Scandinavian journal of work, environment & health最新文献

Objectives: Occupational physical activity (OPA) during pregnancy has been linked to adverse pregnancy outcomes, but crude exposure assessment remains an issue in causal inference. We aimed to develop a quantitative trimester-specific job exposure matrix (JEM) for standing, walking, and forward bending among pregnant workers.

Methods: Accelerometer measurements from 403 female workers across 109 DISCO-08 job codes were obtained in Denmark between January 2023 and June 2024. Full workdays were measured during two weeks among pregnant workers and one week among non-pregnant workers. We used linear mixed-effects models to estimate exposure levels of occupational standing, walking, and forward bending for all 1171 DISCO-08 codes, including age, trimester, and expert ratings as fixed effects, and job codes and workers as random effects.

Results: The between-job variances relative to total variances were 56% for standing, 51% for walking, and 45% for forward bending. The fixed effect trimester reduced standing time by 0.38 hours during the 3rd trimester compared to non-pregnant participants, whereas no differences were observed for walking or forward bending. Based on the trimester-specific JEM for occupational standing time, bakers had the highest exposure (range from non-pregnant to 3rd trimester, 5.41-5.03 hours/workday). For walking and forward bending, the highest exposed jobs from the pregnancy-specific JEM were waiters (1.76 hours/workday) and livestock/dairy producers (1.24 hours/workday), respectively.

Conclusions: The JEM enhances independent objective exposure assessment in epidemiological studies of OPA and pregnancy outcomes and may advance guidelines and potentially prevent adverse pregnancy outcomes.

Objective: This meta-analysis aimed to identify sociodemographic, lifestyle, work-related and health risk factors for voluntary early old-age retirement among middle-aged workers.

Methods: Searches were conducted in PubMed, Web of Science, PsycInfo, and Scopus from their inception until February 2025. Observational longitudinal studies involving workers aged 40-64 years were included. Two reviewers evaluated the methodological quality of the studies. A random-effects meta-analysis was performed, and heterogeneity and publication bias were assessed.

Results: From 13 899 publications, 23 longitudinal studies (N=2 270 430 participants) were included. The following factors were associated with an increased risk of early old-age retirement: age [hazard ratio (HR) 1.35, 95% CI (confidence interval) 1.12-1.63 per year increase], overweight or obesity (HR 1.10, 95% CI 1.03-1.17), physically demanding work (HR 1.29, 95% CI 1.05-1.59), low job control (HR 1.14, 95% CI 1.11-1.17), low influence at work (HR 1.10, 95% CI 1.02-1.19), low organizational justice (HR 1.27, 95% CI 1.10-1.46), lack of skills and knowledge development (HR 2.16, 95% CI 1.63-2.85), suboptimal self-rated general health (HR 1.22, 95% CI 1.12-1.34), chronic physical conditions (HR 1.11, 95% CI 1.05-1.17), and depressive symptoms (HR 1.34, 95% CI 1.12-1.61). Conversely, a lower risk was found among individuals who were unmarried, separated, or widowed (HR 0.74, 95% CI 0.60-0.91).

Conclusions: This meta-analysis underscores the impact of overweight, physical and psychosocial work factors, lacking skills and knowledge development and health conditions on early old-age retirement risk among middle-aged workers. Targeted interventions to encourage healthy lifestyles, foster a supportive work environment, and promote mental health may help to reduce early old-age retirement risk.

Objectives: This discussion paper aims to provide recommendations for the development of occupational exposure limits (OEL) for psychosocial hazards. By comparing the characteristics of non-psychosocial and psychosocial hazards at work as well as approaches to derive occupational limit values for both types of hazards, the paper summarizes conceptual requirements and methodological perspectives for OEL in psychosocial risk assessment.

Methods: An interdisciplinary working group comprised of academics, active practitioners in company occupational health management and members of national committees advising policymakers conducted regular face-to-face and online meetings between October 2022 and August 2024 to draft a narrative review and discussion of the current state of research on OEL for psychosocial hazards within the fields of psychology, sociology and medicine.

Results: The current field of research is in its early stages, indicated by individual efforts and a lack of joint decision-making. Existing approaches towards OEL focus on disease-level outcomes (eg, burnout, depression), which limits their effectiveness for primary prevention and identifying early warning signs of harm.

Conclusion: Based on the limited existing literature, we recommend (i) the use of outcome variables that enable detection of early stages of adverse effects aligned with the no-observed adverse effect level (NOAEL) and the lowest-observed-adverse effect level (LOAEL), (ii) standardization and harmonization of hitherto independent assessments of identical hazards, and (iii) policy-level actions to foster collaborative decision-making based on the full spectrum of scientific evidence.

Objective: We aimed to assess the impact of telework conditions on stress levels among 294 Swedish white-collar workers.

