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Working hours and cardiovascular disease. 工作时间与心血管疾病
IF 6.3 2区 医学 Q1 Medicine Pub Date : 2024-04-01 Epub Date: 2024-03-18 DOI: 10.5271/sjweh.4156
Reiner Rugulies
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引用次数: 0
Education and pandemic SARS-CoV-2 infections in the German working population - the mediating role of working from home. 德国劳动人口的教育与 SARS-CoV-2 大流行感染--在家工作的中介作用。
IF 6.3 2区 医学 Q1 Medicine Pub Date : 2024-04-01 Epub Date: 2024-02-12 DOI: 10.5271/sjweh.4144
Benjamin Wachtler, Florian Beese, Ibrahim Demirer, Sebastian Haller, Timo-Kolja Pförtner, Morten Wahrendorf, Markus M Grabka, Jens Hoebel

Objectives: SARS-CoV-2 infections were unequally distributed during the pandemic, with those in disadvantaged socioeconomic positions being at higher risk. Little is known about the underlying mechanism of this association. This study assessed to what extent educational differences in SARS-CoV-2 infections were mediated by working from home.

Methods: We used data of the German working population derived from the seroepidemiological study "Corona Monitoring Nationwide - Wave 2 (RKI-SOEP-2)" (N=6826). Infections were assessed by seropositivity against SARS-CoV-2 antigens and self-reports of previous PCR-confirmed infections from the beginning of the pandemic until study participation (November 2021 - February 2022). The frequency of working from home was assessed between May 2021 and January 2022.We used the Karlson-Holm-Breen (KHB) method to decompose the effect of education on SARS-CoV-2 infections.

Results: Individuals with lower educational attainment had a higher risk for SARS-CoV-2 infection (adjusted prevalence ratio of low versus very high = 1.76, 95% confidence interval 1.08-2.88; P=0.023). Depending on the level of education, between 27% (high education) and 58% (low education) of the differences in infection were mediated by the frequency of working from home.

Conclusions: Working from home could prevent SARS-CoV-2 infections and contribute to the explanation of socioeconomic inequalities in infection risks. Wherever possible, additional capacities to work remotely, particularly for occupations that require lower educational attainment, should be considered as an important measure of pandemic preparedness. Limitations of this study are the observational cross-sectional design and that the temporal order between infection and working from home remained unclear.

目的:在大流行期间,SARS-CoV-2 感染分布不均,社会经济地位低下的人感染的风险更高。人们对这种关联的内在机制知之甚少。本研究评估了 SARS-CoV-2 感染的教育差异在多大程度上受在家工作的影响:我们使用了血清流行病学研究 "全国电晕监测--第二波(RKI-SOEP-2)"(N=6826)中的德国工作人群数据。自大流行开始至参与研究期间(2021 年 11 月至 2022 年 2 月),感染情况通过 SARS-CoV-2 抗原血清阳性反应和 PCR 确认感染的自我报告进行评估。我们使用卡尔森-霍尔姆-布林(KHB)方法分解了教育对 SARS-CoV-2 感染的影响:教育程度越低的人感染 SARS-CoV-2 的风险越高(低教育程度与高教育程度的调整患病率比=1.76,95% 置信区间为 1.08-2.88;P=0.023)。根据受教育程度的不同,27%(高学历)到 58%(低学历)的感染率差异是由在家工作的频率所调节的:结论:在家工作可以预防 SARS-CoV-2 的感染,并有助于解释感染风险中的社会经济不平等现象。在可能的情况下,应考虑增加远程工作的能力,特别是对教育程度要求较低的职业,以此作为防范大流行病的重要措施。本研究的局限性在于采用了观察性横断面设计,而且感染与在家工作之间的时间顺序仍不清楚。
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引用次数: 0
Effectiveness of a Goldilocks Work intervention in childcare workers - A cluster-randomized controlled trial. 金发女郎工作干预对保育员的效果--分组随机对照试验。
IF 6.3 2区 医学 Q1 Medicine Pub Date : 2024-04-01 Epub Date: 2024-03-04 DOI: 10.5271/sjweh.4145
Kathrine Greby Schmidt, Anders Fritz Lerche, Marie Raunkjær Christensen, Charlotte Lund Rasmussen, Leon Straker, Svend Erik Mathiassen, Andreas Holtermann

