Work ability of workers in western China: reference data

BACKGROUND: The Work Ability Index (WAI) is a validated and widely used research tool. Reference data for Chinese workers by age, gender and work content are poorly documented or lacking. OBJECTIVE: To provide reference data for work ability among workers in western China. METHODS: A random sample of 10 218 workers (including manual, professional, clerical and semi-skilled workers) in western China, aged 16-69 years, was taken from several studies and the WAI questionnaire was administered. RESULTS: All the WAI scores were distributed continuously and nearly normally. The WAI for female workers was significantly higher than for males (P < 0.01) and the 'poor' WAI category only accounted for 3% of females, against 6% of males. WAI scores declined with age and changed variably among workers according to work content and age. Mean WAI scores of manual workers declined rapidly beyond the age of 35 years, and beyond age 45 years for professional and clerical workers. WAI scores were distributed differently according to work content and age group (P < 0.01). WAI categories differed by work content and age group both for male and female workers. CONCLUSION: WAI is validated in Chinese occupational practices. Some reference data are different from Finnish data. This study provides gender, age and work-content-specific WAI reference values that will help enable comparison and intervention evaluation in further studies.     

Test-retest reliability of the Work Ability Index questionnaire

The goal of the study was to assess the test-retest reliability of the Work Ability Index (WAI) questionnaire. Reliability was tested using a test-retest design with a 4 week interval between measurements. Valid data were collected among 97 elderly construction workers aged 40 years and older. We analysed the test-retest reliability of the WAI score itself (range 7-49 points) and classification in one of the four WAI categories based on this score: poor (7-27 points); moderate (28-36 points); good (37-43 points); and excellent work ability (44-49 points). Exactly the same WAI score on both measurements was reported by 25% of the subjects and 95% of the individual differences between measurements were found to be <6.86 points (two times standard deviation). Despite the individual changes between measurements, no significant difference was reported in the mean WAI score at group level between test and retest measurements (40.4 versus 39.9). The percentage of observed agreement for the classification of subjects in one of the four WAI categories on both measurements equalled 66%. The results of this study provided evidence of an acceptable test-retest reliability of the classification of subject's work ability by means of the WAI questionnaire. At group level, the mean WAI score and classification into WAI categories were found to be a stable measure over a 4 week interval. These results give additional support for the applicability of the questionnaire in occupational health research and the daily practice of occupational health care.     

Psychological and occupational predictive factors for back pain among employees of a university hospital in southern Spain

OBJECTIVES: To identify the individual and occupational factors that are predictors for low back pain among the employees of a university hospital in southern Spain. METHODS: A transverse study was conducted in which the population used was the hospital employees who volunteered to participate. The information was obtained by using a questionnaire, which included demographic and anthropometric variables, habits, characteristics of the work done, and of any pain experienced. The mental health condition of subjects was measured using the GHQ-28, using a score of > or = 6 as the cut-off point. To study the variables associated with pain, crude odds ratios (ORs) were calculated (+/- 95% CI) and adjusted according to a logistic regression model. RESULTS: One thousand one hundred and four subjects participated in the study but only 890 of these completed the questionnaire in full (rate of response, 35.7% of total employees). The population studied was notable for the high proportion of women, for subjects > 41 years of age, and subjects who undertook little or no physical exercise. In addition, according to the GHQ-28 test, 29.9% of the total were 'probable psychiatric cases'. The crude ORs were high in all the occupational categories in comparison with the doctors, with the exception of the maintenance, cleaning, and catering group. They were also higher among women, among subjects with poor mental health, and among women with one or more children. The adjusted ORs showed that having a GHQ-28 score of > or = 6, and belonging to the auxiliary technician category, were independent risk factors for suffering low back pain. Being older than 41 years and in temporary employment were protective variables. CONCLUSIONS: The presence of probable mental illness is the variable most strongly associated with the presence of low back pain in the population studied. Its diagnostic confirmation and appropriate treatment could contribute to reducing the prevalence of vertebral pains in this occupational group.     

Smoking and Exposure to Occupational Hazards in 8,304 Workers in Guangzhou, China

This cross-sectional study aimed to describe the pattern ofsmoking in relation to occupational hazard exposure in a workingpopulation in Guangzhou, China. In 1994, data on smoking andoccupational hazard exposure from occupational health recordsof 8,304 subjects aged 35 years or older from 47 randomly selectedfactories were studied. About 49% of the men and 55% of thewomen were exposed to dust, chemicals or other hazards. Theprevalence of smoking was 56.1% in men and in women. The prevalenceof smoking in men was higher in those who were younger, withprimary education or who were workers. In women, those who wereolder, with primary education or in management jobs had highersmoking prevalence. In men and women, subjects who were exposedto occupational hazards had higher smoking prevalence: the highest(71.6%) was found in male workers exposed to dust. Urgent tobaccocontrol measures are needed to prevent the epidemic of smoking-relatedand occupation-related diseases in the workplace in China.     

