Organizational factors associated with work-related sleep problems in a nationally representative sample of Korean workers

Purpose

The purpose of this study was to assess the association of organizational factors with work-related sleep problems (WRSP) among Korean workers.

Methods

The data were derived from the First Korean Working Conditions Survey conducted in 2006 with a representative sample of the Korean working population (n = 10,039).

Results

The overall prevalence of WRSP was 5.1  % (95  % confidence interval (CI) 4.7–5.5). Those who experienced sexual harassment at work (adjusted odds ratio (aOR) 3.47: 95 % CI 1.77–6.81), discrimination due to sex (aOR 2.44: 95 % CI 1.36–4.36) or age (aOR 2.22: 95 % CI 1.52–3.23), violence at work (aOR 1.98: 95 % CI 1.06–3.68), threat of violence (aOR 1.96: 95 % CI 1.05–3.66), poor work-life balance (aOR 1.78: 95 % CI 1.44–2.20), low job satisfaction (aOR 1.69: 95 % CI 1.37–2.09), high cognitive (OR 1.64: 95 % CI 1.32–2.03) and emotional (aOR 1.53: 95 % CI 1.22–1.91) demands, job insecurity (aOR 1.32: 95 % CI 1.07–1.63), and high work intensity (aOR 1.55: 95 % CI: 95 % CI 1.25–1.92) had an increased risk of WRSP compared to their respective counterparts (p < 0.01). Low social support was not significantly associated with WRSP (aOR 0.88: 95 % CI 0.67–1.15).

Conclusion

The results revealed that poor psychosocial working conditions may be related to a high prevalence of WRSP among representative Korean workers.     

Back and neck pain due to working in a cold environment: a cross-sectional study of male construction workers

Objective

To study whether work in a cold environment increased the risk of musculoskeletal symptoms in the neck and low back among construction workers.

Methods

This cross-sectional study is based on a cohort of male workers in the Swedish construction industry that participated in regular health examinations through a nationwide occupational health service. The analysis is based on workers examined from 1971 to 1974, who answered a questionnaire including questions about neck and back pain. The cohort consists of 134,754 male workers, including 16,496 office workers and foremen. The health examinations of the workers were conducted in provinces covering Sweden from the south to the north, and temperature data were collected for the provinces. In the analyses, the results were adjusted for age, BMI and use of nicotine.

Results

The prevalence’s of neck and low back pain were higher among manual construction workers than among foremen and office workers (24.3 vs. 8.6 % and 16.5 vs. 6.2 %, respectively); the corresponding adjusted ORs for low back and neck pain were 1.59 (95 % CI 1.52–1.66) and 1.39 (95 % CI 1.30–1.49), respectively. Workers in the northern and central provinces had higher ORs for low back and neck pain compared to workers in the southern province. The test for trends showed an increased risk of developing low back and neck pain with decreased outdoor temperature.

Conclusions

Outdoor work in a cold environment may increase the risk of low back and neck pain.     

Exposure to disturbing noise and risk of long-term sickness absence among office workers: a prospective analysis of register-based outcomes

Purpose

To investigate the association between self-reported exposure to disturbing noise and risk of long-term sickness absence (LTSA) for more than two consecutive weeks among office workers.

Methods

LTSA was measured using register data that were linked to survey data from 2,883 office workers aged 18–59 who were surveyed in 2005 on exposure to disturbing noise. The risk of LTSA was investigated using Cox proportional hazards model.

Results

Of the study population, 4.4 % had LTSA in the 1-year follow-up period. Compared to office workers who were ‘rarely or never’ exposed to disturbing noise at work, office workers who reported being ‘frequently’ exposed to disturbing noise had a significantly increased estimated risk of LTSA when adjusting for age, gender, smoking status, and managerial position (HR = 1.90; 95 % CI, 1.12–3.22). After additional adjustment for psychosocial work conditions, the estimated risk of LTSA for office workers who were frequently exposed to disturbing noise became marginally insignificant (HR = 1.73; 95 % CI, 0.99–3.01). A subgroup analysis showed that women who reported being frequently exposed to disturbing noise had a significantly increased estimated risk of LTSA (HR = 1.94; 95 % CI, 1.04–3.64), whereas the corresponding risk for men was insignificant (HR = 1.28; 95 % CI, 0.37–4.41).

Conclusions

This study indicates that frequent self-reported exposure to disturbing noise at work is associated with increased risk of LTSA among office workers and that this association may be stronger for women than for men.     

