Scandinavian journal of work, environment & health最新文献

Objectives: This study investigated the associations between shift work characteristics and self-reported work-related accidents as well as incidents of dozing off at work and during the work commute.

Methods: Data from a Norwegian hospital's working-time register encompassed information on quick returns (<11 hours between shifts), day-, evening-, night-, and long (≥12 hours) shifts worked during 2020, and were linked to questionnaire data from 1195 healthcare workers collected in January 2021. The questionnaire assessed work-related accidents causing harm to oneself, patients/others, and/or equipment the last year, as well as dozing off at work the last month and/or during commute the last year. Data were analyzed using negative binomial regressions, adjusting for age, sex, children, marital status, shift work experience, monthly working hours, circadian type, and night shifts.

Results: Number of quick returns the last year was positively associated with causing harm to oneself [incidence rate ratio (IRR) 1.021, 95% confidence interval (CI) 1.009-1.034]. Number of day shifts and evening shifts were negatively associated with causing harm to patients/others (IRR 0.987, 95% CI 0.981-0.992; IRR 0.989, 95% CI 0.982-0.996, respectively). Number of night shifts was positively associated with dozing off at work (IRR 1.005, 95% CI 1.002-1.008) and during commute (IRR 1.007, 95% CI 1.003-1.010), but was not associated with work-related accidents. Number of long shifts was positively associated with healthcare workers causing harm to oneself (IRR 1.198, 95% CI 1.111-1.291), patients/others (IRR 1.209, 95% CI 1.122-1.304), and equipment (IRR 1.174, 95% CI 1.080-1.275).

Conclusion: Limiting quick returns and long shifts may be relevant considerations for improving employee and patient safety.

Objective: Shift work is associated with various leading causes of premature death, which has been linked with individuals with specific chronotypes. This study synthesized evidence on chronotype's role in associations between ever shift work and health outcomes.

Methods: Six databases were searched (inception-September 2025) for cohort/case-control studies assessing chronotype-specific shift work impacts on breast/prostate cancer, diabetes mellitus, and mental health. PRISMA guidelines were used for reporting.

Results: Fourteen studies were included in the review, comprising 2247 breast cancer cases, 3045 prostate cancer cases, 336 218 participants in diabetes studies, and 2128 poor mental health cases. Compared to daytime workers, both night shift workers with morning or evening chronotypes were more susceptible to breast cancer [morning type: pooled odds ratio (OR) 1.54, 95% confidence interval (CI) 1.01-2.37; evening type: pooled OR 1.41, 95% CI 1.04-1.90) and poor mental health (morning type: pooled OR 1.19, 95% CI 1.12-1.27; evening type: pooled OR 1.11, 95% CI 1.05-1.17]. Notably, night shift workers with evening chronotype were 84% more likely to develop prostate cancer than daytime workers. A positive dose-response relationship was identified between cumulative years of night shifts and prostate cancer among night shift workers with evening chronotype, indicating a 2.1% increase in risk for each additional year (P=0.012).

Conclusions: Chronotype-matched scheduling does not effectively mitigate night shift risks. Nevertheless, evening chronotype night shift workers are particularly susceptible to various chronic non-communicable diseases, with a notable positive dose-response relationship observed between prostate cancer and evening chronotype night shift workers.

Objective: This paper discusses the contribution of a widely used theoretical model of the psychosocial work environment, effort-reward imbalance (ERI), to occupational health research. It highlights the development of this approach, its measurement, and its main findings over the past three decades, focusing on epidemiological investigations. Furthermore, several limitations and challenges in view of far-reaching changes of modern work are discussed.

Methods: Based on systematic reviews, meta-analyses, and an extended search for key publications, this discussion paper sets out the main evidence of associations of the model`s measures with health risks, prioritizing prospective investigations. Complementing results addressing psychobiological markers as potential pathways underlying these associations, as well as findings on the model`s expansion beyond paid work, are briefly summarized.

Results: Currently available findings document consistent, moderately elevated related risks of ischemic heart disease (IHD) and depression following exposure to ERI. Quasi-experimental findings on physiological parameters as potential mediators of the link with IHD support this evidence. Results on a range of other disorders, in particular metabolic diseases, drug-related disorders, and indicators of reduced health functioning, while supportive, are less robust.

Conclusions: This paper synthesizes three decades of international research on ERI as a parsimonious model of adverse psychosocial working conditions. At the same time, conceptual and methodological limitations-particularly in light of rapid changes in modern work and employment-point to priorities for future refinement and application of the model.