Methods: Telework during the COVID-19 pandemic was evaluated in terms of the allowance to telework (ie, the degree to which the employee could decide whether to telework), and the utilization of that allowance, using self-reported questions with answers dichotomized into 'high' and 'low'. Perceived stress was measured using the Single Item Stress Question and physiological stress was measured using parameters of heart rate variability (HRV) continuously for three days [root mean square of successive differences (RMSSD) and standard deviation of the interbeat intervals of normal heart beats (SDNN)]. Multilevel linear mixed models examined the effects of telework allowance and utilization on perceived stress and HRV during work, leisure and sleep.

Results: High allowance was associated with higher HRV (lower stress), while a high utilization of telework was associated with higher perceived stress and lower HRV (more stress). After adjusting for age, sex, body mass index, and objectively measured physical activity, these associations became smaller and/or non-significant, with exception of high allowance still being positively associated with higher RMSSD.

Conclusions: Our findings indicate that allowing employees more autonomy in telework decisions (ie, a high allowance in this study) is associated with reduced physiological stress. These results can be used by organizations to improve telework conditions (how, where and how much), while being observant that white-collar workers do not utilize increased autonomy to work extensively and for long hours outside work. Further verification, preferably using prospective designs, is needed to confirm our results.

Objective: This study aimed to investigate productivity loss during the COVID-19 pandemic and identify risk factors by examining indicators of work productivity loss in a population-based cohort in The Netherlands.

Methods: Longitudinal data from the Lifelines COVID-19 cohort were used, enriched with registry data from Statistics Netherlands. Data of N=11 462 workers were collected from 2020-2022. Productivity loss was measured using four indicators: unemployment, sickness absence rate, loss of work hours, and loss of work quality. Generalized estimating equations were used to examine the association between socioeconomic, health-, and work-related characteristics and the four indicators.

Results: Unemployment remained low (<0.5%) throughout the pandemic. In contrast, prevalence of sickness absence, reduction of work hours and work quality peaked at 8.7%, 15%, and 4.7%, respectively. Critical work was associated with higher odds of sickness absence and quality loss, but lower odds of unemployment and loss of hours. Younger age and recent COVID-19 were associated with higher odds of sickness absence, loss of work hours and quality. Chronic health conditions were associated with higher odds of sickness absence and quality loss. Having children was associated with lower odds of unemployment and loss of hours.

Conclusion: Despite low unemployment rates, productivity loss was observed at other indicators: sickness absence, loss of hours and quality. In addition, productivity was lost unequally among groups. When preparing for future crises, attention should be paid to broader indicators of productivity loss among different groups. Findings may help for offering targeted interventions to minimize losses in productivity and protect higher risk groups of workers.

Objectives: In Sweden, the number of working-aged women in employment is now almost equal to that of men. While this has many benefits, it presents challenges in organizing work and non-work responsibilities around children, which may impact employees` mental health.

Methods: Based on the Swedish Longitudinal Occupational Survey of Health (SLOSH) cohort study, we prospectively examined gender differences for the effects of work-family conflict and caring for children on mental health among Swedish workers. Mental health status was assessed using a brief (Hopkins) symptom checklist depression scale. We used information from three waves of data over five years (2014-2018) for 5846 women and 4219 men aged 20-64 at baseline. Linear fixed-effects analyses were performed examining within-person changes in work interfering with family (WFC) and family interfering with work (FWC) and associated changes in depressive symptoms by childcare intensity (0, 1-10, >10 hours/week) and sex.

Results: Changes in mean scores for WFC and FWC were associated with changes in depressive symptoms for men [no childcaring: WFC 1.31 (95% confidence interval (CI) 1.13-1.49), FWC 0.70 (95% CI 0.43-0.96); childcaring >10 hours/week: WFC 1.39 (95% CI 0.53-2.25), FWC 1.24 (95% CI 0.27-2.21)] and women [no childcaring: WFC 1.57 (95% CI 1.41-1.73), FWC 1.04 (95% CI 0.79-1.30); childcaring >10 hours/week: WFC 2.04 (95% CI 1.36-2.73), FWC 1.57 (95% CI 0.82-2.32)].

Conclusion: Higher levels of WFC and FWC are associated with increased depressive symptoms in both men and women. The impact is greater for those with greater childcaring responsibilities intensity.

Objectives: Previous studies mapping pleural mesothelioma in Denmark have found that the risk varies between Danish regions. However, evaluating disease risk for such relatively large geographical units ignores any heterogeneity within the unit and can thus diminish more local spikes in risk, missing smaller areas of excess risk. In this study, we examined the distribution of pleural mesothelioma in Denmark on an unprecedented detailed scale, mapping cases to each of the Danish parishes.

Methods: We identified individuals diagnosed with pleural mesothelioma between 1990 and 2021 in the Danish Cancer Registry. Considering age- and sex-standardized incidence rate ratios (IRR), we used a conditional autoregressive random effects model to smooth IRR across parishes. Parishes with a smoothed parish-to-national IRR >1.25 or >2.0 with a posterior probability of >95% were flagged as parishes with an excess risk of pleural mesothelioma.

Results: We identified 3105 incident cases of pleural mesothelioma in the study period. A total of 74 and 14 parishes were flagged with IRR significantly above 1.25 and 2.0, respectively. These parishes had posterior mean smoothed IRR of 1.82-4.13.