Comparison of Work Ability Index and cognitive function tests]

The purpose of this study was to evaluate the effect of aging with regard to scores for certain cognitive function tests and WAI (Work Ability Index), and to examine the relationship between cognitive function test scores and work ability as measured by WAI. The subjects were 139 male employees of a factory producing steel plate, and their average age was 48.1 yr (SD 16.4). The WAI and cognitive function tests were conducted and valid scores were obtained from 134 subjects as to WAI, and from 88 subjects as to cognitive function tests. The subjects were divided into two groups: young workers (under 45 yr) and middle-aged to elderly workers (45 yr and over). The WAI scores of the two groups were compared, but no significant differences were observed. Nevertheless, for two WAI items, WAI-2 and WAI-7, the scores of the middle-aged to elderly worker group were significantly higher than those of the young worker group. In contrast, the scores for WAI-3 of the middle-aged to elderly group were significantly lower than those of the young worker group. The cognitive function test scores for the two groups were also compared. The scores for Working Memory test, Tracking test, and Sentence-to-sentence Comparison test of the middle-aged to elderly worker group were significantly lower than those of the younger group. Moreover, for the middle-aged to elderly worker group, the average WAI-3 scores for those with good cognitive function test results and those with poor cognitive function test results were compared, but there were no significant differences. This result shows that deterioration of physical function caused by aging is not related to deterioration of cognitive function caused by aging in the subjects of this study. The reason for this may be that the subjects are blue-collar workers, and thus cognitive functions are less important for their work.     

中老年职工心肺功能评价及其与工作能力的关系

本研究测量了162名来自不同行业中老年职工的心肺功能状态，年龄在40～60岁，其中男性110名，女性52名。结果发现心肺功能有着明显的性别差异，女性心肺功能指标的平均水平仅为男性的73％～78％。40～49岁年龄组职工的FVC％平均水平显著高于50～60岁组（P＜0．05）。提示随年龄增加FVC％下降，不同劳动类型间心肺功能的平均水平差异无显著意义（P＞0．05）。相关分析表明，心肺功能各测定指标与WAI间的相关性较低，心肺功能指标与WAI交叉分级间的关系也缺乏有统计学意义的联系，本文对其可能的原因进行了讨论。     

Population-based reference values for the 1-min sit-to-stand test

Objectives

To determine reference values for the 1-min sit-to-stand (STS) test in an adult population.

Methods

Cross-sectional study nested within a nationwide health promotion campaign in Switzerland. Adults performed the STS test and completed questions on demographics and health behavior.

Results

6,926 out of 7,753 (89.3 %) adults were able to complete the STS test. The median number of repetitions ranged from 50/min (25–75th percentile 41–57/min) in young men and 47/min (39–55/min) in young women aged 20–24 years to 30/min (25–37/min) in older men and 27/min (22–30/min) in older women aged 75–79 years.

Conclusions

The reference values support the interpretation of 1-min STS test performance and identification of subjects with decreased lower body muscular strength and endurance.     

Chronic fatigue among bank workers in Brazil

The present study examines the prevalence of chronic fatigue (CF) among bank workers in Brazil and possible associations with gender and working conditions. The study sample included all 735 workers from the department of data processing of a state bank. CF was assessed using the Chalder Fatigue Scale. Working conditions and socio-demographic, socio-economic and psychosocial factors at work were analysed. Psychiatric symptoms were measured with the SRQ-20. The overall estimate of the prevalence of CF was 8.7% [95% confidence intervals (95% CI) = 6.4-10.9%]: 7.8% (95% CI = 5.5-10.7%) among men and 11.0% (95% CI = 6.7-16.9%) among women. The male-female difference was not statistically significant, even after adjusting for minor psychiatric disorders. The overall prevalence of CF without minor psychiatric disorders was 4.5% (95% CI = 2.7-6.3%): 3.9% (95% CI = 1.9-5.9%) among men and 6.4% (95% CI = 2.0-10.1%) among women. In the final model, risk factors for CF were fast work speed [odds ratio (OR) = 3.5], dissatisfaction at work (OR = 3.1), minor psychiatric disorders (OR = 6.8), and medium (OR = 1.8) and heavy domestic workload (OR = 12.0). CF is common among these bank workers and is associated with psychosocial factors at work. Particularly among women, domestic workload, marital status and the presence of young children were associated with CF in the stratified analysis. Domestic workload may add physical and mental stress, putting employees at risk for CF from overload, or CF may cause workers to perceive domestic work as heavy.     