Objective: Poor cardiorespiratory fitness and health is common among childcare workers. We designed the `Goldilocks-games` according to the Goldilocks Work principle to provide high-intensity physical activity for childcare workers. We investigated the effectiveness of this Goldilocks Work intervention in increasing occupational high-intensity physical activity and improving work-related health.

Methods: In a two-arm cluster randomized trial, 16 childcare institutions with 142 workers were randomly allocated to either an 8-week Goldilocks Work intervention or a control group. The primary outcome was occupational time in high-intensity physical activity. Secondary outcomes were occupational time in active physical behaviors, heart rate during sleep, pain, physical exhaustion, energy at work, work productivity, and need for recovery.

Results: The intervention was successfully delivered and received. Both groups had a low amount of occupational high-intensity physical activity at baseline, and the intervention group reported playing the games 3.1 [standard deviation (SD) 1.5] times/week for a duration of 112.2 (SD 175.0) min/week. However, the intervention did not increase high-intensity physical activity or the secondary outcomes, except for energy at work, measured on a scale from 0-10, increasing 0.65 [95% confidence interval (CI) 0.08-1.21], and need for recovery, measured on a scale from 1-5, decreasing -0.32 (95% CI, -0.54- -0.09).

Conclusion: The intervention was successfully delivered and received, but did not increase high-intensity physical activity. The intervention group increased their energy at work and decreased their need for recovery, but not the other health-related outcomes. Further research on how to design and implement health-promoting work environment interventions in childcare is needed.

目的:保育员普遍存在心肺功能和健康状况较差的问题。我们根据 "金发姑娘工作原理 "设计了 "金发姑娘游戏",为保育员提供高强度的体育锻炼。我们研究了这种 "金发姑娘工作 "干预措施在增加职业高强度体力活动和改善工作相关健康方面的有效性:在一项双臂分组随机试验中,16 家托儿机构的 142 名工作人员被随机分配到为期 8 周的 "金发姑娘工作法 "干预组或对照组。主要结果是高强度体育活动的职业时间。次要结果是积极身体行为的职业时间、睡眠时的心率、疼痛、身体疲惫、工作时的精力、工作效率和恢复需求:结果:干预措施成功实施并被接受。干预组每周玩游戏 3.1 [标准差(SD)1.5]次,每周持续时间为 112.2 (SD 175.0) 分钟。然而,干预措施并没有增加高强度体力活动或次要结果,除了工作时的体力(以 0-10 分来衡量,增加了 0.65 [95% 置信区间(CI)0.08-1.21])和恢复需求(以 1-5 分来衡量,减少了-0.32 (95% CI, -0.54--0.09)):结论:干预措施成功实施并被接受,但并未增加高强度体力活动。干预组增加了他们的工作能量,减少了他们对恢复的需求,但没有增加其他与健康相关的结果。关于如何在托儿所设计和实施促进健康的工作环境干预措施,还需要进一步研究。
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引用次数: 0
Change in employment status and its causal effect on suicidal ideation and depressive symptoms: A marginal structural model with machine learning algorithms. 就业状况的变化及其对自杀意念和抑郁症状的因果影响:采用机器学习算法的边际结构模型。
IF 6.3 2区 医学 Q1 Medicine Pub Date : 2024-04-01 Epub Date: 2024-03-10 DOI: 10.5271/sjweh.4150
Jaehong Yoon, Ji-Hwan Kim, Yeonseung Chung, Jinsu Park, Ja-Ho Leigh, Seung-Sup Kim

Objective: This study aimed to assess the causal effect of a change in employment status on suicidal ideation and depressive symptoms by applying marginal structural models (MSM) with machine-learning (ML) algorithms.