Organizational and psychosocial risk factors for carpal tunnel syndrome: a cross-sectional study of French workers

Purpose

The aim of the study was to examine the organizational and psychosocial risk factors for carpal tunnel syndrome (CTS) in workers exposed to various levels of work-related constraints, with a special focus on factors related to the work organization.

Methods

From 3,710 workers, representative of a French region’s working population, trained occupational physicians diagnosed a total of 156 cases of CTS between 2002 and 2005. Diagnoses were established by standardized physical examination, while personal factors and work exposure were assessed by self-administered questionnaires. Statistical associations between CTS and personal and work-related factors were analyzed for each gender using logistic regression modeling.

Results

Among the factors related to work organization, working with temporary workers was associated with CTS for women (OR = 1.99, 95 % CI 1.23–3.25), but not for men. Task rotation during the job (OR = 2.45 95 % CI 1.41–4.24) and work pace dependent on quantified targets (OR = 1.93 95 % CI 1.08–3.46) were associated with CTS only for men. The work-related psychosocial factors highlighted by the logistic modeling were high psychological demand for women (OR = 1.90, 95 % CI 1.17–3.09) and low skill discretion (OR = 1.77, 95 % CI 1.01–3.11) for men.

Conclusion

This study has identified some psychosocial factors and factors related to work organization associated with clinically diagnosed and symptom-only cases of CTS as well as personal and biomechanical factors. However, due to the cross-sectional design of the study, no causal conclusion could be drawn and longitudinal studies are necessary to confirm these results.     

Cancer incidence among Swedish pulp and paper mill workers: a cohort study of sulphate and sulphite mills

Purpose

Associations between various malignancies and work in the pulp and paper industry have been reported but mostly in analyses of mortality rather than incidence. We aimed to study cancer incidence by main mill pulping process, department and gender in a Swedish cohort of pulp and paper mill workers.

Methods

The cohort (18,113 males and 2,292 females, enrolled from 1939 to 1999 with >1 year of employment) was followed up for cancer incidence from 1958 to 2001. Information on the workers’ department and employment was obtained from the mills’ personnel files, and standardized incidence ratios (SIRs) were calculated using the Swedish population as reference.

Results

Overall cancer incidence, in total 2,488 cases, was not increased by work in any department. However, risks of pleural mesothelioma were increased among males employed in sulphate pulping (SIR, 8.38; 95 % CI, 3.37–17) and maintenance (SIR, 6.35; 95 % CI, 3.47–11), with no corresponding increase of lung cancer. Testicular cancer risks were increased among males employed in sulphate pulping (SIR, 4.14; 95 % CI, 1.99–7.61) and sulphite pulping (SIR, 2.59; 95 % CI, 0.95–5.64). Female paper production workers showed increased risk of skin tumours other than malignant melanoma (SIR, 2.92; 95 % CI, 1.18–6.02).

Conclusions

Incidence of pleural mesothelioma was increased in the cohort, showing that asbestos exposure still has severe health consequences, and highlighting the exigency of strict asbestos regulations and elimination. Testicular cancer was increased among pulping department workers. Shift work and endocrine disruptors could be of interest in this context.     

Skin symptoms in bakery and auto body shop workers: associations with exposure and respiratory symptoms

Purpose

Despite the importance of skin exposure, studies of skin symptoms in relation to exposure and respiratory symptoms are rare. The goals of this study were to describe exposure–response relationships for skin symptoms, and to investigate associations between skin and respiratory symptoms in bakery and auto body shop workers.

Methods

Data from previous studies of bakery and auto body shop workers were analyzed. Average exposure estimates for wheat allergen and isocyanates were used. Generalized linear models were constructed to describe the relationships between exposure and skin symptoms, as well as between skin and respiratory symptoms.

Results

Data from 723 bakery and 473 auto body shop workers were analyzed. In total, 5.3 % of bakery and 6.1 % of auto body shop workers were female; subjects’ mean age was 39 and 38 years, respectively. Exposure–response relationships were observed in auto body shop workers for itchy or dry skin (PR 1.55, 95 % CI 1.2–2.0) and work-related itchy skin (PR 1.97, 95 % CI 1.2–3.3). A possible exposure–response relationship for work-related itchy skin in bakery workers did not reach statistical significance. In both groups, reporting skin symptoms was strongly and significantly associated with reporting respiratory symptoms, both work-related and non-work-related.

