Methods to persuade higher management to invest in health promotion programmes in the workplace

This study was conducted to find effective methods to persuadehigher management to invest in workplace health promotion (WHP)programmes. The study included 639 occupational health professionalsselected from the directory of the Japan Society for OccupationalHealth. A questionnaire survey was mailed to health professionalsthroughout Japan in 1992, and all respondents were asked toidentify themselves. We received 242 replies, which constituteda response rate of 38%. Eighty-one per cent of the respondentshad attempted to persuade higher management to implement a WHPprogramme. Health professionals frequently presented their caseto higher management through a safety and health committee (SHC),and advice provided at the SHC was perceived to be the mosteffective method by occupational nurses (ONs) and safety andhealth supervisors (SHSs). This method was rated second by occupationalphysicians (OPs), who thought recommendations from OPs stipulatedby the Industrial Safety and Health Law to be most effective.Statistics on medical examinations constituted the data mostfrequently used to persuade higher management, followed by reportson worksite inspections and health care plans. Nearly 90% ofOPs and 80% of ONs and SHSs felt that the above methods werefairly successful.     

Improving mental well-being in the workplace

Occupational physicians, who are in a key position to influencecompany policy on mental health, have limited access to educationon mental health. This paper discusses the results of a postalsurvey of occupational physicians that was designed to identifythe mental health information needs of occupational physicians,determine the way in which this information should be disseminatedand measure the extent to which occupational physicians encountermental health problems in the workplace.     

湖北省成人糖尿病及糖尿病前期流行状况调查

目的 了解湖北省成人糖尿病及糖尿病前期患病率及分布特点。方法 2013年采取多阶段随机整群抽样方法,在湖北省10个县区调查6 000名≥18岁常住居民,现场调查采用问卷调查、体格检查、采集空腹血样和口服75克无水葡萄糖后2 h血样测定血糖。结果 共调查5 824人,经事后分层权重调整后空腹血糖均值5.46（5.22~5.70）mmol/L,服糖后2 h血糖均值为6.23（5.89~6.58）mmol/L。糖尿病患病率为8.26%（598/5 824）,其中男性患病率9.79%（262/2 331）,女性患病率6.69%（336/3 493）,城镇居民患病率为8.93%（357/3 169）,农村居民为7.24%（241/2 655）。自报糖尿病患病率为2.85%（230/5 822）,血糖升高患病率5.84%（410/5 824）。糖尿病前期患病率14.17%（940/5 824）,其中单纯空腹血糖受损患病率为5.00%（325/5 824）,单纯糖耐量异常患病率为6.64%（467/5 824）,空腹血糖受损合并糖耐量异常患病率为2.54%（148/5 824）。糖尿病及糖尿病前期患病率无性别差异,随年龄的增长患病率迅速上升（P<0.01）,城镇糖尿病患病率高于农村（P<0.01）,农村空腹血糖受损患病率高于城镇（P=0.03）。结论 湖北省成人糖尿病与糖尿病前期患病率呈上升趋势。     

A systematic review of the effectiveness of health promotion interventions in the workplace

The aim of this study was to identify and critically review evaluations of the effectiveness of health promotion programmes in the workplace. In line with guidelines for 'good practice' within the literature on workplace health promotion, this study aimed to assess the extent to which evaluated interventions considered employees' expressed needs or involved employee-employer partnerships. Overall, 110 outcome evaluations were located. Only a quarter of these reported that interventions were implemented in response to the explicit needs and/or views of the employees and very few involved partnerships. Most of the programmes targeted individual behaviour and supportive organizational change was limited. The majority of the outcome evaluations were not sufficiently rigorous to make a strong case for the effectiveness of workplace health promotion. However, some pointers to success were identified. It was concluded that there seems to be a wide disparity between what counts as 'good practice' within workplace health promotion and what is reported in the evaluation of effectiveness literature. This is not to say that 'good practice' does not exist, but that either such programmes are not rigorously evaluated for their effectiveness and/or that many of the evaluation findings remain outside the public domain.     

