Scandinavian journal of work, environment & health最新文献

Objectives: This study aimed to describe occupational, industrial, and temporal trends in relation to absence during pregnancy in the Danish workforce.

Methods: The register-based national cohort DOC*X-Generation was used to identify all pregnancies among women (18-50 years) engaged in regular employment in Denmark 1998-2018. The cohort holds individual-level data on occupations coded according to the Danish versions of the International Standard Classification of Occupations and of EU's nomenclature (NACE, revision 2). Data on absence from work was retrieved from the Danish Register for Evaluation and Marginalization. The study population comprised 884 616 pregnancies in 547 870 women.

Results: In 48% of the included pregnancies, the women had at least one week with registered absence with a median of 8 weeks (5-95% percentile; 1-27 weeks). The highest frequencies of absence were observed among painters (75%) and women in the meat products manufacturing industry (68%), whereas the lowest were seen among professionals in physics, mathematics, engineering, and architecture (30%) and in the research and university education industry (32%). The difference between the lowest and highest number of cumulated weeks with absence was 9 weeks. From 1998-2018, the proportion of pregnancies with registered absence decreased, whereas the extent of absence per pregnancy increased.

Conclusions: Absence during pregnancy was consistently high over time, but with vast differences across occupations and industries. A deeper understanding of underlying reasons for pregnancy-related absence is essential to develop targeted strategies for reducing absence, such as providing better opportunities for adjustments of work task early in pregnancy or other tailored interventions.

Objectives: This study aimed to investigate the impact of low job control on labor market participation expressed through working life expectancy (WLE) and working years lost (WYL) among men and women in Sweden.

Methods: A random sample of 100 000 individuals was drawn from the Swedish Work, Illness, and labor market Participation (SWIP) cohort of the registered Swedish population in 2005 born 1945 to 1975. The multi-state estimated labor market affiliation method was used to estimate WLE and WYL due to unemployment, sickness absence, other, disability pension, early old-age pension, and death over a 15-year period (2006-2020). Job control was assessed through a job exposure matrix.

Results: Men and women in high-control jobs had a longer WLE at each age. At age 30, the WLE for men in high-control jobs was 26.3 years while for men in low-control jobs this was 2.5 years shorter. For women, WLE at 30 was 25.8 years for high-control jobs but nearly five years shorter for low-control jobs. For both men and women, these differences were mostly due to disability pension and unemployment. Those in lower control jobs could expect to lose more working years according to nearly all other states besides active employment.

Conclusions: Higher job control is linked to longer WLE, while low job control is an important determinant of WYL in the Swedish workforce. Addressing low job control could extend working lives and reduce inequities in labor market outcomes.

Objectives: This study aimed to assess the associations between occupational biomechanical factors and occurrence of surgically treated lumbar disc herniation (LDH) and describe the consequences in terms of early exit from the labor market.

Methods: A cohort of 262 850 male construction workers participating in a national occupational health surveillance program was followed prospectively for 33 years (1987-2019). Occupational biomechanical exposures were assessed by a job exposure matrix (JEM) based on specific occupational groups. Workers who underwent surgical treatment for LDH were identified from the national patient register and data on disability pension from the Swedish Social Insurance Agency. Poisson regression models were used to estimate relative risks (RR) and 95% confidence intervals (CI) for biomechanical exposures, adjusted for age, body mass index, smoking status, height and time period.

Results: There were 2451 cases of surgical treatment for LDH and the incidence peaked at age 40-45 years. Increased risks were found for often lifting >25 kg (RR 1.77, 95% CI 1.06-2.94), extreme lumbar flexion/extension (RR 1.60, 95% CI 1.37-1.88) and high exposure to whole-body vibration (RR 1.32, 95% CI 1.05-1.65). Among cases, the mean age for exiting the labor market due to disability pension was 55.9 years for white-collar workers and 51.7 years for construction workers.

Conclusions: Occupational exposure to heavy lifting and working in non-neutral back postures was associated with increased risk of surgical treatment for LDH. Construction workers who have had surgery for LDH exited the labor market with disability pension earlier than white-collar workers.

Objectives: This study aimed to assess 12-month outcomes on return to work (RTW) and cost-effectiveness in adults on sick leave due to musculoskeletal disorders who were randomized to either usual case management (UC), UC+motivational interviewing (MI) or UC+stratified vocational advice intervention (SVAI).

Methods: The study was conducted in the Norwegian Labor and Welfare Administration (NAV). Workers on sick leave due to musculoskeletal disorders for ≥50% of their contracted work hours for ≥7 consecutive weeks were included. Trained caseworkers delivered MI in two face-to-face sessions, and physiotherapists provided SVAI and identified RTW obstacles. The main outcomes were sick leave days over 12 months and cost-effectiveness, cost-utility and cost-benefit.

Results: The trial included 509 workers with a mean age of 48 years. There were statistically significant differences between UC+MI versus UC [-15.6 days, 95% confidence interval (CI) -31.0- -0.2], and UC+SVAI versus UC (-17.6 days, 95% CI -33.0- -2.2). Compared to UC, odds ratios (OR) for receiving wage replacement benefits each month were lower for UC+MI (OR=0.73, 95% CI 0.64-0.84), and UC+SVAI (OR 0.74, 95% CI 0.64-0.84). The probabilities of cost-effectiveness were high for adding either MI or SVAI to UC (ceiling ratio 0.90), and the net benefit for MI was €5225 (95% CI -592-10 985) and for SVAI €7214 ((95% CI 1548-12 851) per person.

Conclusions: Adding MI or SVAI to UC significantly improved RTW outcomes and was cost-effective among people on sickness absence due to musculoskeletal disorders.

Objectives: There is increasing interest in the economic effects of improving working conditions, however, evidence is sparse. This study aims to estimate the economic effects of hypothetical improvements in the psychosocial work environment (PSWE) experienced by Danish workers.

Methods: We included 71 207 workers, reporting information on their psychosocial working conditions in the "Work Environment and Health in Denmark" survey and linked these workers to population-based register data. We used the parametric g-formula method to estimate the economic effects of hypothetical improvements of the general PSWE, in terms of costs related to sickness absence and healthcare use. We further examined which PSWE factors contributed most to the economic effects.

Results: A hypothetical improvement of the PSWE - from the least to the most desirable situation - resulted in an annual gain of €1685 [95% confidence interval (CI) €1234-2135] per worker. When analyzing an improvement from the observed to the most desirable situation, the gain became weaker (€305, 95% CI €134-476). Gains were largely driven by reductions in sickness absence and were larger for women than men and for public sector workers than private sector workers. The PSWE factors with the largest contribution were eliminations of threats of violence and improvements in quality of leadership and social support from colleagues (least to most desirable) and improvements in social support from colleagues, influence at work and quality of leadership (observed to most desirable), respectively.

Conclusions: Hypothetical improvements in the PSWE resulted in substantial economic gains, mostly driven by savings related to sickness absence.

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.