Ageing and fitness to work

Ageing workers can be found in almost all occupations. Assessment of fitness to work in these workers is important, as it aims to match their functional capacity (which is reduced compared to younger workers), to the demands of their work (which may remain the same as that for younger workers). This outcome of assessment is influenced by the interaction between functional capacity, state of health, the nature of work, and possibilities for work accommodation. The assessment of functional capacity should include physical, mental and social capacity, as well as assessment of any disability. In addition to clinical or laboratory measurements, several authors have suggested the use of a 'work ability index' for specific occupations as a practical means of selecting the appropriate worker for the job. This index can also be used for monitoring functional capacity. In addition, as for any fitness to work assessment, a good understanding of the nature of the work and the work environment is required, and possibilities for work accommodations considered. While changes in the work environment and working conditions can be made to suit the functional capacity of the ageing worker, the maintenance of functional capacity is another important issue. There is a place for a greater role for disease screening and health promotion for such workers.     

Work-related life events, psychological well-being and cardiovascular risk factors in male Swedish automotive workers

AIMS: To analyse the relationship between life events, social support, psychological well-being and cardiovascular risk factors in blue- and white-collar Swedish automotive workers. METHODS: Baseline questionnaire regarding life events, social support, depressed mood and mental strain and smoking habits. Follow-up questionnaire after 5 years included the Psychological General Well-being Inventory to assess various health variables. At baseline and follow-up, anthropometric data were obtained. Blood pressure, blood glucose and serum lipids were measured and smoking habits were surveyed. RESULTS: The blue-collar workers showed a profile indicating increased cardiovascular risk with a higher proportion of smokers, a higher waist to hip ratio and higher triglycerides. They also reported themselves to have worse general health and less emotional self-control, but were less anxious than the white-collar workers. Negative life events, especially those related to work seemed to affect the well-being of the blue-collar workers more adversely than the white-collar workers. Being nervous and depressed at baseline increased the risk of poor psychological well-being at the follow-up. Social support within this 5-year perspective was a factor which predicted psychological well-being in both worker categories. Increase in cholesterol/high-density lipoprotein-cholesterol (HDL-C) ratio was the only cardiovascular risk factor associated with the strain of life events but not with work-related events. CONCLUSION: Over a 5-year period, men who experienced negative, strongly stressful and work-related life events displayed poorer psychological well-being at follow-up regardless of worker category. Social support was protective.     

Plasma cholinesterase level of Ethiopian farm workers exposed to chemical pesticide

BACKGROUND: Pesticide applications can have unwanted health consequences. AIM: To study cholinesterase levels in farm workers with varying exposure to chemical pesticide. METHODS: Plasma cholinesterase (PChE) was measured in workers at two Ethiopian farms. A standard questionnaire adopted from the British Medical Research Council was used to determine the health status of the subjects. RESULTS: A total of 82 farm workers and 47 controls participated in the study. While the mean values of plasma cholinesterase were generally lower in those exposed, this difference was only significant in the sprayers at Birr farm (P<0.05). In this group, four sprayers had cholinesterase activity lower than 50%. CONCLUSION: The sprayers in both farms were the most affected groups, suggesting that improved controls on workplace exposure to pesticide is required in these groups of workers.     

Age and ageing: an overview

Europe is ageing, as exemplified by the UK population where, in the foreseeable future, more people will be over than under age 50: industry appears slow to recognise and appreciate all that older workers still have to offer: bundling them off into early retirement wastes precious talents. Memory difficulty is not an inevitable part of ageing.     

Systematic health, environment and safety activities: do they influence occupational environment, behaviour and health?

This study investigated the relationships between systematic health, environment and safety (HES) activities (as defined by Norway's Internal Control Regulation), the working environment, and workers' health-related behaviour and health. A questionnaire on systematic HES activities was answered by 237 managers of motor vehicle repair garages. A further questionnaire, on the working environment, health-related behaviour and health, was answered by workers (n = 2174) from the same garages. Using regression analysis, systematic HES activities were positively and significantly correlated with the following separate outcome variables, measured at an individual level: satisfaction with HES activities, physical working environment, social support, HES-related management support, health-related support, and control and workers' participation in activities related to occupational health. Workers at garages with systematic HES activities reported fewer musculoskeletal symptoms. Firm conclusions on the direction of causality are difficult to draw because of the cross-sectional design.     