Objectives: Occupational health services (OHS) are an important resource within employers' preventive occupational health and safety management (OHSM). The aims of this study were to investigate employers' utilization of OHS in preventive OHSM and identify decisive contextual, structural and/or processual conditions in ensuring successful collaboration with OHS in preventive OHSM.

Methods: A total of 122 organizations within the Swedish welfare sector (education, social services and healthcare), of which 112 had access to OHS, responded to a quantitative survey on the organization and management of their preventive OHSM. Responses were investigated using both conventional descriptive analysis and configurational analysis.

Results: Only a third of the participating organizations utilized OHS to a high or very high degree within their preventive OHSM. Factors for successful collaboration with OHS within preventive OHSM included having a contract that made it possible to use OHS and having established routines for involving OHS in the early phases of preventive measures, especially when managing external demands and complex challenges.

Conclusions: The utilization of OHS within preventive OHSM is limited, and increased utilization may improve the ability of employers to successfully implement OHSM. The successful organization of OHSM practices and the OHS contract were key factors in a successful collaboration with OHS. Working together in preventive OHSM may also strengthen social capital for all stakeholders, which could further enhance collaboration.

Objectives: Sleep supports cognitive performance and recovery, shaping human capital development through education and workplace knowledge application. This study investigates how polygenic indices (PGI) for insomnia (IPGI), short sleep (SSPGI), long sleep (LSPGI), and sleep duration (SDPGI) are associated with educational attainment, occupational group, and income in the Finnish general population.

Methods: Genetic and socioeconomic registry data were merged with pooled data from six pentennial (1992-2017) cohorts representative of Finnish regional populations aged 25-64 (N=20 121). Regression models assessed associations between sleep trait PGI and human capital outcomes. In extended regression models, phenotypic sleep traits were treated as endogenous variables-potentially influenced by unobserved confounders-and instrumented with their respective PGI to isolate variation attributable to genetic predisposition.

Results: IPGI, SSPGI, and LSPGI were substantially negatively associated with educational attainment (P<0.001) and selection into knowledge work occupational group (P≤0.005). Their negative association with income (P<0.005) primarily operated through pathways involving education and occupational group. Extended regression models confirmed that these PGI validly predicted their respective phenotypic sleep traits, which, when instrumented, were significantly negatively associated with education and belonging to the knowledge work occupational group, supporting causal pathways linking genetic sleep predispositions to human capital outcomes via phenotypic sleep traits. In contrast, SDPGI-an aggregate proxy for genetically distinct short and long sleep traits-was not significantly associated with any human capital outcome.

Conclusions: Genetic predispositions to insomnia, short sleep, and long sleep were robustly and substantially negatively associated with human capital development. These associations may help to clarify how genetic sleep traits relate to outcomes in work and health contexts.

Objective: Wearing medical personal protective equipment (PPE) substantially increases heat strain by elevating metabolic heat production while impairing heat dissipation. Cooling vests are a practical countermeasure, yet their efficiency depends on thermal conductivity and comfort. This study examined the thermoregulatory and perceptual responses to PPE use and evaluated the efficacy of a novel carbon-based cooling vest with enhanced heat transfer capacity.

Methods: A randomized crossover design was employed in which 12 participants completed 100 minutes of simulated healthcare activity in a climatic chamber (32 °C, 70% RH) under three conditions: medical scrubs (NoPPE), scrubs with PPE (PPE), and scrubs with PPE plus the cooling vest (PPE+Vest). Physiological, thermoregulatory, and perceptual variables were continuously monitored across conditions.

Results: Compared with PPE alone, PPE+Vest markedly attenuated heat strain, lowering core temperature [PPE 38.4, standard deviation (SD) 0.4, 0C versus PPE+Vest 37.5 (SD 0.4) 0C, P=0.001] and heart rate [PPE 123 (SD 11) bpm versus PPE+Vest 107 (SD 15) bpm, P<0.001], while improving thermal sensation [PPE 2.0 (SD 0.8) versus PPE+Vest 0.8 (SD 0.8), P=0.006]. These thermoregulatory benefits occurred without an increase in metabolic energy expenditure [PPE 317 (SD 50) kcal versus PPE+Vest 317 (SD 53) kcal, P=0.891].

