Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Abdominal symptoms among sewage workers

The objective of this cross-sectional study was to investigatethe prevalence of abdominal symptoms and the abdominal medicalhistory among sewage workers. 142 male sewage workers and 137male referents in 11 Swedish municipalities were addressed witha questionnaire about abdominal symptoms, medical history, occupationalhistory and life style factors. The sewage workers sufferedless from nausea [adjusted odds ratio (adjOR)=0.18, 95% confidenceinterval (Cl)=0.04–0.84] than the referents. There wasno significant difference in the three months prevalence ofdiarrhoea (adjOR=1.7, 95% Cl=0.79–3.4), dyspepsia (adjOR=0.85,95% Cl=0.49–1.5) or irritable bowel syndrome (adjOR=1.4,95% Cl=0.53–3.5). The sewage workers were affected moreoften by peptic ulcers during their present jobs than the referents,although the increased risk was not significant (adjOR=1.4,95% Cl=0.31–6.1). The odds ratios were adjusted for age,use of tobacco products and alcohol consumption. The conclusionof this study was that sewage workers are less affected by nauseathan comparable referents.     

A Study of the Impact of Occupational and Domestic Factors on Insomnia among Industrial Workers of a Manufacturing Company in Japan

Insomnia is one of the most common health problems and has recentlybeen re-termed ‘Disorders of Initiating and MaintainingSleep’, or DIMS. The main purpose of the present studywas to investigate the relationship between daily psychosocialstressors, to which workers are exposed in occupational and/orprivate life, and insomnia among male industrial workers ina medium-sized company located in Nagasaki City, Japan. Allof the workers in the company (n=368, male=319) were asked toanswer six sleep related questions and 24 questions about workingand private conditions. Two hundred and seventy-one (85.0%)of them completed the questionnaire (average age was 40.9 yearsold). Twenty seven point seven per cent of the subjects complainedof insomnia in the last month prior to the survey and the prevalencewas in general accord with previous surveys. On the other hand,the proportion of hypnotic use (1.1%), especially in insomniacgroup (2.7%) was lower than previous reports. The results ofmultiple logis regression analysis demonstrated that four psychosocialfactors were significantly associated with insomnia: i.e. VDTwork overload (odds ratio [OR] 5.058; 95% confidence intervals[95% Cl] 2.381–10.745), limited space of bedroom (OR 2.612;95% Cl 1.283–5.683), over-involvement in job (OR 2.78;95% Cl 1.188–6.540), frequent alcohol beverages consumption(OR 2.595; 95% Cl 1.177–5.719).     

Psychiatric ill health and distribution of body fat mass among female immigrants in Sweden

Given the association between psychiatric factors and obesity, the aims of the present study were to identify these variables among native Swedish as well as immigrant women, and to compare the prevalence of psychiatric ill health in women of foreign ethnicity with Swedish women. Information on melancholia, life satisfaction, sleeping problems, and use of psychoactive drugs as well as alcohol and smoking habits was obtained from questionnaires in a randomly selected population (n = 1464, participation rate 78%, aged 40 y). Height, body weight and circumferences of waist and hip were self-measured, so allowing calculations of the body mass index (BMI) and the waist to hip ratio (WHR) to be made. Among those who responded 246 (21.9%) were immigrants, divided into the following demographic clusters Nordic countries; Rest of Europe; and Non-European. Among native Swedes, use of psychoactive drugs and melancholy were associated with both BMI and WHR. BMI-associated with use of antidepressants in women from Nordic countries with a short duration of stay, and in subjects with a long duration of residence, was related to life satisfaction. Among subjects from the Rest of Europe, the use of hypnotics was negatively related to BMI, and life satisfaction was positively associated with WHR. Among Non-Europeans with a long duration of residence, BMI was positively connected to the use of anxiolytics and, negatively, to life satisfaction. Furthermore, melancholy was positively associated with WHR (borderline, P=0.086) in Non-Europeans. Subjects from Nordic countries were characterised by a relatively low use of psychoactive drugs and infrequent insomnia. In contrast, subjects from the Rest of Europe with short duration of stay showed a relatively extensive use of psychoactive drugs, and the Non-European group with short duration of stay experienced frequent insomnia, and a low degree of life satisfaction as well as high degree of melancholy. The association between psychiatric factors and obesity is not uniform across ethnic groups, suggesting a combination of genetic predisposition and psychosocial vulnerability. The high prevalence of psychiatric ill health among some ethnic groups should be a matter of public health concern.     