Evaluation of a multidisciplinary treatment for patients with chronic non-specific upper-limb musculoskeletal disorders: a pilot study

BACKGROUND: Upper-limb musculoskeletal disorders (ULMSDs) are considered a major health and socio-economic problem. However, knowledge about the effect of treatment programmes is scarce. Objective To evaluate the effect of a multidisciplinary treatment programme on well-being, disability and return to work in patients with chronic non-specific upper-limb disorders. METHODS: A longitudinal and uncontrolled design with pre-post measurements was used. Forty-one patients on long-term sick leave attended for multidisciplinary treatment aimed at training in personal coping strategies and improving activities of daily living. Outcome measures were generic well-being (SF-36), disability (DASH) and return to work (working hours). RESULTS: General well-being improved significantly between pre-treatment and post-treatment. Level of disability declined significantly between pre-treatment and post-treatment. In 63% of the patients, return to own work was complete at follow up, 4 months post-treatment. CONCLUSION: The results of this uncontrolled intervention study suggest that multidisciplinary treatment programmes improve general well-being, reduce disability and facilitate return to work in patients with chronic non-specific ULMSDs.     

Musculoskeletal disorders in hotel restaurant workers

BACKGROUND: A variety of occupational groups have been shown to experience elevated risks of work-related musculoskeletal disorders (WMSD). Little information on WMSD is available in hotel restaurant workers. OBJECTIVE: To document the profile of WMSD in a sample of hotel restaurant workers in Taiwan. METHODS: A self-administered questionnaire was used to gather information regarding body site specific WMSD, pain intensity and strategies for pain relief amongst a sample of hotel restaurant workers. RESULTS: Among 905 restaurant workers, 785 (84%) reported experience of WMSD in the previous month, with the highest prevalence rate found for the shoulder (58%). The highest mean score for perceived pain intensity was found for the lower back/waist (2.50 points). Despite a high prevalence rate, only a small portion of those reporting WMSD (12%) considered their work capacity or activities of daily living to be affected by WMSD, and only <5% of workers with WMSD sought medical treatment. CONCLUSION: WMSD related pain is common among hotel restaurant workers in Taiwan, but it does not appear to interfere with job performance or daily living. Self-treatment and alternative therapies that have not been evaluated for effectiveness are commonly employed by hotel restaurant workers.     

A health promotion programme for oil refinery employees: changes of health promotion needs observed at three years

The main aim of this three-year follow-up study was to evaluatethe long-term effects of a workplace health promotion interventionprogramme offered by the Neste Oyj corporation's occupationalhealth service. Another aim was to study factors associatedwith changes in health promotion needs. These were assessedusing information obtained by means of questionnaires and laboratorymeasurements. The target areas assessed were physical activity,musculoskeletal problems, dietary habits, obesity, blood pressure,serum lipids, smoking, quality of sleep and mental well-being.Participants from one oil refinery were offered special healthpromotion counselling, while those from the other oil refinerystudied received only their personal results, written informationand instructions. Evaluation of the changes in needs was mainlybased on comparison of the results of two examinations performedwith an interval of three years. Effects of special health promotioncounselling were observed in the target area of physical activity.Elimination of certain health promotion needs was seen in bothgroups in all of the target areas. The most extensive changeswere seen in the target areas of musculoskeletal symptoms, dietaryhabits, blood pressure and mental well-being. Basic education,occupational status and age-group, as well as the value of tendinghealth were frequent variables explaining the reduction in theneed for health promotion activities. Worker participation inhealth promotion counselling activities provided by occupationalhealth services can be high, as in this study in which the participationrate was 90% and the drop-out rate during the three years only10%.     

The relationship between waist-to-hip ratio and occupational status and life-style factors among middle-aged male and female Japanese workers.

As a marker of body fat distribution and therefore level of obesity, the waist-to-hip ratio (W:H) is a good indicator of coronary heart disease risk status. The present study investigated the association between occupational status and life-style factors, and W:H of middle-aged Japanese male (n = 2,550) and female (n = 1,283) workers in a metal-products factory. A higher W:H was observed in the management level males as compared with the other male workers and we suggest this was promoted by the sedentary aspect of their work, as well as their higher levels of alcohol consumption and lower levels of leisure-time physical activity. In contrast, a higher W:H was recorded in female labourers, whose work was typically less sedentary as compared with female managers. Life-style factors included in the study were not related to this observation. We conclude that other unmeasured psychosocial factors may be important in promoting higher W:H in female labourers.     