心血管病传统危险因素与糖尿病及其前期关系

目的探讨传统心血管病危险因素与糖尿病及其前期的关联性,为糖尿病的防治提供参考依据。方法采用随机抽样方法对在浙江省湖州市爱山、龙泉和飞英3个街道共1 197名55～75岁的常住居民进行体格检查和血糖检测,采用Logistic回归分析方法分析传统心血管病危险因素与糖尿病及其前期的关联性。结果 1 197名常住居民中,血糖正常者807名,占67.42%,糖尿病前期者267例,占22.31%,糖尿病者123例,占10.27%;3组人群空腹血糖和餐后2 h血糖值分别为(4.83±0.61)、(5.76±0.61)、(6.99±1.43)mmol/L和(5.46±1.65)、(7.94±2.63)、(13.45±4.01)mmol/L;年龄、体质指数(BMI)、中心性肥胖、腹围、臀围、腰臀比和血压等传统心血管病危险因素在正常血糖组、糖尿病前期组和糖尿病组3组人群中分布不同,差异均有统计学意义(P<0.05);多因素Logistic回归分析结果表明,以正常血糖组为参照组,年龄、BMI、中心性肥胖、腹围、臀围、腰臀比和血压与糖尿病前期存在关联性;以正常血糖组为参照组,年龄、BMI、中心性肥胖、腹围、臀围、腰臀比和血压与糖尿病存在关联性;以糖尿病前期组为参照组,中心性肥胖、腹围和腰臀比与糖尿病存在关联性。结论年龄、BMI、中心性肥胖、腹围、臀围、腰臀比、血压等传统心血管病危险因素与糖尿病及其前期均存在关联性。     

Evaluation of a workplace cardiovascular health promotion programme in the Republic of Ireland

This paper describes a comprehensive evaluation of the organizational impact of a workplace health promotion programme, in the context of a framework devised by Nutbeam in 1998. The Happy Heart at Work programme, sponsored by the Irish Heart Foundation, has been in existence for 10 years and aims to promote a healthy lifestyle through specially devised modular materials. A postal census survey of 785 valid registered sites expressing any level of initial interest in the programme yielded a 40% response rate (n = 311). Of these, 194 (63%) were currently active and 114 were not. Active organizations were less likely to be Irish owned (54.5% versus 71.4%, p < 0.05), and more likely to operate in shifts (72.3% versus 51.1%, p < 0.05) or to have an occupational physician amongst the staff (36.9% versus 31%). Programme impact within active organizations, based on pre-defined Health Promoting Workplace parameters, was documented. There was agreement in the questionnaire responses that participating organizations promote a smoke-free environment (mean rating on five-point scale = 4.42), employee health and well-being (4.21) and good nutritional practice (4.11). Triangulation of research methods, including a telephone survey of gatekeepers from within organizations (n = 18), focus groups with participant employees (n = 42) and a review of the staff opinions of the facilitating organization on the programme, all showed strong concordance with respect to the strengths and weaknesses of Happy Heart at Work. The programme was felt to help improve employees' lifestyle habits and morale, as well as the company's public image. The main drawbacks of the programme were its relatively low profile, even in actively participating organizations, and the fact that it was not seen to be independently sustainable without intensive and ongoing support.     

2016—2020年某高校退休教职工糖尿病及糖尿病前期患病趋势分析

目的 探索某高校退休教职工糖尿病及糖尿病前期患病率变化趋势,提出运动干预对策,为糖尿病防治提供依据。方法 收集2016—2020年某高校3 664名60～90岁退休教职工健康体检中的血糖检测资料,使用SPSS 22.0软件进行统计分析。结果 该人群糖尿病患病率14.63%,糖尿病前期患病率19.41%;男性糖尿病、糖尿病前期患病率分别为18.28%、21.44%,高于女性的11.84%、17.85%(χ2=29.933、7.387,P<0.01)。60～岁、70～岁、80～岁年龄组糖尿病患病率分别是12.55%、18.48%、14.36%,糖尿病前期患病率分别是17.25%、19.57%、21.23%,差异均有统计学意义(P<0.01)。2016—2020年糖尿病前期标化患病率分别为19.46%、16.51%、16.84%、22.22%、21.01%,呈上升趋势(χ2趋势=4.632,P<0.05)。结论 该高校退休教职工男性糖尿病及糖尿病前期患病率高于女性,糖尿病前期患病率呈上升趋势,应积极采取运动干预。     

Creating healthy workplaces in Northern Ireland: evaluation of a lifestyle and physical activity assessment programme.

