Scandinavian journal of work, environment & health最新文献

Objective: There is epidemiological evidence of an association between occupational pesticide exposure and cognitive impairment, but studies on the link with Alzheimer`s disease are scarce. We explored the association between agricultural exposures and Alzheimer`s disease in the AGRICAN cohort.

Methods: We analyzed the relationship between doctor-diagnosed Alzheimer`s disease and life-long exposures separately among men and women with the following exposures: work on a farm, pesticide use in any job, growing specific crops (N=13) or rearing animals (N=5), pesticide use on these crops/livestock, with adjustment for age, education, smoking, alcohol consumption and body mass index.

Results: Among 109 287 participants in the analysis, 818 (267 men, 551 women) were classified as Alzheimer`s disease cases. Increased risks were seen for work on a farm [men: odds ratio (OR) 1.81, 95% confidence interval (CI) 0.92-3.57; women: OR 1.58, 95% CI 0.94-2.86] or pesticide use in any job (men: OR 1.14, 95% CI 0.85-1.53; women: OR 1.42, 95% CI 1.10-1.85). Risks for crops and livestock were close to unity when compared with non-farmers, except for pigs (OR 1.38, 95% CI 1.01-1.89) and rapeseed among men (OR 1.45, 95% CI 1.00-2.11) and sunflower among women (OR 1.55, 95% CI 0.90-2.66). Using pesticides increased the risk among men especially for sheep/goats (OR 1.98, 95% CI 1.18-3.34), pigs (OR 1.80, 95% CI 1.19-2.74), potatoes (OR 1.47, 95% CI 1.03-2.10) and meadows (OR 1.54, 95% CI 1.14-2.08). Among women, risks associated with pesticide use on crops were generally elevated, reaching a two-fold increase for corn, rapeseed, sunflower, field peas and fruit growing.

Conclusion: Our results suggest that agricultural exposures may play a role in Alzheimer's disease among both men and women, with the highest risks associated with pesticide use in certain livestock and crop activities.

Objectives: Clinical burnout may have serious personal and societal impacts, such as reduced productivity, prolonged sick leave and long rehabilitation. Regular screening using clinically relevant cut-offs to identify individuals at risk is essential for effective prevention. This study aimed to: (i) establish Swedish clinical cut-off scores for the Burnout Assessment Tool (BAT) versions (ie., BAT23, BAT12, BAT4); (ii) assess the BAT4's ability to classify burnout severity; and (iii) calculate burnout complaints in the Swedish workforce.

Methods: A national representative sample of the Swedish working population (N=1603) and a burned-out group (N=159) diagnosed with exhaustion disorder (ED) were surveyed using BAT23, BAT12, and BAT4. Receiver operating characteristic (ROC) analyses determined diagnostic accuracy and cut-offs for mild (orange) and severe (red) burnout complaints. A sensitivity analysis using clinician-confirmed ED patients (N=25) validated findings.

Results: BAT23 showed the highest accuracy in differentiating between mild and severe complaints. Among the subscales, exhaustion performed best. BAT12 showed good accuracy at the orange and slightly reduced sensitivity at the red cut-off. BAT4, while showing excellent sensitivity (0.93) at the orange cut-off, had poor sensitivity (0.47) at the red cut-off, limiting its clinical utility. Prevalence estimates using Swedish cut-offs showed approximately 13% of the workforce had severe burnout complaints (BAT23 and BAT12).

Conclusions: BAT23 is recommended for comprehensive assessments; BAT12 is useful for workplace screening where a shorter questionnaire is required and BAT4 for broad organizational screening using only the orange cut-off. Findings support the structured application of BAT across varying settings and a deeper understanding of the BAT4.

Objective: This study developed a European job exposure matrix (EuroJEM) for psychosocial work factors in order to examine their prospective associations with diagnosed depression in three register-based Nordic cohorts.

Methods: National, gender-specific psychosocial JEM from Finland, Norway, and Sweden were evaluated for similarities in exposures, exposure definitions, and occupational coding. The EuroJEM harmonized two exposures: quantitative job demands and decision authority. Disagreements on exposure categories across the national JEM were addressed among experts. Associations between exposures and diagnosed depression were examined across three register-based cohorts.

Results: The EuroJEM provides gender-specific exposure categories, based on the proportion of workers exposed, for 371 ISCO-88 (COM - European version of the International Standard Classification of Occupations) occupational codes. All associations were similar across the three cohorts, except for medium-high / high likelihood of exposure to high job demands among women. The pooled hazard ratios (pHR) for depression among workers with a medium-high / high likelihood of exposure to low decision authority had pHR of 1.50 [95% confidence interval (CI) 1.33-1.68] among men and 1.28 (95% CI 1.22-1.35) among women. High strain jobs had pHR of 1.19 (95% CI 1.15-1.24) and 1.07 (95% CI 1.01-1.14) and active jobs 0.79 (95% CI 0.72-0.87) and 0.86 (95% CI 0.79-0.94) among men and women, respectively. The associations between job demands and depression were less clear, especially among women.

Conclusion: We found consistent associations between diagnosed depression and EuroJEM-based psychosocial exposures. Especially decision authority and job strain indicate a good performance of this JEM. The performance for job demands may be suboptimal.

Objectives: We critically examined the proposal to establish occupational exposure limits (OEL) for psychosocial hazards, evaluating its scientific feasibility, methodological challenges, and implications for occupational health practice.

Methods: We reviewed the conceptual framework and recommendations by Pauli et al and compared them with established approaches for chemical and physical hazards. Key obstacles were analyzed, including the reliance on latent constructs, terminological ambiguity, and the absence of objective exposure metrics, while considering the advent of the exposome in epidemiology, emerging technologies and political economy factors.