Conclusions

Exposure–response relationships were observed for skin symptoms in auto body shop workers. The lack of significant exposure–response associations in bakery workers should be interpreted cautiously. Workers who reported skin symptoms were up to four times more likely to report respiratory symptoms. Improved awareness of both skin and respiratory outcomes in exposed workers is needed.     

Immigration, work and health in Spain: the influence of legal status and employment contract on reported health indicators

Objective

To analyze the relationship of legal status and employment conditions with health indicators in foreign-born and Spanish-born workers in Spain.

Methods

Cross-sectional study of 1,849 foreign-born and 509 Spanish-born workers (2008–2009, ITSAL Project). Considered employment conditions: permanent, temporary and no contract (foreign-born and Spanish-born); considered legal statuses: documented and undocumented (foreign-born). Joint relationships with self-rated health (SRH) and mental health (MH) were analyzed via logistical regression.

Results

When compared with male permanently contracted Spanish-born workers, worse health is seen in undocumented foreign-born, time in Spain ≤3 years (SRH aOR 2.68, 95% CI 1.09–6.56; MH aOR 2.26, 95% CI 1.15–4.42); in Spanish-born, temporary contracts (SRH aOR 2.40, 95% CI 1.04–5.53); and in foreign-born, temporary contracts, time in Spain >3 years (MH: aOR 1.96, 95% CI 1.13–3.38). In females, highest self-rated health risks are in foreign-born, temporary contracts (aOR 2.36, 95% CI 1.13–4.91) and without contracts, time in Spain >3 years (aOR 4.63, 95% CI 1.95–10.97).

Conclusions

Contract type is a health determinant in both foreign-born and Spanish-born workers. This study offers an uncommon exploration of undocumented migration and raises methodological issues to consider in future research.     

Stigma related to sex work among men who engage in transactional sex with men in Ho Chi Minh City,Vietnam

Objectives

Male sex workers (MSW) in Vietnam face high levels of stigma related to sex work, which may be associated with depression and increased vulnerability to HIV.

Methods

In 2010, 300 MSW completed a behavioral and psychosocial survey. Multivariable models assessed factors associated with sex work-related stigma and the association between stigma and depression.

Results

Factors associated with increased stigma included having disclosed sexual orientation to healthcare workers (b 1.75, 95 % CI 0.69–2.80), meeting clients in the street/park (b 1.42, 95 % CI 0.32–2.52), and having been forced to have sex without a condom (b 2.36, 95 % CI 1.27–3.45). Factors associated with decreased stigma included meeting clients via the telephone or internet (b ?1.26, 95 % CI ?2.39 to ?0.12) and receiving financial support from family or friends (b ?1.31, 95 % CI ?2.46 to ?0.17). Stigma was significantly associated with increased odds of depression (AOR 1.07, 95 % CI 1.01–1.15).

Conclusions

Addressing stigma and depression in HIV prevention interventions is crucial for tailoring these programs to MSWs’ needs, and may result in decreased HIV spread.     

The effect of workplace smoking bans on heart rate variability and pulse wave velocity of non-smoking hospitality workers

Objectives

To investigate the effect of a change in second-hand smoke (SHS) exposure on heart rate variability (HRV) and pulse wave velocity (PWV), this study utilized a quasi-experimental setting when a smoking ban was introduced.

Methods

HRV, a quantitative marker of autonomic activity of the nervous system, and PWV, a marker of arterial stiffness, were measured in 55 non-smoking hospitality workers before and 3–12 months after a smoking ban and compared to a control group that did not experience an exposure change. SHS exposure was determined with a nicotine-specific badge and expressed as inhaled cigarette equivalents per day (CE/d).

Results

PWV and HRV parameters significantly changed in a dose-dependent manner in the intervention group as compared to the control group. A one CE/d decrease was associated with a 2.3 % (95 % CI 0.2–4.4; p = 0.031) higher root mean square of successive differences (RMSSD), a 5.7 % (95 % CI 0.9–10.2; p = 0.02) higher high-frequency component and a 0.72 % (95 % CI 0.40–1.05; p < 0.001) lower PWV.

Conclusions

PWV and HRV significantly improved after introducing smoke-free workplaces indicating a decreased cardiovascular risk.     