Conclusions: The novel carbon-based cooling vest effectively suppressed heat storage by enhancing conductive heat transfer, leading to core and skin temperatures comparable to NoPPE. Importantly, despite its additional weight, the vest did not impose extra metabolic demands, offering a practical strategy to maintain thermal comfort and physiological stability during prolonged medical work in hot environments.

Objective: This study aimed to investigate the effect of a 12-week multi-component intervention on neck pain among Swiss office workers.

Methods: Between January 2020 and April 2021, we conducted a stepped-wedge cluster randomized controlled trial involving 120 office workers (18-65 years) without severe neck problems from two Swiss companies. Participants started in the control condition and sequentially transitioned to the intervention condition by their cluster. The 12-week intervention included neck exercises, health-promotion workshops, and workplace ergonomics. Neck pain was assessed by intensity [numeric rating scale (NRS) 0=no pain, 10=maximum pain], frequency (days with neck pain in the past 28 days), and disability [Neck Disability Index (NDI) 0%=no disability, 100%=maximum disability). Mixed-effects models were used to assess the intervention's effect on neck pain intensity, frequency, and disability.

Results: This analysis includes 517 observations (295 control, 222 intervention). At baseline, the mean age was 43.7 years [standard deviation years (SD) 9.8], and 71.7% were female. The average neck pain intensity was NRS 2.4 (SD 2.0), frequency 6.8 days (SD 8.0), and disability 11.8% (SD 9.9). A statistically significant effect favoring the multi-component intervention was found for neck pain frequency, with a marginal predicted mean reduction of 1.55 days [95% confidence interval (CI) -2.84--0.26], and neck disability, with a marginal predicted mean reduction of NDI 2.23% (95% CI -2.96--1.68).

Conclusions: This study provides evidence of the effectiveness of a 12-week multi-component intervention in reducing neck pain among office workers. Specifically, office workers experienced neck pain less frequently and with a milder impact on daily activities. Further research is needed to investigate long-term effects.

Objective: This study aimed to examine the association between job strain (combination of job demands and job control) and alcohol-related health problems among men and women and the extent to which workplace social support moderates this association.

Methods: This study used information from the register-based Swedish Work, Illness, and Labor-market Participation (SWIP) cohort, focusing on working individuals born 1945-1975, who were registered in Sweden in 2005 (N=2 822 462). Job demands, control and workplace social support were measured using job exposure matrices (JEM). Information on alcohol-related health problems (morbidity, mortality, medication prescription, sickness absence and disability pension) was obtained from multiple registers between 2006 and 2020. Cox regression models were employed to estimate associations between job strain and alcohol-related health problems, adjusting for sociodemographic background and previous health. The modifying effect of social support was assessed using relative excess risk due to interactions (RERI).

Results: High-strain and passive jobs were related to an increased risk of alcohol-related health problems among both men [hazard ratios (HR) 1.28 and 1.32] and women (HR 1.06 and 1.05), after adjusting for important individual and parental covariates. Weak social support had diverging associations with the outcome for men and women. Strong social support appeared to buffer the risk in passive jobs but only among women (RERI=0.08).

Conclusions: In Sweden, job strain seems to influence alcohol-related health problems, particularly among men. Women, however, appear to experience the protective effects of strong work-related social support measured at the occupational level.

Objectives: We investigated changes in weight, exercise frequency, and perceived health from the first to last health profile assessment (HPA) and between the number of tests within five years. We examined whether sociodemographic factors, or baseline values influenced these changes.

Methods: Data from 106 005 employees with ≥2 HPA (1990-2021) were included. Change between the first and last HPA within a five-year period was analyzed. Baseline age, sex, education, occupation, and baseline values of each outcome were included as predictors. XGBoost models assessed changes in the outcomes, and performance was evaluated via root mean squared error, mean absolute error, and R-squared. We employed Shapley Additive Explanations and forward marginal effects to interpret dose-response relationships and subgroup differences.

Results: Predictive performance was low, suggesting that the included variables only partially explained observed changes. Nonetheless, longer intervals between the first and last HPA correlated with greater weight gain, while a higher number of tests predicted slightly lower weight gain and modest improvements in perceived health and exercise frequency, compared to the average change. Younger participants had larger weight increases, whereas those with higher education showed smaller declines in exercise frequency.

Conclusions: Infrequent HPA alone did not appear to substantially influence the lifestyle-related factors studied. However, more frequent HPA, coupled with enhanced feedback and support, may yield small improvements in weight, perceived health, and exercise frequency compared to the average change.