Communication between an occupational physician and other medical practitioners--an audit

Four hundred and seventy-two consecutive referral episodes relatingto 386 patients attending the Occupational Health Departmentof a general teaching hospital were analyzed to evaluate thefrequency, content and effect on management of communicationsbetween the occupational physician and other doctors. In all,250 episodes (53%) were associated with such a communication.The likelihood of a communication was strongly influenced byreason for referral, particularly in respect of long or shortterm sickness absence; univariate odds ratios (OR)=10.58, 95%Cl=8.13–27.08) and 2.65, 95% Cl=1.55–4.60) respectively;a medical diagnosis of psychiatric illness (OR=3.17, 95% Cl=1.69–5.97));and by number of consultations. Communication was also morelikely when the occupational outcome was ill health retirement,rehabilitation in work or modified work. Ninety-eight per centof specific requests for information or an opinion eliciteda reply. Information received from other doctors influencedthe occupational health physician's management in 52 referralepisodes (20%). Specific action by GPs as a result of communicationwas documented in 54 and by specialists in 37 episodes. Theimportance of communication between occupational health physicianand other doctors in the occupational health process is confirmed.     

Musculoskeletal Problems in the Tomato Growing Industry: 'Tomato Trainer's Shoulder'?

Tomato training entails highly repetitive shoulder muscle contractions,static contractions and work at shoulder level, factors linkedin other working groups with neck and shoulder complaints. Thefrequency of musculoskeletal complaints was compared using theNordic Questionnaire in 56 tomato trainers and 52 other matchedglasshouse workers whose job did not include these work taskfactors. A higher 12- month (odds ratio (OR) = 5.9; [95% confidenceinterval (Cl) = 2.4–16.7] and 7- day (OR = 3.6, Cl = 1.2–11.1)period prevalence of shoulder complaint was recorded in trainersthan in pickers and deleafers. Other upper limb and upper trunkcomplaints were also more common in tomato trainers, highlightingan area of ergonomic concern.     

A five-year study comparing early retirements on medical grounds in ambulance personnel with those in other groups of health service staff: Part I: Incidences of retirements

The objective of this study was to compare morbidity betweenambulance staff and other groups of health service workers,to facilitate planning of occupational health (OH) services.A retrospective study of employees of The Eastern Health andSocial Services Board, Northern Ireland was conducted. Subjectswere 181 men and 353 women assessed at OH between 1988–92and found eligible (on the basis of permanent incapacity) toapply for early retirement on medical grounds (EROMG). Ambulancepersonnel showed a high rate of EROMG (55.9/1,000 per annum)both compared with previous ambulance studies (5.7–22.5/1,000),and with other groups in the present study (manual 24.8/1,000,nursing 5.9/1,000 and non-manual 2.6/1,000). Indirect standardizationwas used to correct for age-sex differences between groups,by deriving standardized early retirement ratios (SERR). Ambulanceand manual staff showed high SERRs (636, Cl=558–714 and164, Cl=149–179), whereas nursing and non-manual staffshowed low SERRs (91, Cl=75–107 and 38, Cl=25–52),(all results except that for nursing staff being significantat <0.001). There is evidence that ambulance staff are agroup with high morbidity, and thus deserving of particularattention in terms of preventative and health promotional activities.Other issues requiring consideration in relation to ambulancestaff are redeployment and lowering of the retirement age.     

Smoking as a predictor of long-term work disability in physically active and inactive people

Data from a Norwegian 4-year prospective questionnaire studywere used to test our hypothesis that smoking is a weaker predictorof long-term work disability in physically active than inactivepersons. Of 1,788 respondents who were working and not olderthan 62 years in 1990, 1,426 (80%) also returned a questionnairein 1994. For respondents who were taking physical exercise lessthan once a week, smoking predicted long-term work disabilityfour years later [odds ratio (OR)=2.24; 95% confidence interval(Cl)=1.30–3.87; p<0.01], when adjusting for age, sex,workhours per week, heavy lifting at work, emotional symptomsand musculoskeletal pain at time 0. In respondents who wereexercising at least once a week, there was no association betweensmoking and long-term work disability.     