Contemporary exposure to cigarette smoke and noise of automobile manufacturing company workers

Background

Noise-induced hearing loss (NIHL) is one of the oldest occupational diseases. Evidence has accumulated in recent years on the adverse effects of smoking on hearing among the working population, but the absence of such an association has also been reported. Both cigarette smoking and noise exposure have a common pathway to produce hearing loss.

Materials and Methods

We surveyed the effect of smoking on NIHL in 478 workers in a large automobile manufacturing company who were exposed to unauthorized levels of noise. All required data were obtained using direct interviews and questionnaires. The results of the chi-square test and the regression models are expressed as odds ratios (OR) with 95% confidence intervals (95% CI).

Results

The frequency of hearing loss in smokers was higher than in non-smokers based on model 1 (hearing threshold differences ≥30 dB between 4,000 Hz and 1,000 Hz in both ears; OR 23, 95% CI: 11.90–44.42; p?<?0.001) and model 2 (hearing threshold level of >25 dB at 4,000 Hz in the better ear; OR 6.94, 95% CI: 4.53–10.64; p?<?0.001). These results were confirmed by the logistic regression statistical method.

Conclusion

It can be concluded that smoking may accelerate noise-induced hearing loss, and smoking cessation may be useful for prevention of NIHL, but more studies are required to confirm this.     

Sick leave due to back pain in a cohort of young workers

Purpose

Evidence on risk factors for sick leave from prospective studies in work settings is limited. Furthermore, most available studies focused on workers with substantial low back disorders. These studies consistently report that physical work factors constitute a hindrance to work. However, it remains unclear whether the same risk factors are relevant in workers with less severe conditions or in early phases of the development of back pain. Therefore, this article aims to study risk factors for the occurrence of sick leave due to low back pain (LBP) among young workers with no or a modest history of back pain.

Methods

Participants were 716 young healthcare or distribution workers with no or minimal antecedents of LBP in the year before inclusion. We investigated the role of potential physical, psychosocial and individual risk factors at baseline on the occurrence of sick leave due to LBP 1 year later. To this purpose, we used Cox regression with a constant risk period.

Results

Six per cent (95 % CI 4.1–7.6) of the workers reported sick leave 1 year later; they accounted for 12 % of the sick-leave days independent of cause. A non-stimulating psychosocial work environment turned out to be the strongest risk factor for sick leave due to LBP (RR 6.08; 95 % CI 1.42–26.07). Physical factors were not predictive.

Conclusions

In the early phases of back pain and in less severe conditions, the main benefit of interventions lies in targeting the organisation and design of jobs to create a challenging professional environment.     

Risk for low back pain from different frequencies, load mass and trunk postures of lifting and carrying among female healthcare workers

Purpose

To investigate the risk of developing non-chronic and chronic low back pain (LBP) from frequency, load mass and trunk postures of occupational lifting and carrying among female healthcare workers.

Methods

A total of 9,847 workers in eldercare answered a questionnaire about occupational lifting and carrying frequency (rarely, occasionally and frequently), load mass (low: 1–7 kg, moderate: 8–30 kg and heavy: >30 kg), trunk posture (upright or forward bent back), and days with LBP in 2005. The odds ratio (OR) for developing non-chronic (1–30 days the last 12 months) and chronic (>30 days the last 12 months) LBP reported in 2006 from these characteristics of occupational lifting and carrying was investigated with multi-adjusted logistic regressions among female healthcare workers without LBP in 2005 (n = 1,612).

Results

Frequently lifting and carrying low load mass with forward bent back doubled the risk for developing chronic LBP (OR: 2.14; 95 % CI: 1.02–4.50). Occasionally and frequently lifting or carrying of any load mass with upright back did not increase the risk for chronic LBP. Lifting and carrying did not increase the risk for non-chronic LBP.

Conclusions

Preventive initiatives for LBP among healthcare workers ought to pay attention to frequent lifting and carrying of low load mass with forward bent back.     

Shift work and risk of non-cancer mortality in a cohort of German male chemical workers

Objectives

Shift work is widely considered to be a health risk. In a previous study, we observed no elevated risk of total mortality in BASF shift workers followed up until the end of 2006. The present study aims to investigate non-cancer mortality, especially mortality caused by ischaemic heart disease (IHD), relative to shift work.