Methods: We analyzed data from the 8-15th waves (2013-2020) of the Korean Welfare Panel Study, a nationally representative longitudinal dataset. Our analysis included 13 294 observations from 3621 participants who had standard employment at baseline (2013-2019). Based on employment status at follow-up year (2014-2020), respondents were classified into two groups: (i) maintained standard employment (reference group), (ii) changed to non-standard employment. Suicidal ideation during the past year and depressive symptoms during the past week were assessed through self-report questionnaire. To apply the ML algorithms to the MSM, we conducted eight ML algorithms to build the propensity score indicating a change in employment status. Then, we applied the MSM to examine the causal effect by using inverse probability weights calculated based on the propensity score from ML algorithms.

Results: The random forest algorithm performed best among all algorithms, showing the highest area under the curve 0.702, 95% confidence interval (CI) 0.686-0.718. In the MSM with the random forest algorithm, workers who changed from standard to non-standard employment were 2.07 times more likely to report suicidal ideation compared to those who maintained standard employment (95% CI 1.16-3.70). A similar trend was observed in the analysis of depressive symptoms.

Conclusions: This study found that a change in employment status could lead to a higher risk of suicidal ideation and depressive symptoms.

研究目的本研究旨在通过应用边际结构模型(MSM)和机器学习(ML)算法,评估就业状况变化对自杀意念和抑郁症状的因果效应:我们分析了韩国福利面板研究第 8-15 波(2013-2020 年)的数据,这是一个具有全国代表性的纵向数据集。我们的分析包括来自 3621 名参与者的 13 294 个观测值,这些参与者在基线(2013-2019 年)时拥有标准就业率。根据随访年(2014-2020 年)的就业状况,受访者被分为两组:(i) 保持标准就业(参照组),(ii) 转为非标准就业。过去一年的自杀倾向和过去一周的抑郁症状通过自我报告问卷进行评估。为了将 ML 算法应用于 MSM,我们采用了八种 ML 算法来建立表明就业状况变化的倾向得分。然后,我们根据 ML 算法得出的倾向得分计算出反概率权重,应用 MSM 检验因果效应:随机森林算法在所有算法中表现最佳,曲线下面积最高,为 0.702,95% 置信区间 (CI) 为 0.686-0.718。在使用随机森林算法进行的 MSM 分析中,与维持标准就业的工人相比,从标准就业转为非标准就业的工人报告有自杀倾向的可能性要高出 2.07 倍(95% 置信区间:1.16-3.70)。在抑郁症状分析中也观察到类似的趋势:本研究发现,就业状况的改变可能会导致更高的自杀倾向和抑郁症状。
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引用次数: 0
Perceived work stressors and the transition to burnout among nurses in response to the pandemic: implications for healthcare organizations. 护士在应对大流行病时感受到的工作压力和向职业倦怠的转变:对医疗机构的影响。
IF 6.3 2区 医学 Q1 Medicine Pub Date : 2024-04-01 Epub Date: 2024-03-13 DOI: 10.5271/sjweh.4148
Emanuele Maria Giusti, Marco Mario Ferrario, Giovanni Veronesi, Alessia D'Amato, Francesco Gianfagna, Licia Iacoviello

Objectives: This study aimed to assess the associations of pre-pandemic perceived work stressors and work satisfaction among nurses, including nurse assistants, with burnout profiles and their transitions in response to the pandemic.

Methods: Three hundred and thirty-seven nurses working in an Italian University hospital participated in a longitudinal study including a survey in August 2019 investigating perceived work stressors (assessed using the HSE Indicator Tool), work satisfaction (Work Satisfaction Scale), and burnout (Maslach Burnout Inventory), and a second survey in December 2020 assessing burnout. Using latent transition analysis, we identified burnout profiles and then estimated the associations between work stressors and satisfaction on profiles and transitions.