Cohort mortality study of rubber and plastics product makers in Italy

A retrospective cohort mortality study was carried Out in 20industrial factories in the Local Health Unit Bologna Sud (EmiliaRomagna, Italy), where different rubber and plastics productswere manufactured. The cohort consisted of 925 subjects (578males and 347 females) employed for at least six months continuously;follow-up was between the beginning of operation of each factory,ranging between mid fifties and mid seventies, and 31 December1989. For those exposed more than one year cause specific StandardizedMortality Ratios (SMRs) were computed using regional rates forcomparison, 90% confidence intervals (Cl) were calculated assumingthe Poisson distribution. Among the 748 subjects employed formore than one year (457 males and 291 females) there were nolost to follow-up, 54 individuals were dead (41 males and 13females) and for three subjects the cause of death was unknown.The results showed that all causes mortality was above expectancyin the total cohort (SMR=123; 54 Obs; 90% Cl=97–154),among males (SMR=117; 41 Obs; 90% Cl=89–152) and females(SMR=143; 13 Obs; 90% Cl=85–228). Increased mortalityfor all malignant tumours was observed in the total cohort (SMR=150;25 Obs; 90% Cl=104–209) and for both genders. All ninelung cancer cases were observed among males, the SMR was equalto 218 and was statistically significant; seven cases occurredat duration of exposure less than 10 years and six at latencyup to 20 years. The interpretation in terms of causality ofthe present investigation is limited by the small number ofobservations and by exposure definition solely in terms of employmentin the study factories; nonetheless the results are indicatingthe existence, in this group of rubber and plastics productmakers, of an adverse health effect which deserve further investigation.     

Absence attributed to incapacity and occupational disease/accidents among female and male workers in the fish-processing industry

Sick-leave between 1984 and 1989 was higher among both female(n=515) and male (n=304) fish-processing workers [observed/expected(O/E) 2.24 and 1.69, respectively] than among non-exposed groups(0.62 and 0.89). Diagnoses in the musculoskeletal system dominated(i.e., neck/upper limbs; females, exposed vs. non-exposed workers:30 vs. 12%: males: 11 vs. 5.8%). In subjects who left employment,the O/E-ratio decreased (females: 3.02 vs. 1.55; males: 2.40vs. 1.55). Among those women hired before the start of the observationperiod, exposed subjects had higher frequencies of sick-leavethan non-exposed, for both total illness and musculoskeletaldiagnoses. In the men, there were corresponding differences,though not fully statistically significant. Reported occupationaldiseases [O/E: females: 4.5; (95% confidence interval) Cl=3.2–6.1;males: 2.3; Cl=1.3–3.9] and accidents (females: 4.3; Cl=3.0–5.9;males: 1.8; Cl=1.2=2.7) were also higher in female than in malefish-processing workers, and much higher than in non-exposedworkers. In conclusion, work in the fish-processing industrywas associated with increased frequencies of sick-leave, especiallybecause of diagnoses of the musculoskeletal system, and occupationaldisorders and accidents, in particular among female workers.     

Mortality among Finnish Sea Pilots 1956 85: A Retrospective Cohort Study

The National Board of Navigation in Finland employed 942 seapilots in 1956–85, during which time 262 of them died(SMR = 77, 95% Cl = 68–86). The male population in southwestFinland served as control. The causes of deaths were collectedfrom death certificates. The mortality rate for all cardiovasculardiseases and lung cancer was lower among sea pilots than inthe comparison population (SMR = 83, 95% = Cl 69–97 andSMR = 67, 95% Cl 37–97) while for ischaemic heart diseases,it was similar to that of the population as a whole (SMR = 96,95% Cl = 77–115). Health selection due to ischaemic heartdisease was seen in the lower mortality rates among young pilotswho started work in 1956–85. Otherwise, the slightly higherrates may indicate a possibility of adverse health effects ofsea piloting.     

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.     

Attitudes to job turnover among Finnish anaesthetists

Background Structural changes have led to higher workload andmore frequent conflicts among hospital staff, which in turnhas been shown to be associated with increased employee turnover. Aims To study the willingness of anaesthetists to change theiremployment and factors associated with it. Work-related, individualand family-related factors were investigated as potential influenceson such willingness. Method A postal questionnaire was sent to all working Finnishanaesthetists (N = 550). Results The response rate was 60%; 175 (53% of responders) weremen. Of the respondents, 31% were willing to consider changingto another physician's job and 43% to a profession other thanmedicine. The most important correlates for these views wereconflicts with superiors (odds ratio 6.1; 95% confidence interval2.1–17.7) and co-workers (4.2; 1.4–12.2), low jobcontrol (2.6; 1.4–4.9), a sense of organizational injustice(2.4; 1.3–4.6), stress (6.5; 2.6–16.3) and job dissatisfaction(4.6; 2.4–8.8). Conclusions The establishment of respect, trust and genuinedialogue between co-workers and superiors is needed to minimizethe risk of loss of members of this occupational group.     

