Purpose
Sickness presenteeism, defined as ‘going to work despite judging that one should have reported in sick’, is usually considered to be a complementary alternative to sickness absence. Nonetheless, several studies have reported a positive association between sickness absence and sickness presenteeism. The aim of the present study was to investigate whether the contemporaneous positive association between sickness absence and sickness presenteeism can be explained by illness, work incapacity, and/or work environment.Methods
A cross-sectional study based on answers to a comprehensive questionnaire from 8,304 working women and men, those in the second wave of the nationally representative Swedish Longitudinal Occupational Survey of Health. Logistic regression was used to investigate the association between sickness presenteeism and sickness absence.Results
Sickness absence was strongly associated with sickness presenteeism. Sickness absence of 1–7?days during a 12-month period more than doubled the odds of also having sickness presenteeism of more than 8?days during the same 12-month period (OR?=?2.11; 95% CI: 1.79–2.49). Adjusting for age and sex did not attenuate the association; further adjustment for work environment, self-rated health, chronic diseases, and work capacity reduced the odds somewhat, but they remained highly significant (OR?=?1.88; 95% CI: 1.56–2.25).Conclusions
The results suggest that sickness presenteeism is not, as earlier hypothesised, just an alternative to sickness absence, given a certain level of health or work incapacity. Other, so far unknown explanations for both sickness absence and sickness presenteeism must be sought. 相似文献Background
The “Do Not Resuscitate” orders (DNR) are defined as advance medical directives to withhold cardiopulmonary resuscitation during cardiac arrest. Age-related multimorbidity may influence the DNR decision-making process. Our objective was to perform a systematic review and meta-analysis of published data examining the relationship between DNR orders and multimorbidity in older patients.Methods
A systematic Medline and Cochrane literature search limited to human studies published in English and French was conducted on August 2012, with no date limits, using the following Medical Subject Heading terms: “resuscitation orders” OR “do-not-resuscitate” combined with “aged, 80 and over” combined with “comorbidities” OR “chronic diseases”.Results
Of the 65 selected studies, 22 met the selection criteria for inclusion in the qualitative analysis. DNR orders were positively associated with multimorbidity in 21 studies (95%). The meta-analysis included 7 studies with a total of 27,707 participants and 5065 DNR orders. It confirmed that multimorbidity were associated with DNR orders (summary OR = 1.25 [95% CI: 1.19–1.33]). The relationship between DNR orders and multimorbidity differed according to the nature of morbidities; the summary OR for DNR orders was 1.15 (95% CI: 1.07–1.23) for cognitive impairment, OR=2.58 (95% CI: 2.08–3.20) for cancer, OR=1.07 (95% CI: 0.92–1.24) for heart diseases (i.e., coronary heart disease or congestive heart failure), and OR=1.97 (95% CI: 1.61–2.40) for stroke.Conclusions
This systematic review and metaanalysis showed that DNR orders are positively associated with multimorbidity, and especially with three morbidities, which are cognitive impairment, cancer and stroke. 相似文献Objectives
Electricity generation from biomass has become a boom business. However, currently, concerns over their environmental and health impact have emerged. This study aimed to explore these health problems by studying two small biomass power plants in Thailand.Materials and Methods
Data concerning chronic diseases and health symptoms was collected from 392 people by trained interviewers by the use of a questionnaire.Results
Residents living within 1 km from the power plants had a higher prevalence of allergies (Odds ratio = 2.4, 95% CI: 1.5–4.0), asthma (OR = 2.1, 95% CI: 1.0–4.4) and chronic obstructive pulmonary disease (COPD) (OR = 2.7, 95% CI: 1.0–8.4). The risks of other symptoms, itching/rash, eye irritation, cough, stuffy nose, allergic symptoms, sore throat, and difficulty breathing among those living within 0.5 km from the power plants (OR = 2.5–8.5) were even more marked.Conclusions
It has been concluded that without a proper control, pollution from the biomass power plants can cause significant health problems to the nearby residents. 相似文献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. 相似文献Objectives
This study examined sickness absence as a risk factor for job termination, unemployment, and disability pension among temporary and permanent workers.Methods
Prospective cohort study with data on employment contract and sickness absence in 1996, job termination by 1997, and employment status in 1997 and 2000 for 19 093 temporary and 41 530 permanent public sector employees.Results