Results: We identified three pre-pandemic profiles, namely engaged (67%), ineffective (15%), and burnout (18%); and three pandemic profiles, namely engaged (37%), exhausted (51%), and severe burnout (12%). The severe burnout profile consisted of 70% nurses classified in the burnout profile before the pandemic. Overall, work stressors and satisfaction were associated with both pre-pandemic and pandemic burnout profiles. Among nurses not in the burnout profile prior to COVID-19, pre-pandemic hostile relationships increased [odds ratio (OR) 1.19, 95% confidence interval (CI) 1.05-1.34] and work satisfaction decreased (OR 0.82, 95% CI 0.68-0.98) the probability to transition to exhausted. Moreover, work satisfaction (OR 0.54, 95% CI 0.32-0.91) and participation in work organization (OR 0.69, 95% CI 0.51-0.93) protected from transitioning to severe burnout. The association between peer support and the transition to exhausted needs further investigation.

Conclusions: Pre-pandemic work stressors and satisfaction were associated with pandemic burnout and burnout transitions. To enhance preparedness for future crises, healthcare managers should carefully assess and tackle work-related constraints affecting nurses.

研究目的本研究旨在评估大流行前护士(包括护士助理)感知到的工作压力源和工作满意度与职业倦怠特征及其应对大流行的转变之间的关联:在一家意大利大学医院工作的 337 名护士参加了一项纵向研究,其中包括 2019 年 8 月的一项调查,调查内容包括感知的工作压力源(使用 HSE 指标工具评估)、工作满意度(工作满意度量表)和职业倦怠(马斯拉奇职业倦怠量表),以及 2020 年 12 月的第二次调查,评估职业倦怠。通过潜伏转变分析,我们确定了倦怠特征,然后估算了工作压力源和满意度与特征和转变之间的关联:我们确定了三种大流行前的倦怠特征,即投入(67%)、低效(15%)和倦怠(18%);以及三种大流行特征,即投入(37%)、疲惫(51%)和严重倦怠(12%)。其中,70%的护士在大流行前被归类为严重职业倦怠。总体而言,工作压力和满意度与大流行前和大流行时的职业倦怠状况都有关联。在 COVID-19 之前不属于倦怠状况的护士中,大流行前的敌对关系会增加[几率比(OR)1.19,95% 置信区间(CI)1.05-1.34],而工作满意度会降低(OR 0.82,95% CI 0.68-0.98)转为精疲力竭的概率。此外,工作满意度(OR 0.54,95% CI 0.32-0.91)和对工作组织的参与度(OR 0.69,95% CI 0.51-0.93)可防止向严重职业倦怠过渡。同侪支持与过渡到精疲力竭之间的关系还需要进一步研究:结论:大流行前的工作压力和满意度与大流行倦怠和倦怠过渡有关。为加强对未来危机的准备,医疗管理人员应仔细评估并解决影响护士的工作相关限制因素。
{"title":"Perceived work stressors and the transition to burnout among nurses in response to the pandemic: implications for healthcare organizations.","authors":"Emanuele Maria Giusti, Marco Mario Ferrario, Giovanni Veronesi, Alessia D'Amato, Francesco Gianfagna, Licia Iacoviello","doi":"10.5271/sjweh.4148","DOIUrl":"10.5271/sjweh.4148","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to assess the associations of pre-pandemic perceived work stressors and work satisfaction among nurses, including nurse assistants, with burnout profiles and their transitions in response to the pandemic.</p><p><strong>Methods: </strong>Three hundred and thirty-seven nurses working in an Italian University hospital participated in a longitudinal study including a survey in August 2019 investigating perceived work stressors (assessed using the HSE Indicator Tool), work satisfaction (Work Satisfaction Scale), and burnout (Maslach Burnout Inventory), and a second survey in December 2020 assessing burnout. Using latent transition analysis, we identified burnout profiles and then estimated the associations between work stressors and satisfaction on profiles and transitions.