Conclusions: We provided a detailed mapping of pleural mesothelioma cases in Denmark and found five distinct areas, each covering several parishes, with a significantly elevated risk. All these areas were in the proximity of previous asbestos-using industries.

Objective: This study aimed to construct a job-exposure matrix (JEM) for the risk of being infected by infectious agents through airborne or droplet transmission in an occupational setting, which might lead to a respiratory disease.

Methods: An established COVID-19-JEM formed the basis for the development of the general airborne infectious agents JEM. Nine researchers in occupational epidemiology from three European countries (Denmark, The Netherlands and the United Kingdom) discussed and agreed on which factors from the COVID-19-JEM were relevant and whether new factors or adjustments of risk levels were needed. Adjustments to the COVID-19 JEM were made in a structured iterative. based on an expert assessment, a JEM on solar ultraviolet radiation (UVR) exposure including information on hours per day working inside, and national data on hours per week on site. Finally, a risk score was assigned to all factors for each job title within the International Standard Classification of Occupations system 2008 (ISCO-08).

Results: This airborne infectious agents JEM contains five factors: (i) hours spent per week on site, (ii) hours spent per day working inside, (iii) number and (iv) nature of contacts, and (v) being in close physical contact to others. Per occupation, a risk score ranging from 1 (low risk) to 3 (high risk) was provided for all five factors separately.

Conclusion: This newly developed infectious agents JEM assesses the risk at population level using five factors. Following validation, this JEM could serve as a valuable tool in future studies investigating the role of work in the occurrence of a respiratory disease.

Objectives: Exposure to wood dust, resin acids, microbial and volatile components among sawmill workers may impair respiratory health, with inflammation indicated as a key mechanism. Previous, mostly cross-sectional studies have shown mixed results, and a conclusive association between wood dust exposure and chronic respiratory inflammation has therefore not yet been established. This study assessed associations between exposure to bioaerosols and volatile terpenes and serum inflammatory marker levels over three years.

Methods: Serum biomarkers and blood cell counts were analyzed based on 702 observations from 450 exposed sawmill workers and 102 observations from 65 unexposed sawmill workers in Norway at baseline and after three years. Job-exposure-matrices, based on measurements among the same cohort, were used to assess exposures for wood dust, endotoxins, resin acid, monoterpenes, fungal spores, and fungal fragments. Changes in exposures, biomarkers and cell counts over the study period, as well as group differences and potential cause-and-effect associations were assessed using linear mixed regression.

Results: Exposures were relatively low and below occupational limits, although variances were relatively high (GSD_tot 2.1-8.3), largely driven by differences between workers (GSD_bw 1.9-7.8). Serum CC-16 and mCRP were slightly higher after three years, whereas IL-1β, TNF-α and IL-10 levels were significantly lower among exposed compared with unexposed workers. Exposures positively associated with increases in biomarker levels included endotoxin with mCRP, monoterpenes with IL-10, and fungal spores with TNF-α and IL-8. Exposed workers had higher counts of total leucocytes, neutrophils, lymphocytes and basophils after three years. Several of the increased leucocyte counts were associated with concurrent increase in mCRP and IL-6 concentrations, predominantly in the exposed group. Conversely, increased CC-16 levels were associated with lower leucocyte and neutrophil counts, mainly in the unexposed group.

Conclusion: Continuous exposure to wood dust and related components for three years appears to induce a chronic low-grade inflammatory response among sawmill workers with a shift in cytokine profiles towards a less regulated, potentially more muted immune state.

Objective: Occupational differences in COVID-19 are well documented, but the empirical evidence on potential reasons for these differences remains limited. Possible reasons include pre-existing health conditions. This study investigated occupational differences in COVID-19 disease severity and whether they can be attributed to pre-existing health conditions.

Methods: Our study used German health insurance data covering 3.17 million insured individuals (age 18-67 years), with details on COVID-19-related hospitalization and mortality in 2020 and 2021, information on occupation (regrouped into four classifications) and pre-existing health conditions (divided into seven disease groups). In addition to descriptive statistics, we estimated multivariable Cox regression models with varying sets of adjustments.

Results: We found clear occupational differences in COVID-19 hospitalization and mortality, with the highest risks for the production sector (especially manufacturing), commercial services (especially cleaning) and for low-skilled occupations. These findings persisted after adjusting for age, sex, and region, and also after mutual adjustment for other occupational classifications. We also found some evidence that the association between occupation and disease severity was partly explained by pre-existing conditions, especially in the case of low skill levels.

Conclusions: Our findings provide support for occupational differences in COVID-19, where the occupational classifications under study were independently related to risk differences (eg, skill-level and job sector). Furthermore, we provide empirical evidence that differences by occupational skill levels are partly due to pre-existing conditions. This finding suggests that occupational inequalities in health increased during the pandemic, with those with poorer health who worked in disadvantaged occupations also being more likely to experience severe COVID-19 outcomes.