Is open-angle glaucoma associated with early menopause? The Rotterdam Study.

The authors examined the association between age at menopause and open-angle glaucoma among women aged > or = 55 years in the population-based Rotterdam Study (1990--1993). Information on age and type of menopause was obtained by interview. Subjects (n = 3,078) were stratified into three categories according to age at menopause: <45 years, 45--49 years, and > or = 50 years, with the last group serving as the reference group. Diagnosis of open-angle glaucoma was based on the presence of a glaucomatous visual field defect and glaucomatous optic neuropathy. Open-angle glaucoma was diagnosed in 78 women with a natural menopause and 15 women with an artificial menopause. In the category of natural menopause, women who went through menopause before reaching the age of 45 years had a higher risk of open-angle glaucoma than the reference group (odds ratio = 2.6; 95% confidence interval: 1.5, 4.8), after adjustment for age and use of hormone replacement therapy. Among women who went through menopause between the ages of 45 and 49 years, the odds ratio was 1.1 (95% confidence interval: 0.7, 2.0). These findings suggest that early menopause is associated with a higher risk of open-angle glaucoma.     

Socioeconomic differences in road traffic injuries during childhood and youth: a closer look at different kinds of road user

STUDY OBJECTIVE: To investigate if there are socioeconomic differences in road traffic injuries among Swedish children and adolescents, and if this applies to the same extent to all categories of road users. To assess the modification effect of gender of child. DESIGN: A closed population-based cohort study based on the Swedish Population and Housing Census of 1985. Individual census records are linked to Sweden's National Hospital Discharge Register (1987-1994). SETTING AND SUBJECTS: All children aged 0-15 years in 1985 (approximately 1.5 million subjects) were monitored for five categories of road traffic injuries over eight years, and divided into seven socioeconomic groups on the basis of parental socioeconomic status. Odds ratios and population attributable risks were computed using the children of intermediate and high level salaried employees as reference group. MAIN RESULTS: The injury risks of pedestrians and bicyclists are 20% to 30% higher among the children of manual workers than those of intermediate and high level salaried employees. Socioeconomic differences are greatest for injuries involving motorised vehicles-that is, moped, motorcycle and car. If all children had the same rate as children in the reference group, the rate for all groups would be 25% lower for moped riders and 37% lower for car drivers. CONCLUSIONS: Socioeconomic differences in road traffic injuries are substantial for both boys and girls. Socioeconomic injury-risk differentials increase when young people use motorised vehicles.     

Fat-free and fat mass percentiles in 5225 healthy subjects aged 15 to 98 years.

OBJECTIVES: Fat-free mass (FFM) and fat mass (FM) are important in the evaluation of nutritional status. Bioelectrical impedance analysis (BIA) is a simple, reproducible method used to determine FFM and FM. Because normal values for FFM and FM have not yet been established in adults aged 15 to 98 y, its use is limited in the evaluation of nutritional status. The aims of this study were to determine reference values for FFM, FM, and percentage of FM by BIA in a white population of healthy adults, observe their differences with age, and develop percentile distributions for these parameters between ages 15 and 98 y. METHODS: Whole-body resistance and reactance of 2735 healthy white men and 2490 healthy white women, aged 15 to 98 y, was determined by 50-kHz BIA, with four skin electrodes on the right hand and foot. FFM and FM were calculated by a previously validated, single BIA formula and analyzed for age decades. RESULTS: Mean FFM peaked in 35- to 44-y-old men and 45- to 54-y-old women and declined thereafter. Mean FFM was 8.9 kg or 14.8% lower in men older than 85 y than in men 35 to 44 y old and 6.2 kg or 14.3% lower in women older than 85 y than in women 45 to 54 y old. Mean FM and percentage of FM increased progressively in men and women between ages 15 and 98 y. The results suggested that the greater weight noted in older subjects is due to larger FM. CONCLUSIONS: The percentile data presented serve as reference to evaluate deviations from normal values of FFM and FM in healthy adult men and women at a given age.     