Immunity to Hepatitis A in Paediatric and Nursery Nurses

A cross-sectional epidemiological survey of immunity to thehepatitis A virus (HAV) was undertaken in paediatric and nurserynurses to ascertain whether these occupational groups were atan increased risk of infection with the virus. Seropositivityto HAV was measured in 33 surgical (control), 36 paediatric,55 nursery and 29 specialist paediatric nurses in a districtgeneral hospital, community clinics and a children's hospitalin the West Midlands. IgG antibodies to HAV were found in 27%of surgical (control), 31% of paediatric (relative risk [RR]= 1.19, 95% confidence interval [CI] = 0.56–2.51), 26%of nursery nurses (RR = 0.99, CI = 0.48–2.04) and 10%of specialist paediatric nurses (RR = 0.40, CI = 0.12–1.35).These data are comparable to immunity to HAV for this age groupin the general population of this country and do not supportroutine immunization of paediatric or nursery nurses againstHAV.     

Work-related factors, sleep debt and insomnia in IT professionals

BACKGROUND: Reduced sleep can be associated with a risk of health problems. Information technologies (IT) professionals often work long hours and this could have an effect on their sleep quality. AIMS: To examine the prevalence of sleep debt, insomnia and long working hours among Finnish IT professionals and to analyse which specific work-related factors are associated with shortened sleep. METHODS: Cross-sectional, representative data from a questionnaire survey of IT professionals. Hierarchical regression analyses were applied to investigate relationships of sleep debt and insomnia. RESULTS: A total of 2,334 IT professionals responded to the survey. Thirty-seven per cent reported sleep debt of at least 1 h and 6% of at least 2 h, while 16% reported insomnia. Twenty-seven per cent worked for a minimum of 50 h a week, while 31% spent at least 50 h a week on work. The most important factors associated with both sleep debt and insomnia were work-related demands requiring long hours, mental stamina and problem solving and positive perceptions of work, such as job control and importance of the respondents' own work in their life. CONCLUSIONS: Even though long working hours were common among IT professionals in Finland, sleep debt and insomnia were not. Work-related factors were associated with insufficient sleep.     

Differences in body fat and central adiposity between Swedes and European immigrants: the Malmö Diet and Cancer Study

OBJECTIVE: Comparative data on ecological differences in body fatness and fat distribution within Europe are sparse. Migration studies may provide information on the impact of environmental factors on body size in different populations. The objective was to investigate differences in adiposity between European immigrants and native Swedes, specifically to examine gender differences and the effect of time since immigration, and to compare two selected immigrant groups with their native countrymen. RESEARCH METHODS AND PROCEDURES: A cross-sectional analysis of 27,808 adults aged 45 to 73 years participating in the Malm? Diet and Cancer prospective cohort study in Sweden was performed. Percentage body fat (impedance analysis) and waist-hip ratio (WHR) were compared between Swedish-born and foreign-born participants. RESULTS: Obesity was 40% more prevalent in non-Swedish Europeans compared with Swedes. Controlling for age, height, smoking, physical activity, and occupation, it was found that women born in the former Yugoslavia, southern Europe, Hungary, and Finland had a significantly higher percentage of body fat, and those from Hungary, Poland, and Germany had more centralized adiposity compared with Swedish women. Men born in the former Yugoslavia, Hungary, and Denmark had a significantly higher mean percentage of body fat compared with Swedish-born men, whereas Yugoslavian, Finnish, and German men differed significantly in mean WHR. Length of residence in Sweden was inversely associated with central adiposity in immigrants. A comparison between German and Danish immigrants, their respective native populations, and Swedes indicated an intermediate positioning of German immigrants with regard to body mass index and WHR. DISCUSSION: Differences in general and central adiposity by country of origin appear to remain after migration. Central adiposity seems to be more influenced than fatness per se by time of residency in Sweden.     