For women aged 40 years or less and for women over 40, a high sickness absence increased the risk of job termination among temporary employees (OR 1.52 (95% CI 1.36 to 1.71) and OR 1.70 (95% CI 1.36 to 2.13) respectively). High absence was not associated with job termination among men in temporary employment. Among permanent employees, high sickness absence predicted job termination among older, but not among younger employees. Temporary employees with high sickness absence were at the highest risk of immediate unemployment and unemployment three years later. Among older permanent employees, high sickness absence was associated with subsequent work disability pension.Conclusions
A high rate of sickness absenteeism increases the risk of job termination and unemployment among women in temporary public sector jobs. For permanent employees, secure employment provides protection against unemployment even in the case of high sickness absence. 相似文献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. 相似文献Introduction
Studies based on the ISAAC questionnaire suggest a correlation between the use of antibiotics and the prevalence of asthma and allergy in children aged 6–7 years. The number of courses of antibiotic therapy is an important factor.Objectives
To investigate the relationship between the use of antibiotics during the first years of life and the prevalence of allergy and asthma among children (aged 6–8 years) in the urban population of Poland.Materials and Methods
A survey-based study with a self-completed questionnaire. The respondents were parents of children aged 6-8 years living in Warszawa, Poland. 1461 completed questionnaires were collected.Results
Asthma was declared in 4.3% of the children. Wheezing and/or sibilant rhonchi within 12 months before the study was observed in 13.5% of the cases. Asthma medication was taken by 21.8% of the children. Allergic rhinitis was declared in 18.7% of the children. Problems with sneezing, rhinorrhea, and nasal congestion not associated with cold or fever were observed in 40.7% of the children. The analysis of the odds ratios between the use of antibiotics and the symptoms of allergic diseases revealed a clear correlation. The highest odds ratio was observed between the completion of over three courses of antibiotic therapy prior to the age of 12 months and the declaration of one of the following: asthma (OR = 5.59, 95% CI: 2.6–12.01), wheezing and/or sibilant rhonchi (OR = 4.68, 95% CI: 3.01–7.27) and taking medicines for breathlessness (OR = 5.12, 95% CI: 3.42–7.68).Conclusions
There is a direct relationship between antibiotic use in the first 3 years of life and asthma and allergy symptoms in children aged 6–8 years old. 相似文献Purpose
This study examined associations of functional limitation due to any health problems and six chronic diseases (arthritis, diabetes, coronary heart disease, heart attack, hypertension, and stroke) with food security among U.S. adults.Methods
The 2011 National Health Interview Survey data for 30,010 adults (≥18 years) were used. Adults were categorized into food secure, low food secure, or very low food secure. Multivariable logistic regressions were used to estimate adjusted odds ratio (OR) and 95% confidence interval (CI) for having functional limitation and chronic diseases while adjusting for sociodemographic and lifestyle factors.Results
The prevalence of functional limitation and the chronic diseases were higher in low–food-secure and very low–food-secure than food-secure adults. The adjusted ORs were significant in both low food secure and very low food secure, respectively, for functional limitation (OR: 1.87; 95% CI: 1.63, 2.14), (OR: 2.20; 95% CI: 1.91, 2.52), inflammatory diseases or joint/muscular pain (OR: 1.42; 95% CI: 1.21, 1.68), (OR: 1.74; 95% CI: 1.49, 2.04), diabetes (OR: 1.26; 95% CI: 1.06, 1.51), (OR: 1.23; 95% CI: 1.02, 1.48), and hypertension (OR: 1.18; 95% CI: 1.04, 1.35), (OR: 1.42; 95% CI: 1.22, 1.65) when compared with food-secure adults.Conclusions
Findings indicate that food insecurity is associated with functional limitation and chronic diseases, whereas directionality is unknown. Besides the traditional food assistance program for food-insecure populations, interventions to prevent or manage chronic diseases may be necessary to help them reduce the risk of the diseases and manage their conditions. 相似文献Objectives
Ambient ozone (O3) exposure is associated with a variety of health conditions. The objective of this study was to examine the effect of increased daily concentrations of ozone on emergency department (ED) visits due to lower respiratory diseases (LRD), such as acute or chronic bronchitis, in Edmonton, Canada.Materials and Methods
Data concerning 10 years (1992–2002) were obtained from 5 Edmonton hospital Emergency Departments. Odds ratios (ORs) for ED visits associated with the increased ozone levels were calculated employing a case-crossover technique with a time-stratified strategy to define controls. In the constructed conditional logistic regression models, adjustments were made for daily number of influenza ED visits and weather variables using natural splines. ORs and their 95% confidence intervals (95% CI) were reported in relation to an increase in the interquartile range (IQR = 17.9 ppb) of the ground-level ozone.Results