Inequality in the health status of workers in small-scale enterprises

BACKGROUND: Small-scale enterprises (SSEs) usually share poorer resources for promoting occupational health. AIM: To investigate inequality of health status among SSEs in Japan. METHOD: A cross-sectional, multiple-centred study was carried out using the periodical health check-up data for the fiscal year 2000 to compare the age-adjusted proportions of workers with hypertension (HT), hyperlipidaemia, impaired glucose tolerance (IGT) and obesity and of current smokers by size of enterprise, i.e. or=1000 employees in Japan. RESULTS: From five leading occupational health organizations, data were collected for 9833 enterprises with a total of 436 729 subjects, 302 383 males and 134 346 females. The proportions of workers in SSEs with or=50 male employees. The prevalence of smokers in SSEs with or=50 male employees. These proportions showed a significantly increasing tendency with decreasing size of male workforce. CONCLUSION: Despite the cross-sectional design and only adjusting age as a potential confounder, higher proportions of HT, IGT, obesity and smoking in male workers were found in SSEs compared to larger organizations.     

Are socio-economic inequalities in mortality decreasing in Trent Region,UK? An observational study, 1988-1998

BACKGROUND: There is substantial national interest in the widening gap in socio-economic inequalities. The aim of this study was to examine time trends in age-specific mortality in Trent Region comparing rates by socio-economic deprivation from 1988 to 1998. METHODS: Mortality rates from 1988 to 1998 were calculated for each of five deprivation categories (derived using 1991-based enumeration district level Townsend scores) for men and women aged 45-54, 55-64, 65-74 and 75-84 years. Rate ratios (95 per cent confidence intervals) were calculated for the years 1988-1990 and 1996-1998, comparing the most deprived with the least deprived categories. RESULTS: For men aged 45-54, the rate ratio for the most deprived relative to the least deprived category was 2.42 (2.2-2.67) in 1988-1990 and 2.4 (2.17-2.65) in 1996-1998. Amongst women the ratio fell from 2.14 (1.88-2.42) to 1.67 (1.47-1.88). For men aged 55-64, the rate ratio fell from 2.07 (1.95-2.19) to 1.79 (1.67-1.91). For women the fall was from 1.99 (1.84-2.14) to 1.59 (1.46-1.73). For those aged 65-74, the fall was from 1.65 (1.58-1.72) to 1.33 (1.28-1.39) for men and from 1.55 (1.47-1.63) to 1.37 (1.30-1.45) for women. For people aged 75-84, no clear convergence in rates was seen. CONCLUSION: There appear to be decreases in socio-economic inequalities in mortality between 1988 and 1998 in Trent Region. These trends run counter to those described in the majority of recent literature.     

The self-reported well-being of employees facing organizational change: effects of an intervention

The objective of this study was to investigate the self-reported well-being of employees facing organizational change, and the effect of an intervention. It was a controlled intervention study. Subjects were allocated to study and control groups, and brief individual counselling was offered to the subjects in the study groups. Questionnaire measures were administered before and after counselling (a 3-month interval), and non-counselled subjects also completed questionnaires at the same times. The setting was 15 estate offices in an urban local authority Housing Department. Subjects comprised the total workforce of the Housing Management division: 193 employees, male and female, aged 22-62 years, facing compulsory competitive tendering between 1994-97. Main outcome measures were baseline and comparative measures of psychological morbidity, including the General Health Questionnaire (GHQ) and the Occupational Stress Indicator (OSI). Questionnaire response rates were 72% and 47% on first and second occasions respectively. The uptake of counselling was 37%. In comparison with (1) the UK norms for the OSI and (2) the norms for a similar occupational group, this group of workers were under more work-related pressure and their self-reported health was markedly poorer. They were not however at a disadvantage in terms of coping strategies. Those accepting the offer of counselling were subject to greater levels of work stress, had poorer self-reported health and markedly lower levels of job satisfaction than those who did not. Questionnaire scores were not significantly different before and after counselling, giving no evidence of treatment effects on symptomatology. However, almost all subjects rated counselling as having been extremely helpful. This study suggests that adverse effects on staff facing organizational change may be ameliorated by improved management practice.     