An observational study was carried out on 2595 Northern Ireland civil servants who attended a workplace lifestyle and physical activity assessment programme involving self-reported lifestyle history, measurement of physiological parameters and a 6 month follow-up postal questionnaire survey. Almost two-thirds of participants did not engage in regular moderate physical activity, with females twice as likely not to than men. Approximately one in six participants were smokers and three-quarters were found to have body fat estimations above the acceptable level, with females much more likely to be obese than men. Aerobic capacity was below average in 17% of participants and was associated with increasing age, smoking in the under 35s and poor physical activity levels. Excessive alcohol intake was found in 8% of all participants, and was more likely in men and smokers. In the follow-up survey, 83% needed to make one or more changes to their lifestyle. Smoking was the most difficult to change, with only 14% remaining abstinent after 6 months. Almost two-thirds were maintaining improved dietary habits and exercise activity, with around one-half moderating alcohol intake and achieving weight reduction. Overall, the average level of non-attempted behaviour change was one in five (19.6%), tried but failed accounted for almost one in three (31.2%) and successful maintenance of positive lifestyle change occurred in one-half (49.2%). Brief lifestyle and physical activity assessment programmes are effective interventions in getting employees to modify their lifestyles. The impact this has on wider organizational issues such as absenteeism and productivity needs further evaluation.     

Health surveys in the workplace: comparison of postal, email and World Wide Web methods

Health surveys in the workplace are an important part of epidemiology, needs assessment and health promotion. Since the workplace is changing rapidly with the use of computer networks, we examined the feasibility, validity and cost of health surveys using e-mail and the World Wide Web (WWW). Five hundred systematically sampled university staff in a convenience sample of 10 English universities were surveyed using either e-mail alone, e-mail plus a WWW form or postal questionnaire. Response rates, speed of response, validity and costs were examined. The postal survey obtained the best response rate: 72% as compared with 34% for e-mail alone and 19% for the WWW, but it was also the most expensive at 92p per reply, with 35p for e-mail, and 41p for the WWW. Most of the electronic responses were made within five days. In 1997, the increased response rate justified the higher cost of postal questionnaires. e-mail and WWW surveys are easy, quick and inexpensive to administer, and despite low response rates may be useful for pilot studies. The rapid changes in the spread and use of information technology means we have to keep reassessing the methods we use for health surveys in the workplace.     

Characteristics of health counselling in the workplace via e-mail.

This study was conducted to examine how health counselling via electronic mail (e-mail health counselling) was used in the workplace. The definition of health counselling employed in this study was 'any assistance to an individual seeking to solve any health problem'. A total of 2119 health counsellings conducted at a Japanese company's head office (700 employees) in 1997 and 1998 was used for the analysis, which compared four health counselling methods: e-mail, face-to-face, telephone and ordinary mail. This study distinguished four main characteristics of e-mail health counselling. First, the most and second most frequently used counselling methods were face-to-face and telephone counselling, at 70 and 15%, respectively, with e-mail health counselling ranked third at 13%. e-mail counselling was the second most frequently used method for employees in their 20s and 30s, while it ranked third among those over 40. Only 6% of employees in their 50s used e-mail counselling. Secondly, the proportion of mental health issues treated via e-mail counselling was significantly higher, at 26%, than for other counselling methods, which was at or below 10% for each of the other methods. Thirty-two per cent of all mental health counselling was conducted via e-mail. Thirdly, compared with face-to-face counselling, e-mail counselling dealt with more health issues related to primary prevention than with those related to secondary or tertiary prevention. Fourthly, compared with face-to-face counselling, e-mail counselling dealt more with health issues of third parties. These results suggest that e-mail health counselling may be useful in reaching people other than those targeted by the remaining counselling methods.     

Developing programmes to achieve a healthy society: creating healthy workplaces in Northern Ireland

Healthy workplaces help to prevent occupational disease and injury as well as promoting positive healthy lifestyle behaviours. The concept of creating healthy workplaces through workplace health promotion has been identified as a legitimate area of activity for public health policy in Northern Ireland, supporting as it does, the settings approach as a means of improving the health and well-being of the population at large. Benefits accrue to businesses, organizations and individuals from the enhancement of positive healthy lifestyle messages in addition to reinforcing the principles of good occupational health practices. Developing a framework for the creation of healthy workplaces is part of a joint initiative between the Northern Ireland Health Promotion and Health and Safety Agencies. Commitment to delivering the concept is required from all the key players who include: employers, employees, trade union groups and health and safety professionals. A healthy workplace model needs to be created which is flexible and adaptable to suit all types of business and in particular the needs of small businesses which predominate in Northern Ireland. The principles underpinning the Business Excellence Model may be a useful vehicle for delivering workplace health promotion onto an organization's agenda.     