</p><p><strong>Results: </strong>We identified three pre-pandemic profiles, namely engaged (67%), ineffective (15%), and burnout (18%); and three pandemic profiles, namely engaged (37%), exhausted (51%), and severe burnout (12%). The severe burnout profile consisted of 70% nurses classified in the burnout profile before the pandemic. Overall, work stressors and satisfaction were associated with both pre-pandemic and pandemic burnout profiles. Among nurses not in the burnout profile prior to COVID-19, pre-pandemic hostile relationships increased [odds ratio (OR) 1.19, 95% confidence interval (CI) 1.05-1.34] and work satisfaction decreased (OR 0.82, 95% CI 0.68-0.98) the probability to transition to exhausted. Moreover, work satisfaction (OR 0.54, 95% CI 0.32-0.91) and participation in work organization (OR 0.69, 95% CI 0.51-0.93) protected from transitioning to severe burnout. The association between peer support and the transition to exhausted needs further investigation.</p><p><strong>Conclusions: </strong>Pre-pandemic work stressors and satisfaction were associated with pandemic burnout and burnout transitions. To enhance preparedness for future crises, healthcare managers should carefully assess and tackle work-related constraints affecting nurses.</p>","PeriodicalId":21528,"journal":{"name":"Scandinavian journal of work, environment & health","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11014740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Respirable crystalline silica and lung cancer in community-based studies: impact of job-exposure matrix specifications on exposure-response relationships. 社区研究中的可吸入结晶二氧化硅与肺癌:工作-暴露矩阵规格对暴露-反应关系的影响。
IF 6.3 2区 医学 Q1 Medicine Pub Date : 2024-04-01 Epub Date: 2024-01-24 DOI: 10.5271/sjweh.4140
Johan Ohlander, Hans Kromhout, Roel Vermeulen, Lützen Portengen, Benjamin Kendzia, Barbara Savary, Domenico Cavallo, Andrea Cattaneo, Enrica Migliori, Lorenzo Richiardi, Nils Plato, Heinz-Erich Wichmann, Stefan Karrasch, Dario Consonni, Maria Teresa Landi, Neil E Caporaso, Jack Siemiatycki, Per Gustavsson, Karl-Heinz Jöckel, Wolfgang Ahrens, Hermann Pohlabeln, Guillermo Fernández-Tardón, David Zaridze, Jolanta Lissowska Jolanta Lissowska, Beata Swiatkowska Beata Swiatkowska, John K Field John K Field, John R McLaughlin, Paul A Demers, Tamas Pandics, Francesco Forastiere, Eleonora Fabianova, Miriam Schejbalova, Lenka Foretova, Vladimir Janout, Dana Mates, Christine Barul, Thomas Brüning, Thomas Behrens, Kurt Straif, Joachim Schüz, Ann Olsson, Susan Peters

Objectives: The quantitative job-exposure matrix SYN-JEM consists of various dimensions: job-specific estimates, region-specific estimates, and prior expert ratings of jobs by the semi-quantitative DOM-JEM. We analyzed the effect of different JEM dimensions on the exposure-response relationships between occupational silica exposure and lung cancer risk to investigate how these variations influence estimates of exposure by a quantitative JEM and associated health endpoints.

Methods: Using SYN-JEM, and alternative SYN-JEM specifications with varying dimensions included, cumulative silica exposure estimates were assigned to 16 901 lung cancer cases and 20 965 controls pooled from 14 international community-based case-control studies. Exposure-response relationships based on SYN-JEM and alternative SYN-JEM specifications were analyzed using regression analyses (by quartiles and log-transformed continuous silica exposure) and generalized additive models (GAM), adjusted for age, sex, study, cigarette pack-years, time since quitting smoking, and ever employment in occupations with established lung cancer risk.