Misclassification of occupation-based socioeconomic position and gender comparisons of socioeconomic risk

AIMS: Because occupational classification systems tend to be less precise in the female sector of the working market there has been concern that this might imply more misclassification of socioeconomic position among women, biasing comparisons of gender-specific socioeconomic differences in risk. METHODS: The Stockholm Heart Epidemiology Program (SHEEP) is a population-based case-control study of risk factors for incident myocardial infarction. The study base included all Swedish citizens aged 45-70 in Stockholm County during 1992-94, 550 female and 1201 male cases, and 776 female and 1538 male controls. The use of an occupational classification as the base for categorizing socioeconomic position was compared with socioeconomic position based on detailed self-reported information on job titles and work tasks. RESULTS: Women are categorized into fewer occupational categories than men and the socioeconomic heterogeneity within occupational categories is substantial for women as has been reported by others. However, despite more occupational categories for male types of jobs the socioeconomic heterogeneity within occupational categories is actually larger for men, implying larger misclassification among men. In simulations with different levels of socioeconomic misclassification among women, the effects on the gender comparison of socioeconomic differences in disease risk were small and they were mostly compensated for by less misclassification among men. CONCLUSIONS: The findings do not support the assumption that misclassification of socioeconomic position among women due to a restricted working market and a crude occupational classification for female jobs is an important issue when comparing measures of socioeconomic inequalities in health between men and women.     

The beginning of the end of the lung cancer epidemic among Dutch women

OBJECTIVE: To describe and interpret recent changes in lung cancer mortality and incidence, and changes in smoking prevalence among young and middle-aged women in The Netherlands. DESIGN: Secondary data analysis. METHOD: Mortality data were collected from Statistics Netherlands (CBS; 1960-2006), data on the incidence were obtained from The Netherlands Cancer Registry (NCR; 1989-2003), and data on smoking prevalence were collected from the Dutch Foundation on Smoking and Health (STIVORO; 1988-2007). Mortality and incidence rates were calculated for four age groups (20-44, 45-49, 50-54 and 55-59 years). Changes in trends in mortality and smoking prevalence were examined using joinpoint regression and birth cohort analysis. RESULTS: Since the 1960s, lung cancer mortality and incidence has increased dramatically among women in The Netherlands. In the mid-1990s, lung cancer mortality and incidence rates in young women (aged < 50 years) surpassed those in men. Mortality rates in young women (aged 20-49 years) increased 4-6% annually. However, these rates started to stabilise since 1999. Among women born after 1950, mortality rates and smoking prevalence have decreased. CONCLUSION: An end to the lung cancer epidemic in women in The Netherlands is in sight. The first indications are the recent reduction in mortality and incidence among young women, particularly in women born after 1950. In the future, this reduction is expected to translate into a stabilisation or modest decrease in total lung cancer mortality and incidence.     

The reported incidence of work-related ill-health in Scotland (2002-2003)

BACKGROUND: Although incidence data for work-related ill-health in the UK are available, more detailed information for smaller geographical areas has hitherto been unpublished. AIMS: To estimate the incidence of work-related ill-health reported by clinical specialists in Scotland, 2002-2003. METHODS: THOR (The Health and Occupation Reporting network) is a UK wide reporting scheme for work-related ill-health. In 2002-2003, 241 out of 2162 physicians in THOR were based in Scotland. We have summarized the reported cases and calculated incidence rates for categories of ill-health by age, gender and industry. The UK Labour Force Survey (2002) was used to provide denominator data, with comparisons made between rates for Scotland and the rest of the UK. RESULTS: In 2002-2003, 4043 estimated cases were reported from Scotland. Mental ill-health was most frequently reported (41%); followed by musculoskeletal disorders (31%), skin disorders (16%), respiratory disease (10%), hearing disorders (2%) and infection (1%). The reported average annual incidence rate per 100,000 employees for all work-related ill-health in Scotland was 86.0. The highest reported rate for mental ill-health was found for employees in public administration and defence (76.7 per 100,000), and health and social work (72.3 per 100,000). The construction industry had the highest reported rate of musculoskeletal disorders (41.6 per 100,000), while hairdressers appeared at most risk of developing occupational contact dermatitis (rate=86.4 per 100,000). CONCLUSIONS: Despite its limitations, THOR has indicated types of work-related ill-health and related industries for targeted disease prevention in Scotland.     

中老年在职职工工作能力现况研究

对４３６例中老年职工（４０～６０岁）的工作能力（ＷＡＩ）进行了定量分析，研究对象分为脑力劳动、体力劳动和体脑混合３种劳动类型，将ＷＡＩ分为好、中、差３个等级．分析结果表明：男女职工ＷＡＩ均随年龄增加而明显下降，女性平均水平高于男性（Ｐ＜０．０５）；体力劳动者ＷＡＩ平均水平最低，男女分别为３１．７和３３．０，而脑力劳动者最高，男女均为３８．８，劳动类型间的差异有显著意义（Ｐ＜０．０１）．