Results: Our analysis shows that analogies with physical and chemical OEL offer useful insights but cannot be directly applied to psychosocial hazards. Unlike traditional hazards, psychosocial hazards are context-dependent, socially constructed, and often measured through self-reported surveys, limiting the derivation of adverse effect levels. Current psychosocial models of occupational stress aggregate diverse stressors under broad constructs, impeding actionable risk assessment. While organizational hazards such as shift work and long working hours can be objectively quantified using human resource data and sensors, social and moral dimensions remain elusive. Individual biomarkers might not offer adequate diagnostic value, while using multiple biomarkers in combination introduces challenges related to cost and feasibility. Furthermore, regulatory decisions are shaped by economic interests and stakeholder conflicts, complicating consensus and OEL adoption.

Conclusions: A paradigm shift is required: moving from generic theoretical models to specific, measurable indicators, integrating multi-source data, and harmonizing methodologies. Without this transformation, OEL risk over-simplifying complex psychosocial phenomena and failing to achieve meaningful preventive outcomes. For occupational safety and health practice, work organizations should prioritize the more specific identification and measurement of psychosocial hazards, using context-specific data and harmonized methods, to enable more effective risk management and prevention, pending the establishment of formal occupational exposure limits for psychosocial hazards.

Objectives: The aim of this review was to map the characteristics and the effects of interventions that reduce working hours with full pay maintained on workers' health, well-being and work-life balance and to assess whether a gender perspective was incorporated.

Methods: A scoping review was conducted following PRISMA-ScR and JBI guidelines. Scientific databases (PubMed, Scopus, Web of Science, PsycINFO, CINAHL, Cochrane, ProQuest, Epistemonikos) and grey literature sources (international, European and national labor and occupational health agencies) were systematically searched for studies published between April 2014 and May 2025 in English or Spanish. Eligible studies comprised employed adults in Scandinavian and Western European countries, the United States, Canada, Australia and New Zealand exposed to interventions reducing working hours with full pay maintained. Screening, data extraction, and quality appraisal were conducted independently. An evidence map was developed to synthesize the findings.

Results: Ten scientific articles and five grey literature reports were included, seven from Scandinavian, seven from Western European countries, and one that included both regions. Working time reductions ranged from 10-25%. Most studies reported positive effects on work-life balance (100%), mental health (81.8%), and general health and well-being (58.3%). Qualitative data confirmed improvements in recovery, fatigue, and family time. Eleven studies included a gender perspective, with eight providing stratified analyses. Several studies indicated that women increased the time dedicated to caregiving and household, reinforcing traditional roles, while men's involvement rose slightly without shifting responsibility equity.

Conclusions: Despite heterogeneity of interventions and limited implementation contexts, it seems that reducing working hours to around 30-35 per week without pay loss may improve work-life balance, health, and well-being. Gender differences emerged, with women often facing increased unpaid work. As the evidence is still scarce particularly regarding long-term effects, sector-specific interventions, and gendered effects, further research is needed to inform and evaluate policies that promote equitable and sustainable work-time arrangements.

Objective: This study investigated whether (i) young adults' mental health problems change when starting career work, (ii) potential changes in mental health problems differ by psychosocial work quality, and (iii) mental health problems during adolescence moderate potential changes in mental health by psychosocial work quality.

Methods: We used data from the TRracking Adolescents' Individual Lives Survey (TRAILS) cohort. Follow-up time was 2-4 years. Mental health was measured with the youth and adult self-report scales. Longitudinal fixed-effects regression analyses were applied to estimate within-person changes in mental health of young adults entering career work with good, moderate, or poor psychosocial work quality (N=850) and model adolescent mental health as effect modifier of this change (N=766).

Results: When psychosocial job quality of the first career job was ignored, mental health problems did not significantly change among young adults after having entered career work compared with not having career work. Taking psychosocial job quality into account, mental health problems increased among young adults starting career work in poor psychosocial quality compared with not having career work (adjusted mean score increase 0.12, 95% confidence interval 0.03-0.21). No significant changes in mental health problems were found for young adults entering work with moderate-to-good psychosocial work quality. We found no evidence for adolescent mental health problems as moderator.

Conclusion: Psychosocial work quality potentially plays a role for young workers' mental health. Improving poor psychosocial work quality of young adults might contribute to a mentally healthier start of one's working life.

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: In low- and middle-income countries (LMIC), there is mixed evidence on the effectiveness of interventions in improving workplace conditions among hazardous industries. In Thailand, a particularly hazardous industry with high injuries is informal electronic waste (e-waste) recycling. We investigated whether developing an optimized tool to dismantle e-waste would reduce injuries.

Methods: We conducted a quasi-randomized control trial to determine the perceptions and efficacy of the optimized tool in reducing worker injuries over three months among 89 workers. The optimized tool for dismantling e-waste was designed following employee and business owner input using conjoint analysis. Workers were quasi-randomized into an intervention (ie, receiving the tool) or control (ie, not receiving) group from an auction. We conducted differences-in-differences Poisson regression to examine differences in self-reported injuries and near misses over three months follow-up between the intervention and control groups.

Results: Among 44 workers who received the tool, workers self-reported that the tool created a safer work environment and reduced near misses, hammer danger, hand vibrations and hand pain. Among 42 workers (21 treatments, 21 controls) with complete information, the intervention reduced self-reported injuries over three months [difference-in-differences: -58%, 95% confidence interval (CI) -19- -79%]. Similar reductions in near misses were observed but not statistically significant (-53%, 95% CI -92-173%).

Conclusions: Our study suggests that meaningful reductions in injury risk for specific types of work can be achieved with co-designed tools optimized to consider inputs from multiple stakeholders. This approach can be especially useful in resource-constrained environments, including working conditions in LMIC.

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.