Results: SYN-JEM and alternative specifications generated overall elevated and similar lung cancer odds ratios ranging from 1.13 (1st quartile) to 1.50 (4th quartile). In the categorical and log-linear analyses SYN-JEM with all dimensions included yielded the best model fit, and exclusion of job-specific estimates from SYN-JEM yielded the poorest model fit. Additionally, GAM showed the poorest model fit when excluding job-specific estimates.

Conclusion: The established exposure-response relationship between occupational silica exposure and lung cancer was marginally influenced by varying the dimensions of SYN-JEM. Optimized modelling of exposure-response relationships will be obtained when incorporating all relevant dimensions, namely prior rating, job, time, and region. Quantitative job-specific estimates appeared to be the most prominent dimension for this general population JEM.

目的:定量工作暴露矩阵 SYN-JEM 由多个维度组成:特定工作估计值、特定地区估计值以及半定量 DOM-JEM 对工作的预先专家评级。我们分析了不同 JEM 维度对职业二氧化硅暴露与肺癌风险之间的暴露-反应关系的影响,以研究这些变化如何影响定量 JEM 的暴露估计值和相关健康终点:使用 SYN-JEM,以及包含不同维度的替代 SYN-JEM 规范,对从 14 项国际社区病例对照研究中汇集的 16 901 例肺癌病例和 20 965 例对照病例进行了累积二氧化硅暴露估算。使用回归分析(按四分位数和对数转换的连续二氧化硅暴露量)和广义加和模型(GAM)分析了基于 SYN-JEM 和替代 SYN-JEM 规范的暴露-反应关系,并对年龄、性别、研究、吸烟包年、戒烟时间和曾经从事的肺癌风险职业进行了调整:SYN-JEM和替代规格产生了总体升高和相似的肺癌几率比,从1.13(第一四分位数)到1.50(第四四分位数)不等。在分类和对数线性分析中,包含所有维度的 SYN-JEM 模型拟合度最高,而排除 SYN-JEM 中特定工作的估计值后,模型拟合度最差。此外,在排除特定工作估计值的情况下,GAM 的模型拟合效果最差:结论:职业性二氧化硅暴露与肺癌之间已确立的暴露-反应关系受 SYN-JEM 不同维度的影响很小。当纳入所有相关维度(即先前评级、工作、时间和地区)时,暴露-反应关系的模型将得到优化。针对特定工作的定量估计似乎是这一普通人群 JEM 最突出的维度。
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引用次数: 0
Effects of a participatory work stress prevention approach for employees in primary education: results of a quasi-experimental study. 针对初等教育机构员工的参与式工作压力预防方法的效果:一项准实验研究的结果。
IF 6.3 2区 医学 Q1 Medicine Pub Date : 2024-04-01 Epub Date: 2024-01-30 DOI: 10.5271/sjweh.4141
Maartje C Bakhuys Roozeboom, Noortje M Wiezer, Roosmarijn M C Schelvis, Irene M W Niks, Cécile R L Boot

Objective: Work stress is a serious problem for employees in primary education. This study evaluates the effects of a work stress prevention approach on emotional exhaustion and work stress determinants (job crafting behavior, quantitative and emotional demands, leadership, support, autonomy, team culture and feelings of competence), and the impact of implementation success (management commitment, employee involvement, communication during implementation) on these outcomes.

Methods: A quasi-experimental study was conducted with an intervention group (4 schools, N=102 employees) and a control group (26 schools, N=656 employees) using questionnaires at baseline (T0), one-year (T1) and two-year (T2) follow-up. Multilevel mixed model analyses were performed to test effects of condition and implementation success on changes in emotional exhaustion and work stress determinants between T0 and T2 in the intervention and control group.

Results: No effect were found for emotional exhaustion. Improvement of quality of leadership between T0 and T2 was significantly larger in the intervention compared to the control group. Additionally, implementation success was associated with a decrease in unnecessary demands and an increase in quality of leadership, team culture and job crafting behavior.