Methods

The cohort consisted of 14,038 male shift and 17,105 male day workers from manufacturing plants, who were employed for at least 1 year between 1995 and 2005. Vital status was followed from 2000 to 2009. Cause-specific mortality was obtained from death certificates. Non-cancer mortality as well as mortality specific to diagnoses from I20.0 to I25.9 according to International Classification of Disease version 10 was compared between the two working-time systems. To estimate the impact of shift work on the outcome of interest, Cox proportional hazard model was used to adjust for potential confounders such as age, smoking, alcohol consumption, job level, and disease status at baseline. The effect estimates were then given as hazard ratio (HR) with 95 % confidence interval (CI).

Results

Between 2000 and 2009, a total of 1,062 deaths occurred in the cohort: 513 (3.6 %) in shift and 549 (3.2 %) in day workers. Among them were 122 deaths resulting from IHD, 55 (0.39 %) and 67 (0.39 %), respectively. After adjustment for age at entry and job level, no increased risk of non-cancer mortality (HR 0.94; 95 % CI 0.77–1.15) as well as of IHD-caused mortality was found among shift workers (HR 0.77; 95 % CI 0.52–1.14). The risk estimates were robust after further adjustment for more factors in all models and consistently tended to be in favour of shift workers. Considering the duration of exposure to shift, no dose–response relationship was found.

Conclusion

The present analysis does not find strong evidence for an increased mortality risk due to non-cancer disease and, more specifically, IHD-caused mortality associated with this shift system. Initial selection based on health criteria as well as ongoing health surveillance and health promotion is likely to have contributed to this result. Shift work over 34 years may lead to a loss of this initial selection advantage over time, but the respective risk estimates lacked statistical precision.     

Cancer incidence among workers occupationally exposed to dinitrotoluene in the copper mining industry

Purpose

Epidemiological and toxicological studies point to a potential carcinogenic effect of dinitrotoluene (DNT), particularly with respect to renal and urothelial cancer.

Methods

The cohort comprised all men born between 1920 and 1974 (n = 16,441) who were gainfully employed between 1953 and 1990 in one of two underground copper mines in Mansfeld, Saxony-Anhalt, former German Democratic Republic, and who were followed up for cancer incidence, 1961–2005. Incident cancer cases were identified by record linkage with the Common Cancer Registry of the New Laender. Standardized incidence ratios (SIR) were calculated with the general population of Saxony-Anhalt as the reference.

Results

Standardized incidence ratios for all cancers were not significantly elevated in the cohort (SIR = 1.04; 95 % confidence intervals (CI) 0.96–1.14). We found an increase in lung cancer (SIR = 1.29; 1.13–1.46), but not in kidney cancer (SIR = 1.01; 95 % CI 0.79–1.27) or bladder cancer (SIR = 1.04; 95 % CI 0.82–1.30). Standardized incidence ratios stratified by duration of employment with DNT exposure indicated moderately increased risks for kidney and bladder cancer in cohort members with longer exposure.

Conclusions

The SIR analysis of workers in the copper mining industry in comparison with the general population of Saxony-Anhalt overall did not indicate increased risks for renal or bladder cancer. However, results by years of exposure to DNT suggested weakly increased risks for outcomes of a priori interest, bladder and kidney cancer. A subsequent case-cohort analysis including expert assessment of DNT exposure and identification of additional cancer cases from a network of pathology institutes will provide further insight into a potential etiologic role of DNT in renal and urothelial cancer.     

A prospective cohort study on musculoskeletal risk factors for long-term sickness absence among healthcare workers in eldercare

Purpose

The socioeconomic burden of sickness absence from musculoskeletal disorders is considerable. However, knowledge about the risk of sickness absence from pain in different body regions among specific job groups is needed to more efficiently target preventative strategies. This study estimates the risk of long-term sickness absence (LTSA) from pain in different body regions among healthcare workers.

Methods

Prospective cohort study among 8,952 Danish healthcare workers responding to a questionnaire in 2004–2005 and followed for 1?year in a national register of social transfer payments (DREAM). Using Cox regression hazard ratio (HR) analysis controlled for age, gender, BMI, smoking, seniority, leisure physical activity and psychosocial working conditions, we modeled risk estimates of sub-chronic (1–30?days last year) and chronic pain (>30?days last year) in the low back, neck/shoulder and knees for onset of LTSA (receiving sickness absence compensation for at least eight consecutive weeks) during one-year follow-up.