A snapshot of workplace drug testing in the UK

BACKGROUND: There is a growing trend towards workplace drug testing in the UK, but there is little published data associated with this work. AIM: This survey reviews our findings from workplace drug testing in comparison with the results obtained from routine illicit drug monitoring. METHODS: The results of the analysis of 1617 specimens from 82 workplace drug testing sources and 12,281 submitted from drug dependency units were collated and compared. RESULTS: Workplace specimens were found to be positive for amphetamines, benzodiazepines, cannabis, cocaine and heroin. CONCLUSIONS: The data presented here suggest that a regular monitoring is required to discern the true extent of drug use in the workplace, especially in safety critical areas.     

Prevalence, management and impact of urinary incontinence in the workplace

BACKGROUND: The few prior studies of urinary symptoms in the workplace have been small investigations of women in specific occupations (e.g. nursing) or industries (e.g. pottery manufacture). In this study, the aims were to describe the prevalence, management and impact of urinary incontinence for a large cross-section of employed women in the USA. METHODS: Five-page questionnaires were mailed to 5130 American households selected from the National Family Opinion survey panel during the spring of 2004. Usable questionnaires were returned by 3364 women in the target age range of 18-60 years. RESULTS: About 37% of the 2326 employed respondents reported urine loss during the last 30 days. The most common strategies for managing incontinence at work included frequent bathroom breaks and wearing pads. The use of urine control methods increased with the severity of urine loss. The effect of incontinence on workplace activities also increased with the severity of urine loss: 88% of employed women with the most severe symptoms reported at least some negative impact on concentration, performance of physical activities, self-confidence or the ability to complete tasks without interruption. CONCLUSION: Urinary incontinence is prevalent among employed women. Those who experience severe symptoms report that it has a negative effect on aspects of work. Programs on the prevalence and impact of urinary incontinence would help educate both employers and employees, and may lead to the development of better management techniques in the workplace.     

Low back pain interventions at the workplace: a systematic literature review

OBJECTIVE: To assess the effect of controlled workplace interventions on low back pain (LBP) through a review of controlled studies. The rising costs of employees with LBP have resulted in an abundance of offers to society and organizations of interventions to prevent and/or treat the problem. Little is known of the effect of the different interventions. METHODS: A systematic literature search based on the inclusion criteria: controlled trial, work setting and assessment of at least one of the four main outcome measures: sick leave; costs; new episodes of LBP; and pain. Effect of the interventions was reported for the four main outcome measures. RESULTS: Thirty-one publications from 28 interventions were found to comply with the inclusion criteria. Exercise interventions to prevent LBP among employees and interventions to treat employees with LBP have documented an effect on sick leave, costs and new episodes of LBP. Multidisciplinary interventions have documented an effect on the level of pain. CONCLUSIONS: The results show that there is good reason to be careful when considering interventions aiming to prevent LBP among employees. Of all the workplace interventions only exercise and the comprehensive multidisciplinary and treatment interventions have a documented effect on LBP. There is a need for studies employing good methodology.     

Social context for workplace health promotion: feasibility considerations in Costa Rica,Finland, Germany,Spain and Sweden

We constructed a simple, flexible procedure that facilitates the pre-assessment of feasibility of workplace health promotion (WHP) programmes. It evaluates cancer hazards, workers' need for hazard reduction, acceptability of WHP, and social context. It was tested and applied in 16 workplace communities and among 1085 employees in industry, construction, transport, services, teaching and municipal works in Costa Rica, Finland, Germany, Spain and Sweden. Social context is inseparable from WHP. It covers workers' organizations and representatives, management, safety committees, occupational health services, health and safety enforcement agencies, general health services, non-government organizations, insurance systems, academic and other institutions, regulatory stipulations pertaining WHP, and material resources. Priorities, risk definitions, attitudes, hazard profiles, motivations and assessment methods were highly contextual. Management preferred passive interventions, helping cover expert costs, participating in planning and granting time. Trade unions, workers' representatives, safety committees and occupational health services appeared to be important operational partners. Occupational health services may however be loaded with curative and screening functions or be non-existent. We advocate participatory, multifaceted WHP based on the needs and empowerment of the workers themselves, integrating occupational and lifestyle hazards. Workforce in irregular and shift work, in agriculture, in small enterprises, in the informal sector, and immigrant, seasonal and temporary workers represent groups in need of particular strategies such as community health promotion. In a more general framework, social context itself may become a target for intervention.     