Conclusions: This study shows no direct effect of the approach on emotional exhaustion, but it does show beneficial effects on quality of leadership. Additionally, results suggest that, when successfully implemented, the approach also has beneficial effects on other work stress determinants (ie, job crafting behavior, unnecessary demands and team culture). Results indicate that - if implemented successfully - the organizational-level intervention has the potential to improve the psychosocial work context.

目的工作压力是小学教育从业人员面临的一个严重问题。本研究评估了工作压力预防方法对情绪衰竭和工作压力决定因素(工作雕琢行为、数量和情感要求、领导力、支持、自主性、团队文化和胜任感)的影响,以及实施成功(管理承诺、员工参与、实施过程中的沟通)对这些结果的影响:对干预组(4 所学校,102 名员工)和对照组(26 所学校,656 名员工)进行了一项准实验研究,在基线(T0)、一年(T1)和两年(T2)的跟踪调查中使用了调查问卷。对干预组和对照组进行了多层次混合模型分析,以检验条件和实施成功与否对 T0 和 T2 之间情绪衰竭和工作压力决定因素变化的影响:结果:没有发现情绪衰竭的影响。与对照组相比,干预组在 T0 和 T2 之间对领导力质量的改善明显更大。此外,实施成功与减少不必要的要求以及提高领导力质量、团队文化和工作精心设计行为有关:本研究表明,该方法对情绪衰竭没有直接影响,但对领导力质量有好处。此外,研究结果表明,如果成功实施该方法,它还会对其他工作压力决定因素(即工作雕琢行为、不必要的要求和团队文化)产生有益影响。结果表明,如果成功实施,组织层面的干预措施有可能改善社会心理工作环境。
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引用次数: 0
The adequacy of workplace accommodation and the incidence of permanent employment separations after a disabling work injury or illness. 工伤或疾病致残后,工作场所是否提供适当的便利以及永久性离职的发生率。
IF 6.3 2区 医学 Q1 Medicine Pub Date : 2024-04-01 Epub Date: 2024-03-06 DOI: 10.5271/sjweh.4149
Cameron A Mustard, Christa Orchard, Kathleen G Dobson, Nancy Carnide, Peter M Smith

Objective: This study aimed to estimate the influence of the adequacy of employer accommodations of health impairments in predicting permanent separation from the employment relationship in a cohort of workers disabled by a work-related injury or illness.

Methods: The study used data from a retrospective, observational cohort of 1793 Ontario workers who participated in an interviewer-administered survey 18 months following a disabling injury or illness. The relative risks (RR) of a permanent employment separation associated with inadequate employer accommodations were estimated using inverse probability of treatment weights to reduce confounding.

Results: Over the 18-month follow-up, the incidence of permanent separation was 30.1/100, with 49.2% of separations related to health status. Approximately 51% of participants experiencing a separation were exposed to inadequate workplace accommodations, compared to 27% of participants in continuing employment. The propensity score adjusted RR of a health-related separation associated with inadequate accommodation was substantial [RR 2.72; 95% confidence interval (CI) 2.20-3.73], greater than the RR of separations not related to health (RR 1.68; 95% CI 1.38-2.21).

Conclusions: Incidence of permanent separation in this cohort of Ontario labor force participants was approximately two times more frequent than would be expected. The adequacy of employer accommodation was a strong determinant of the risk of permanent separation. These findings emphasize the potential for strengthened workplace accommodation practices in this setting.