Risk factors for first-ever low back pain among workers in their first employment

BACKGROUND: Low back pain has been estimated to be the most costly ailment of people of working age. Both work characteristics and individual factors have been identified as risk factors. The first interaction between work characteristics and individual factors occurs when workers start in their first job. AIMS: To investigate work-related risk factors for first-ever low back pain in young workers in their first employment. METHODS: A cross-sectional analysis was performed on 278 young workers in their first employment and without a history of low back pain prior to working. Work-related physical factors, psychosocial work characteristics, individual variables and first-ever low back pain were queried by means of a questionnaire. RESULTS: About half of the workers who developed low back pain after job start did so in the first year of employment. An increased risk was observed for (i) long periods of seated work [relative risk (RR) = 3.2, 95% confidence interval (CI) = 1.6-6.4]; (ii) more than 12 flexion or rotation movements of the trunk per hour (RR = 3.0, 95%CI = 1.4-6.4); and (iii) more than 3 years seniority in a job involving lifting more than 25 kg at least once an hour (RR = 3.7, 95%CI = 1.4-9.4). As to psychosocial work characteristics, first-ever low back pain was associated with a combination of low psychological job demands and low supervisor support. CONCLUSION: Work-related physical factors and psychosocial work characteristics should be considered as risk factors for first-ever low back pain. First-ever episodes of low back pain are common in the first year of employment. This may reflect a lack of work experience or training.     

The influence of social surroundings on consultation of private care, emergency department, hospital out-patient departments, and primary health care 1384 Consultations made by a defined population in a residential area

The influence of social surroundings on the clients' consultationof four different caregivers (primary health care centre, emergencydepartment, hospital out-patient departments, and private care)was studied prospectively. The study had the advantage of beingpopulation-based, focusing on different social surroundingsin the same residential area, and taking into considerationfour different caregivers. This was a new approach to the studyof health care utilization. We chose a single residential area,whose borders coincided with the catchment area of the localprimary health care centre. This population (n=5085) made 1384consultations to the above-mentioned four caregivers duringseven weeks In the autumn of 1988. The residential area wascomposed of sub-areas with different social surroundings withrespect to the form of tenure. People living In socially disadvantagedmultioccupancy blocks consulted the emergency department moreoften than expected (age- and sex-standardized Relative Risk(RR)= 1.50, 95% confidence interval (Cl) = 1.02–2.21).The population in the socioeconomically most disadvantaged multioccupancyblock made few consultations to private care (RR=0.53, 95% Cl=0.30–0.91)but more to primary health care (RR=4.45, 95% Cl=3.11–6.36).The conclusion was that the population living in socially disadvantagedsurroundings in multioccupancy blocks had an increased riskof consulting the emergency department and primary health care.They had less risk of consulting hospital out-patient departmentsand private care. This result is of importance as it might providehealth planners with information about the influence of socialsurroundings on care utilization. The family physician and thedistrict nurse might play a central role in the meeting of theincreasing demands of care utilization in socially disadvantagedresidential areas.     

Ventilatory function of factory workers exposed to tea dust

A cross-sectional study was conducted in order to determinethe prevalence of respiratory symptoms and the effect on ventilatorycapacity in workers exposed to tea dust for at least five yearsduring the sifting process of tea manufacture compared to acontrol group of field workers who were not exposed to tea dustpreviously. Fifty-three subjects each in the study and controlgroups were matched for age, sex, ethnic group and height. Prevalenceof chronic respiratory symptoms was obtained by questionnaire.Spirometric measurements included forced vital capacity (FVC),forced expiratory volume in the first second (FEV_1.0) and forcedmid-expiratory flow rate (FEF_25–75%). The study grouphad a chest radiograph. The odds ratio for any chronic respiratorysymptom was 11.6 (95% confidence interval [Cl] = 3.7–39.4)in the study group. Mean values for the spirometric tests werelower in the study group; the differences in FEV_1.0 and FEF_25–75%were significant. Tuberculosis was not found in the study group,while one subject (2.4%) had radiological evidence of bronchiectasis.It may therefore be concluded that chronic tea dust exposurecauses increased prevalence of respiratory symptoms and a significantdegree of small airways obstruction.     

Health-related quality of life and migration: A cross-sectional study on elderly Iranians in Sweden

Background  

Although elderly Iranian immigrants in Sweden are the largest elderly group born outside Europe, little is known about their health-related quality of life (HRQL). The aim of this study was to examine the association between migration status and HRQL in a comparison of elderly Iranians in Iran, elderly Iranian immigrants in Sweden, and elderly Swedes in Sweden.