Socioeconomic and occupational groups and risk of asthma in Sweden

AIM: To investigate possible associations between hospitalization for asthma and socioeconomic status and occupation. METHODS: A nationwide database was constructed by linking Swedish Census data to the Hospital Discharge Register (1987-2004). The hospital diagnoses of asthma were based on the International Classification of Diseases. Standardized incidence ratios were calculated for different socioeconomic and occupational groups. Ninety-five per cent confidence intervals were calculated assuming a Poisson distribution. RESULTS: A total of 13,202 male and 11,876 female hospitalizations for asthma were retrieved at ages >30 years. The socioeconomic groups with < 9 years of education were associated with a significantly increased risk of hospitalization for asthma. Among male occupations, increased risks were noted for farmers, mechanics and iron and metal workers, welders, bricklayers, workers in food manufacture, packers, loaders and warehouse workers, waiters and chimney sweeps with prolonged exposures in two censuses. For female occupations, increased risks were observed among assistant nurses, religious, juridical and other social science-related workers, drivers, mechanics and iron and metalware workers and wood workers. CONCLUSIONS: The present study suggests that socioeconomic status (low educational level) and occupation have an effect on the population's risk of hospitalization for asthma.     

Screening for high-risk and elevated alcohol consumption in day and shift workers by use of the AUDIT and CDT

BACKGROUND: Alcohol consumption levels and drinking patterns have been reported to vary between day and shift workers, although the results have been conflicting. Previous results indicate that questions about alcohol habits may be asked in the workplace. However, no studies have evaluated the Alcohol Use Disorders Identification Test (AUDIT) or the alcohol biomarker carbohydrate-deficient transferrin (CDT) in serum for this purpose. AIM: To investigate, in conjunction with routine health examinations, whether there is any difference between permanent day and shift workers in high-risk alcohol consumption, according to the AUDIT and CDT. Gamma-glutamyl transferase (GGT) in serum was included mainly as a comparison test. METHODS: The employees who attended for a regular health examination during the study period were offered voluntary alcohol screening with the AUDIT and CDT. RESULTS: Altogether, 990 employees (day, two-shift, and three-shift workers) participated in the study, 194 (20%) of whom screened positive with the AUDIT and/or CDT. There were no significant differences in the screening results between day and shift workers, whereas significantly fewer of the two-shift workers (odds ratio=0.5, 95% confidence interval=0.3-0.9) screened positive with CDT. CONCLUSIONS: The present findings on employees who attended for regular health examinations suggest that shift workers did not show a higher level of risky alcohol consumption than day workers, according to the results with the AUDIT, CDT and GGT. On the contrary, the two-shift workers appeared to drink significantly less.     

Leisure time physical activity and sickness absenteeism; a prospective study

AIM: To establish whether workers with frequent leisure time physical activities are at higher or lower risk of sickness absence compared to inactive workers. METHOD: Self reported and company recorded sickness absence data were collected during 18 months of follow-up for 8902 workers. Frequency of leisure time physical activities was queried at baseline. RESULTS: Overall, we found that workers active in their leisure time twice or more each week reported significantly less sickness absence compared to inactive workers (14.8 versus 19.5 days/year), mainly due to a decrease in sick leave because of musculoskeletal disorders. CONCLUSION: Demotivating sports participation by making workers liable for workdays lost due to sporting injuries might be counter-productive in decreasing absenteeism and its related costs. Promoting worker participation in sport might lead to reduced absenteeism.     

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.     

Overweight and obesity among Kuwait Oil Company employees: a cross-sectional study

BACKGROUND: Overweight and obesity are considered major risk factors for many diseases, and their prevalence is known to be high in Kuwait from previous studies. AIM: To assess the prevalence of overweight and obesity and related risk factors among Kuwait Oil Company (KOC) employees. METHOD: A cross-sectional study of full-time KOC employees was carried out using a structured questionnaire that was completed during periodic medical examinations. The questionnaire included demographic details, frequency and duration of physical activity, history of chronic diseases and medication. All participants were counselled and examined. Blood pressure, body mass index and fasting glucose were recorded. RESULTS: Some 3282 out of 3900 employees completed the study; 85% of participants were male, 62%were field workers and 38%were office workers. The overall prevalence of overweight and obesity among KOC employees was 75%. Males showed a higher level of overweight and obesity (79%) than females (56%). Field workers had a higher level of overweight and obesity (78%) and higher inactivity (65%) than office workers (72% and 56%, respectively). CONCLUSION: Overweight and obesity, together with inactivity, are highly prevalent among KOC employees, and more so among field workers than office workers. Encouraging an active lifestyle, healthy eating habits and weight control programmes are all possible interventions to reduce the prevalence of overweight and obesity.     