Results

At baseline, the prevalence of chronic pain was 23% (low back), 28% (neck/shoulder) and 12% (knees). During follow-up, the 12-month prevalence of LTSA was 6.3%. Chronic pains in the low back (HR 1.47 [95% CI 1.17–1.85]), neck/shoulder (HR 1.60 [95% CI 1.27–2.02]) and knees (HR 1.92 [95% CI 1.52–2.42]) were significant risk factors for LTSA. However, only chronic neck/shoulder (HR 1.41 [95% CI 1.09–1.82]) and knee pain (HR 1.69 [95% CI 1.32–2.16]) remained significant with mutual adjustment for all three musculoskeletal pain regions.

Conclusion

Musculoskeletal pain is a risk factor for LTSA among healthcare workers. Future research among healthcare workers in eldercare should include the management of neck/shoulder and knee pain in addition to the management of back pain.     

Musculoskeletal symptoms and psychosocial work environment,among Swedish commercial pilots

Purpose

The associations between psychosocial work conditions and health in pilots are understudied, and therefore, the associations between the psychosocial work conditions and musculoskeletal problems among Swedish commercial pilots were investigated.

Methods

In 2010, a self-administered questionnaire study was performed among pilots in one Swedish commercial airline: 354 pilots participated (61 %). Musculoskeletal symptoms and the psychosocial work conditions measured by the demand control social support model were investigated. Odds ratios (OR) with 95 % confidence interval (95 % CI) were expressed per change of one unit on the interquartile score scale.

Results

Pilots on long-haul flights had less elbow symptoms (OR 0.34, 95 % CI 0.14–0.85), and women had more hand symptoms (OR 2.90, 95 % CI 1.11–7.52). There were associations between high work demands and symptoms from the neck (OR 2.04, 95 % CI 1.45–2.88), shoulders (OR 1.46, 95 % 1.05–2.03), elbows (OR 1.79, 95 % CI 1.10–2.90) and low back (OR 1.42, 95 % CI 1.02–1.96) in pilots. Low social support was associated with symptoms from the neck (OR 1.87, 95 % 1.35–2.58), shoulders (OR 1.56, 95 % CI 1.14–2.14) and low back (OR 1.63, 95 % CI 1.18–2.24). Low supervisor support was associated with neck (OR 1.67, 95 % CI 1.22–2.27), shoulders (OR 1.38, 95 % CI 1.02–1.87) and low back symptoms (OR 1.48, 95 % CI 1.09–2.01). The associations were mainly found among first officers.

Conclusions

Musculoskeletal symptoms in pilots can be affected by poor psychosocial work conditions such as high demands and low social support, especially for first officers. The psychosocial aspects of organisational changes in commercial airlines should be taken into consideration.     

Coffee and caffeine intake and risk of endometriosis: a meta-analysis

Purpose

The potential association between endometriosis and coffee/caffeine consumption has been analysed in several epidemiological studies. In order to establish whether caffeine influences the risk of endometriosis, we provide to summarize the evidence from published studies on this issue.

Methods

We performed a meta-analysis of epidemiological studies published up to January 2013. We computed summary relative risks (RR) of endometriosis for any, high and low versus no coffee/caffeine consumption.

Results

We identified a total eight studies, six case–control and two cohort studies, including a total of 1,407 women with endometriosis. The summary RR for any versus non-consumption were 1.26 [95 % confidence interval (CI) 0.95–1.66] for caffeine and 1.13 (95 % CI 0.46–2.76) for coffee consumption; the overall estimate was 1.18 (95 % CI 0.92–1.49). The summary RR were 1.09 (95 % CI 0.84–1.42) and 1.09 (95 % CI 0.89–1.33) for high and low caffeine consumption as compared to no consumption, respectively.

Conclusion

The present meta-analysis provided no evidence for an association between coffee/caffeine consumption and the risk of endometriosis. Coffee/caffeine consumption, as currently used in diet, does not carry a health risk.     

Major depressive disorder, panic disorder, and post-traumatic stress disorder in Korean subway drivers

Purpose

The purposes of this study are to investigate the prevalence of major depressive disorder, panic disorder, and post-traumatic stress disorder (PTSD) in Korean subway drivers, and find the association between these disorders and the drivers’ person-under-train (PUT) experiences.

Methods

A total of 826 subway drivers who participated in a cross-sectional work and health survey were included for this study. The Korean version of the Composite International Diagnostic Interview 2.1 was applied to assess major depressive disorder, panic disorder, and PTSD. The date of PUT, whether victim died, and how many PUTs the drivers experienced were asked using a structured questionnaire.