Overall, 48 252 ED visits due to LRD were identified, of which 53% were made by males. The presentations peaked in December (12%) and February (11.7%) and were the lowest in August (5.6%). Positive and statistically significant results were obtained for acute bronchitis: for same day (OR = 1.09, 95% CI: 1.05–1.13, lag 0) and for lag 2, lag 3–7 and 9 days; for chronic bronchitis: for lag 6, 7, and lag 9 days (OR = 1.11, 95% CI: 1.05–1.18, lag 9). For all ED visits for LRD, lag 0, lag 1, and lag 3–9 days showed positive and statistically significant associations (OR = 1.06, 95% CI: 1.03–1.09, lag 0).Conclusions
These findings support the hypothesis concerning positive associations between ozone and the ED visits due to LRD. 相似文献Objectives
The aim of the article is to investigate the differences in sickness present and non-sickness present in the group of disabled health care professionals.Methods
Data were gathered from all disabled health care professionals suffering from invalidity of category II or III who were identified in the research among all health care professionals at the University Medical Centre Ljubljana and who were employed there in the period between 1 January 2010 and 31 December 2010. Each employee obtained a questionnaire composed of three standardized international questionnaires.Results
There were 248 disabled workers of the II. and III. category of invalidity among the participants. Disabled sickness present reported to have more chronic diseases than disabled non-sickness present (OR = 57.0; 95% CI = 24.4–133.2), lower salary when on sick leave (OR = 13.1; 95% CI = 5.7–30.2) and poor self-rated health (OR = 5.8; 95% CI = 2.7–12.3).Conclusions
The prerequisite for sickness presence among disabled workers is their chronic bad health. It is also formally recognized with the degree of disability. Economic factors are among the most important to direct disabled workers towards sickness presence. The results indicate that workplaces are not adapted to disabled workers in regard to their limitations. 相似文献Objectives
This study examined the effect of shift work on developing the metabolic syndrome by comparing groups of exposed and unexposed Iranian drivers.Methods
We considered as night-shift drivers those drivers whose shifts included at least 15 h per week between 9:00 p.m. and 7:00 a.m. Daytime drivers were defined as drivers working regularly without shift work. 3039 shift work drivers were selected. These were matched with non-shift workers. The differences in baseline characteristics and the prevalence of the components of the metabolic syndrome were assessed with Student’s t test, and chi-square tests.Results
We found central adiposity in 52.0% of the shift workers versus 42.6% of the day workers (p < 0.0001). The hypertension component was not significantly related to shift work (p > 0.05); but there were significant differences as regards other components of the metabolic syndrome (p < 0.0001). Among the shift workers, the odds ratios of the increased FBS, low HDL-C, higher TG levels, as well as higher waist circumference were 1.992 (95% CI: 1.697–2.337), 1.973 (95% CI: 1.759–2.213), 1.692 (95% CI: 1.527–1.874), and 1.460 (95% CI: 1.320–1.616), respectively. The metabolic syndrome was more common among the shift workers (OR = 1.495; 95% CI: 1.349–1.657).Conclusion
In evaluating such results, further consideration is needed to find pathophysiological clarification; in turn, stress linked to shift work must be considered to likely have had a relevant influence on the outcome. In our opinion, shift work acts as an occupational factor for the metabolic syndrome. 相似文献Methods: The Poisson regression analyses of recorded all-cause sickness absences with medical certificate and the logistic regression analyses of minor psychiatric morbidity, as assessed by the General Health Questionnaire, and poor self rated health status were based on a cohort of 416 male and 3357 female employees working during 1998–2000 in 10 hospitals in Finland.
Results: Low versus high justice of decision making procedures was associated with a 41% higher risk of sickness absence in men (rate ratio (RR) 1.4, 95% confidence interval (CI) 1.1 to 1.8), and a 12% higher risk in women (RR 1.1, 95% CI 1.0 to 1.2) after adjustment for baseline characteristics. The corresponding odds ratios (OR) for minor psychiatric morbidity were 1.6 (95% CI 1.0 to 2.6) in men and 1.4 (95% CI 1.2 to 1.7) in women, and for self rated health 1.4 in both sexes. In interpersonal treatment, low justice increased the risk of sickness absence (RR 1.3 (95% CI 1.0 to 1.6) and RR 1.2 (95% CI 1.2 to 1.3) in men and women respectively), and minor psychiatric morbidity (OR 1.2 in both sexes). These figures largely persisted after control for other risk factors (for example, job control, workload, social support, and hostility) and they were replicated in initially healthy subcohorts. No evidence was found to support the hypothesis that organisational justice would represent a consequence of health (reversed causality).
Conclusions: This is the first longitudinal study to show that the extent to which people are treated with justice in workplaces independently predicts their health.
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