Out of sight, out of mind: workplace smoking bans and the relocation of smoking at work

As the cultural climate toward smoking changes, restrictiveworkplace smoking policies are becoming widely accepted by bothemployers and employees. There is, however, a crucial differencebetween those policies which accommodate reserved areas forsmoking and those which do not. Smokers at work tend to preferthe former especially when the alternative is a total ban. Anevaluation of a smoking ban implemented at a Scottish Universityin October 1997 suggests that the total ban is not only unpopularwith smokers but also among non-smokers who experience unintendedconsequences of the new policy. The greatest complaint fromnon-smokers stems from the relocation of smoking to outsideand particularly around the entrances to University buildings.This relocation has increased environmental pollution for thoseentering and leaving work, presents a poor image to outsidersand visitors, creates unsightly smoking debris and heightensthe risk of fire. Furthermore, employees who smoke outside,in all weathers, have aroused the sympathies of a large numberof their non-smoking colleagues. These unintended consequenceshave prompted many non-smoking staff to favour the reinstatementof reserved smoking areas inside work. In this article we argue,however, that this is not a sensible solution and that theremay indeed be some advantage in increasing the visibility ofsmokers at work. In the short term non-smoking staff becomemore aware of the problems faced by smokers. In the longer term,this raised awareness may have implications for changing organizationalattitudes to the provision of health intervention programmesat the University. Certainly, continuing organizational-basedcessation support might demonstrate, alongside a restrictivesmoking policy, a less punitive and more caring approach tothe promotion of health-related behavioural change at work.     

Psychopathological features of a patient population of targets of workplace bullying

BACKGROUND: A strong association between workplace bullying and subsequent anxiety and depression, indicated by empirical research, suggests that bullying is an aetiological factor for mental health problems. AIMS: To evaluate levels of stress and anxiety-depression disorder developed by targets of workplace bullying together with outcome at 12 months and to characterize this population in terms of psychopathology and sociodemographic features. METHODS: Forty-eight patients (36 women and 12 men) meeting Leymann Inventory of Psychological Terror criteria for bullying were included in a prospective study. Evaluations were performed at first consultation and at 12 months using a standard clinical interview, a visual analogue scale of stress, the Hospital Anxiety and Depression (HAD) scale, the Beech scale of stress in the workplace and a projective test (Picture-Frustration Study). RESULTS: At first consultation, 81% of patients showed high levels of perceived stress at work and 83 and 52% presented with anxiety or depression, respectively. At 12 months, only 19% of working patients expressed a feeling of stress at work. There was a significant change in symptoms of anxiety while there was no change in symptoms of depression. Stress at work and depression influenced significatively capacity to go back to work. At 12-month assessments, workers showed a significantly better score on the HAD scale than non-workers. Over half the targets presented a neuroticism-related predominant personality trait. CONCLUSION: Workplace bullying can have severe mental health repercussions, triggering serious and persistent underlying disorders.     

Post-trauma support in the workplace: the current status and practice of critical incident stress management (CISM) and psychological debriefing (PD) within organizations in the UK

Employers' duties of care under both common and statute law include the need to take reasonable care of the health and safety of the workforce. This includes both the moral and legal duties to consider the psychological needs of personnel following exposure to traumatic events related to the workplace. While this has been recognized within many high-risk occupations such the police, fire and rescue services and the military, there is also evidence that post-trauma support in the workplace is increasingly commonly provided not only among health and social services agencies, but within many private sector organizations. Over the past decade, however, there has been considerable controversy over the provision of early psychological support to personnel in the form of critical incident stress management (CISM) processes. In particular, one aspect of CISM, the use of psychological debriefing (PD) has come under scrutiny and criticism as two studies indicated that PD was ineffective and had the potential to do harm. Inevitably, this has provoked much uncertainty and confusion among some organizations as what should be the most appropriate support. It has also led to misconceptions and misunderstandings as to the aims and purpose of PD, together with inaccuracies of terminology, for example describing PD as 'counselling'. Despite the controversy, both CISM and PD continue to be provided on a widespread basis, often utilizing a framework of voluntary peer group support. This paper intends to (i) present a review of the current status of CISM practices, including the use of PD within various organizations in the UK and (ii) provide a clear framework and understanding of the main issues and to clarify conceptual misunderstandings. The history, principles and background of the use of post-trauma support in the workplace, charting trends over the past two decades, previous research, problems with the evidence base and current thinking and practice in the field are reviewed. The relevance and implications of the National Institute for Clinical Excellence Guidelines on the Assessment and Management of Post Traumatic Stress Disorder, which make recommendations for early interventions for post-traumatic stress disorder are discussed. Reference is made to the use of CISM and PD within both statutory and voluntary organizations in an international context.