Occupational health in the Andalusian Fisheries Sector

BACKGROUND: The conditions of work in the fisheries sector are arduous with high rates of occupational accidents. Numerous factors are known that can directly influence the health of the sailor or fisherman both in fishing and merchant fleets. AIM: To evaluate the health status, safety and working conditions in the Andalusian fishing sector. METHODS: Cross-sectional questionnaire study with proportional sampling of the health and lifestyles of fishery workers in 19 of the 23 Andalusian ports. RESULTS: A total of 247 workers employed on 202 craft fishing boats responded. In all 87% of workers reported a current medical condition. The main problems reported were musculoskeletal disorders, respiratory diseases, diseases of the digestive system, eye problems and skin problems. A total of 72% reported taking some self-prescribed medication, and 60% of fishery workers smoked. Nine per cent of fishery workers admitted taking illicit drugs and 3% reported using illicit drugs on board. Diets on board were poorly balanced. While on board, 62% of crews reported a subjective significant worsening of previous health. The lifetime prevalence of accidents was 76%. CONCLUSIONS: Fishery workers had a high prevalence of self-reported medical problems, a high prevalence of self-medication, poor diets and frequently smoked. Self-medication and some medical conditions (diabetes, angina and depression) may reflect a potential failing of health checks and pre-employment checks. National health services and insurance companies dealing with occupational health should focus more on appropriate health checks, illness prevention and health promotion activities for this population.     

Dehydroabietic acid as a biomarker for exposure to colophony

BACKGROUND: Colophony (rosin) is a natural product derived from the resin of coniferous trees with many industrial applications including soldering fluxes. Exposure to colophony fume through soldering is one of the leading causes of occupational asthma in the UK. AIMS: To assess occupational exposure to colophony from solder fume at selected workplaces in the UK and to investigate the use of dehydroabietic acid (DHA) as a biomarker of exposure. METHODS: Six companies in the UK electronics industry were visited and occupational hygiene assessments of extent and control of exposure to rosin-based solder flux fume were undertaken. Urine samples were analysed for one of the main constituents of rosin, DHA. RESULTS: There was a positive linear relationship between airborne exposure to solder fume and urinary DHA level. The levels of urinary DHA measured in UK workers were significantly lower than those previously measured in African workers because of the use of appropriate exposure control measures, for example, local exhaust ventilation with fixed ducting and flexible hose, tip extraction, etc. It is suggested that good occupational hygiene practice would result in urinary DHA levels of <3 micromol/mol creatinine in a post-shift urine sample. CONCLUSIONS: Urinary DHA is a valid biomarker of exposure to colophony in solder fume. Further work on the excretion kinetics of urinary DHA, the possibility of skin absorption and further occupational hygiene surveys would be beneficial.     

Window renovation and exposure to lead--an observational study

BACKGROUND: Renovation of windows in old houses has recently established itself as an industry. A recognizable occupational lead exposure exists, which has not been studied previously. AIM: To compare lead exposure amongst window renovators with other groups of lead-exposed workers. METHODS: Using blood lead results measured at the Health and Safety Laboratory (HSL), Sheffield, comparisons were made between three cohorts: window renovation workers, all male workers monitored by HSL during the period 1999-2001 and 63 male subjects involved in chemical paint-stripping of wood. RESULTS: Both the window renovation and the wood-stripping cohorts show significantly higher blood lead distributions than the 'all workers' cohort (P < 0.001). A similar pattern was also found for comparison of the prevalence of subjects above the UK suspension level of 60 microg/dl (2.89 microM) (window renovation, P < 0.001; wood-stripping, P < 0.0001). Blood lead results at or above the suspension level in wood-strippers were significantly higher compared to window renovators (P = 0.034). CONCLUSION: Window renovation is shown to present a potential for significant lead exposure, and suspension from work under The Control of Lead at Work Regulations 2002. Two groups of risk factors predominate: the well-documented potential for release of lead from old paint, and the peripatetic nature of the work.     

Designing and managing healthy work for older workers

Throughout many countries in the developed world, largely because of increasing life expectancy, the population is ageing. One of the economic implications of this demographic change is that workers may need to work longer and retire later than they have done in recent years. Much needs to be done to ensure that work remains a positive experience for workers throughout their career trajectories, and that it does not damage their health. The major contemporary challenges to health at work are those associated with the way work and work organizations are designed and managed. This is especially true for older workers. This paper focuses on the relationships between age and work performance, between age and work-related health, and between age and work-related stress. It concludes that there remains considerable scope for designing optimal work systems to harness the potential and protect the health of older workers. This important initiative will require a co-ordinated and multidisciplinary occupational health strategy.