceptions of psychosocial work environment.     

Musculoskeletal symptoms among truck assembly workers

BACKGROUND: Concerns were raised about the possibility of a high prevalence of musculoskeletal symptoms in a truck assembly plant. AIM: The aim of this study was to investigate the prevalence of musculoskeletal symptoms in a group of truck assembly workers. METHOD: A cross-sectional study of 461 truck assembly workers was carried out using a modified version of the Nordic questionnaire and the General Health Questionnaire (GHQ12). Employees were further subdivided into three distinct occupational subgroups: skilled line workers (252), bench subassembly workers (108) and material handlers (101). Responses were analysed according to occupational subgroup. RESULTS: Seventy per cent of 461 truck assembly workers responded to the questionnaires. Seventy-nine per cent of respondents had been troubled with musculoskeletal symptoms in the last 12 months. The commonest musculoskeletal symptoms were from the lower back (65%), neck (60%) and shoulders (57%). Musculoskeletal symptoms were related to age, length of service, occupational subgroup and GHQ12 score. CONCLUSION: There was a high reported prevalence of musculoskeletal symptoms in this group of truck assembly workers, with a differing pattern of symptom reporting depending on occupational subgroup. Risk reduction recommendations were made to the site management. A further study investigating the relationship between symptoms and specific hazards is planned.     

Musculoskeletal complaints and psychosocial risk factors among Chinese hospital nurses

BACKGROUND: Musculoskeletal complaints represent a common occupational problem for health care workers throughout the world. Despite their sizeable numbers, however, few epidemiological studies have investigated musculoskeletal complaints among Chinese hospital nurses. Objective To assess the prevalence of, and risk factors for, musculoskeletal complaints among hospital nurses in mainland China. METHODS: A total of 282 female, registered nurses were surveyed (92% response rate) using a modified Chinese-language version of the Standardized Nordic Questionnaire. Body sites were divided into the neck, shoulder, upper back and lower back regions. RESULTS: The 12 month period-prevalence of musculoskeletal complaints at any of the four regions was 70%. The lower back was the most commonly reported body site (56%), followed by the neck (45%), shoulder (40%) and upper back (37%). High mental pressure, boring or tedious tasks and limited work support were identified as significant risk factors (adjusted odds ratios: 1.79-2.52). No correlations were found between manual handling or perceived physical exertion and increased reporting of musculoskeletal complaints. CONCLUSION: This study has shown that musculoskeletal complaints are prevalent among Chinese hospital nurses. The correlation with various psychosocial factors is also consistent with evidence from other countries.     

Effect of psychosocial work environment and job satisfaction on burnout syndrome among specialist physicians

OBJECTIVES: To describe the prevalence of burnout syndrome according to medical specialty and to examine the impact of work psychosocial risk factors, job satisfaction and professional characteristics on burnout syndrome among specialist physicians throughout Spain. METHODS: A cross-sectional survey was carried out among 1,021 Spanish physicians. The outcome variables were the 3 dimensions of burnout syndrome: emotional exhaustion, depersonalization, and personal accomplishment. The explanatory variables were work psychosocial risk factors and job satisfaction evaluated by a stress scale specifically designed for physicians. Adjusted odds ratios and their 95% confidence intervals were calculated by logistic regression. RESULTS: The probability of high emotional exhaustion and depersonalization were greater in physicians exposed to a high level of contact with suffering and death and to a negative impact of work on home life. The probability of high emotional exhaustion was greater among physicians with a high work overload. The risk of low personal accomplishment was higher among physicians with low professional satisfaction and those without training activities. Dissatisfaction with relationships with patients and relatives had a negative effect on the 3 dimensions of burnout. CONCLUSIONS: Psychosocial work environment and job satisfaction have a negative effect on burnout syndrome, especially on emotional exhaustion and depersonalization.     

The psychosocial work environment and incident diabetes in Ontario, Canada

Background Relatively few longitudinal studies have explored the relationship between psychosocial work conditions and diabetes incidence. Given the increasing global burden of diabetes this is an important area for public health research. Aims To examine the relationships between dimensions of the psychosocial work environment on the subsequent incidence of diabetes among men and women in Ontario, Canada over a 9 year period. Methods We used data from Ontario respondents (35 to 60 years of age) to the 2000-01 Canadian Community Health Survey linked to the Ontario Health Insurance Plan database for physician services and the Canadian Institute for Health Information Discharge Abstract Database for hospital admissions. Our sample of actively employed labour market participants with no previous diagnoses for diabetes was followed for a 9 year period to ascertain incident diabetes. Results There were 7443 participants. Low levels of job control were associated with an increased risk of diabetes among women, but not among men. Counter to our hypotheses high levels of social support were also associated with increased diabetes risk among women, but not among men. No relationship was found between any psychosocial work measure and risk of diabetes among men. Conclusions Given the increasing prevalence of diabetes worldwide, job control could potentially be an import ant modifiable risk factor to reduce the incidence of diabetes among female, but not among male, workers. More research is needed to understand the pathways through which low social support may protect against the development of diabetes.