Results

The standardized prevalence ratios (SPRs) for lifetime prevalence of panic disorder and PTSD in subway drivers were 13.3 (95 % confidence interval [CI] 6.6–22.4) and 2.1 (95 % CI 1.1–3.4), respectively. In lifetime prevalence, after adjusting for age, education, income, and working career, the drivers who experienced PUT had significantly higher risks for panic disorder (odds ratio [OR] = 4.2, 95 % CI 1.2–16.6) and PTSD (OR = 4.4, 95 % CI 1.3–16.4). In 1-year prevalence, the drivers who experienced PUT had a significantly higher risk for PTSD (OR = 11.7, 95 % CI 1.9–225.8). There was no significant value of SPR and OR in major depressive disorder.

Conclusions

This study suggests that Korean subway drivers are at higher risk for panic disorder and PTSD compared to the general population, and PUT experience is associated with panic disorder and PTSD. Drivers who have experienced PUT should be treated quickly, sympathetically, and sensitively by a psychological professional and their colleagues, so they can return to work soon.     

Physically demanding work and preterm delivery: a systematic review and meta-analysis

Objective

Physically demanding work may increase the risk of preterm delivery (PTD), defined as delivery before 37 weeks. We assessed the available evidence.

Methods

A systematic search in Medline, Embase and Nioshtic for the period 1990 to June 2012 for observational and intervention studies on physically demanding work (prolonged standing, heavy lifting, physical exertion, occupational fatigue and demanding posture) and PTD. Selected studies were assessed for their risk of bias and pooled using a random effects model. Results of case–control and cohort studies were reported separately in subgroups.

Results

We found 10 studies with low risk of bias and seven studies with moderate risk of bias. Standing and walking at work during pregnancy for more than 3 h per day was associated with an increased risk for PTD [OR 1.3 (95 % CI 1.1–1.6)], just as lifting and carrying >5 kg [OR 1.3 (95 % CI 1.05–1.6)] or lifting and carrying in the third trimester of the pregnancy [OR 1.3 (95 % CI 1.01–1.8)]. Jobs that required physical effort or physical exertion were associated with an increased risk of PTD [OR 1.4 (95 % CI 1.19–1.66)]. Working during pregnancy in jobs with a combination of two or more physical tasks, physical effort or occupational fatigue was also associated with an increased risk of PTD [OR 1.5 (95 % CI 1.1–2.0)].

Conclusions

Physically demanding work during pregnancy is associated with an increased risk of PTD, especially in jobs with a combination of tasks with physical effort. In general, only small to moderate elevations of risks were found.     

Association between perceived inadequate staffing and musculoskeletal pain among hospital patient care workers

Objective

To examine association between perceived inadequate staffing and musculoskeletal pain and to evaluate the role of work-related psychosocial and physical work factors in the association among hospital patient care workers.

Methods

A cross-sectional study was conducted among 1,572 patient care workers in two academic hospitals. Perceived inadequate staffing was measured using the “staffing adequacy subscale” of Nursing Work Index, which is a continuous scale that averages estimates of staffing adequacy by workers in the same units. Musculoskeletal pain (i.e., neck/shoulder, arm, low back, lower extremity, any musculoskeletal pain, and the number of area in pain) in the past 3 months was assessed using a self-reported Nordic questionnaire. Multilevel logistic regression was applied to examine associations between perceived inadequate staffing and musculoskeletal pain, considering clustering among the workers in the same units.

Results

We found significant associations of perceived inadequate staffing with back pain (OR 1.50, 95 % CI 1.06, 2.14) and the number of body area in pain (OR 1.42, 95 % CI 1.01, 2.00) after adjusting for confounders including work characteristics (job title, having a second job or not, day shift or not, and worked hours per week). When we additionally adjusted for physical work factors (i.e., use of a lifting device, and the amount of the time for each of five physical activities on the job), only the association between perceived inadequate staffing and back pain remained significant (OR 1.50, 95 % CI 1.03, 2.19), whereas none of the associations was significant for all of musculoskeletal pains including back pain (OR 0.96, 95 % CI 0.66, 1.41) when we additionally adjusted for work-related psychosocial factors (i.e., job demands, job control, supervisor support, and co-worker support) instead of physical work factors.

Conclusions

Perceived inadequate staffing may be associated with higher prevalence of back pain, and work-related psychosocial factor may play an important role in the potential pathway linking staffing level to back pain among hospital workers.