研究目的本研究旨在估算雇主对健康损害的适当照顾对预测因工伤或疾病致残的工人群体永久性脱离雇佣关系的影响:该研究使用了 1793 名安大略省工人的回顾性观察队列数据,这些工人在伤病致残 18 个月后参加了由受访者主持的调查。为了减少混杂因素,我们使用反向治疗概率加权法估算了与雇主提供的住宿不足有关的永久性离职相对风险(RR):在 18 个月的随访中,永久性离职的发生率为 30.1/100,其中 49.2% 的离职与健康状况有关。在经历离职的参与者中,约有 51% 的人在工作场所受到不适当的照顾,而在继续就业的参与者中,这一比例仅为 27%。经倾向得分调整后,与健康状况相关的离职与住宿不足相关的RR相当高[RR为2.72;95%置信区间(CI)为2.20-3.73],高于与健康状况无关的离职的RR(RR为1.68;95% CI为1.38-2.21):在安大略省的这批劳动力参与者中,永久性离职的发生率约为预期的两倍。雇主提供的便利是否充分是永久性离职风险的一个重要决定因素。这些发现强调了在这种情况下加强工作场所便利措施的潜力。
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引用次数: 0
Successful prevention of organic solvent induced disorders: history and lessons. 成功预防有机溶剂引起的疾病:历史与教训。
IF 6.3 2区 医学 Q1 Medicine Pub Date : 2024-04-01 Epub Date: 2024-03-14 DOI: 10.5271/sjweh.4155
Maria Albin, Gunnar Johanson, Christer Hogstedt

In this discussion paper, we describe the history of the science and societal action resulting in the mitigation of neurotoxic disorders from exposure to organic solvents at the workplaces in Sweden. When alkyd paints were introduced in large scale in construction painting in the 1960s and 1970s, Scandinavian unions voiced increasing concern as members reported symptoms like headache and vertigo, supported by participatory studies and case studies. Although acute and chronic neurotoxic effects were established for some specific solvents such as carbon disulphide, this was not the case for those used in the new paints. Union advocacy promoted formal epidemiological studies, providing increasing evidence for chronic neurotoxicity at levels far below current occupational exposure levels. The results were widely disseminated and accepted and led to concerted action with preventive measures, most importantly substitution of the organic solvents in paints for indoor use, but also drastic reductions in occupational exposure limits. The findings also resulted in funding of further research on solvent toxicity and the establishment of expert groups to advice authorities on occupational standards for exposure to chemicals. The substitution strategy was subsequently adopted in many other countries and occupational exposure limits were lowered, although several years or even decades later. While the societal context in Sweden was unique in many ways, we conclude that there are lessons to be learned from this preventive success when addressing current challenges.

在本讨论文件中,我们介绍了瑞典为减轻工作场所接触有机溶剂所导致的神经毒性疾病而采取的科学和社会行动的历史。二十世纪六七十年代,醇酸树脂涂料被大规模引入建筑涂装领域,斯堪的纳维亚工会对此日益关注,因为会员们报告了头痛和眩晕等症状,参与性研究和案例研究也证实了这一点。虽然二硫化碳等一些特定溶剂的急性和慢性神经毒性已被证实,但新涂料中使用的溶剂却并非如此。工会的倡导促进了正式的流行病学研究,为慢性神经毒性提供了越来越多的证据,其水平远远低于目前的职业接触水平。研究结果被广泛传播和接受,并促成了采取预防措施的一致行动,其中最重要的是室内使用的油漆中有机溶剂的替代品,以及职业接触限值的大幅降低。研究结果还促成了对溶剂毒性的进一步研究,并成立了专家组,就接触化学品的职业标准向当局提供建议。随后,许多其他国家也采用了这一替代战略,并降低了职业接触限值,尽管是在几年甚至几十年之后。虽然瑞典的社会环境在很多方面都很独特,但我们得出结论,在应对当前挑战时,可以从这一预防性成功中吸取经验教训。
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引用次数: 0
What are the economic costs of a poor work environment? 恶劣的工作环境会造成哪些经济损失?
IF 6.3 2区 医学 Q1 Medicine Pub Date : 2024-03-01 Epub Date: 2024-02-01 DOI: 10.5271/sjweh.4143
Reiner Rugulies, Alex Burdorf
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引用次数: 0
期刊
Scandinavian journal of work, environment & health
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