Scandinavian journal of work, environment & health最新文献

Objectives: This study aimed to investigate the effect of a brief training intervention for occupational health services (OHS) professionals on multiprofessional resource utilization and the costs of biopsychosocial management of patients with low-back pain (LBP) compared to usual care among all participants and those in work disability-based risk groups.

Methods: OHS utilization and back-related sick leave data were collected from electronic patient records over one-year follow-up comparing 232 patients in the intervention arm and 80 control-arm patients, stratified for risk of work disability based on the Örebro Musculoskeletal Pain Screening Questionnaire. We estimated costs using linear mixed models by multiplying unit costs (in euros) by each type of OHS resource use (visits to physicians, physiotherapists, nurses, use of imaging) and the number of sick leaves. Estimated mean cost differences with confidence intervals (CI) were reported using bootstrapping to deal with skewed cost data.

Results: The median number of visits to physicians and physiotherapists in the intervention versus control arms was 1 [interquartile range (IQR) 0-3] and 2 (IQR 1-4) versus 2 (IQR 1-3) and 1 (IQR 0-2), respectively. The intervention arm accrued lower physician costs (€-43, 95% CI €-82- -3, P=0.034) and higher physiotherapist costs (€55, 95% CI €26-84, P<0.001) compared to the control arm. There was no statistically significant difference in average total costs between the arms (€-1908, 95% CI €-6734-2919). In the low- and medium-risk groups of work disability, physiotherapist costs were higher in the intervention than control arm, but no statistically significant differences were observed between the arms in the total resource utilization or sickness absence costs.

Conclusions: Brief biopsychosocial training may support shifting OHS resources towards multiprofessional physiotherapist-driven care, instead of solely physician-driven care, for management of patients with LBP in differing risk groups of work disability with no substantial differences in total costs.

Objectives: The growing care demands of an aging population and a smaller workforce is a big societal problem. Therefore, knowledge on how to organize eldercare work without hampering workers` health is needed. We aimed to investigate if workers` daily number of residents cared for over 14 months is associated with low-back pain in eldercare workers.

Methods: We included 513 eldercare workers from 122 wards. In each ward, we gathered quarterly data over 14 months on the number of residents, workers, and work schedules and calculated the daily numbers of residents each worker cared for. Workers reported intensity and days with low-back pain via monthly text messages over 14 months. Using generalized linear mixed models adjusted for confounders, we investigated the association between the number of residents workers cared for daily and low-back pain among those workers.

Results: In 3-month periods over 14 months, caring for ≥1 resident per day was associated with a 4% [95% confidence interval (CI) 1.02-1.07] increased risk of more days with low-back pain, and a 2% (95% CI 1.00-1.03) increase in low-back pain intensity among workers.

Conclusions: Eldercare workers are at a higher risk of experiencing low-back pain during periods when they care for a greater number of residents each day. Maintaining a consistent number of residents and workload for workers over a 14-month period could serve as an effective organizational strategy to prevent low-back pain.

Objective: The aim of this systematic review was to identify, evaluate, and synthesize the relation between ten potential occupational sensitizing exposure groups and asthma.

Methods: A systematic literature search was conducted in three databases for peer-reviewed articles published between July 2011 and March 2023. Exposures included ten potential occupational sensitizing exposure groups (amines, anhydrides, biocides [eg, pesticides], crustaceans, enzymes, mammals, metals, "mold, fungi and yeast", molluscs, and other chemicals [eg, cleaning agents]) classified as having no or limited evidence of a causal relation with asthma in our previous overview of systematic reviews. We included observational and case studies. Study selection, data extraction, risk of bias assessment, and evidence level evaluation were conducted independently by two reviewers, who also upgraded or downgraded the level of evidence found in our overview.

Results: This review included 55 articles. The overall confidence in study results was rated high in 8, moderate in 18, and low in 29 studies. No new studies were found for molluscs. For the remaining exposures, we upgraded main groups of crustaceans and enzymes to moderate evidence, mammals and metals to limited/contradictory, and amines and biocides to very limited/contradictory. For subgroups/specific exposures, pesticides, cleaning agents - such as chloramine and disinfection products - and an unspecified group of other chemicals, specifically acrylates and epoxy, were upgraded to moderate.

Conclusion: New occupational sensitizing exposures with moderate evidence include crustaceans, enzymes, pesticides, cleaning agents such as chloramine and disinfection products, and chemicals such as acrylates and epoxy.

Objectives: This population-based cohort study examined the association between psychosocial work environment exposures and autoimmune rheumatic diseases, including rheumatoid arthritis (RA), systemic sclerosis (SS), and systemic lupus erythematosus (SLE).

Methods: The total Danish working population, 19-58 years of age (N=2 319 337) was followed from 1997-2018 (37 529 977 person years). Quantitative demands, decision authority, emotional demands, job insecurity, physical violence, role conflicts and possibilities for development at work, as well as a combined psychosocial index were assessed by job-exposure matrices (JEM) and linked with diagnoses of autoimmune rheumatic diseases, ie, RA, SS, and SLE identified in The Danish National Patient Registry. For each psychosocial work environment exposure, recent exposure, accumulated exposure, and number of years with high exposure level were calculated for every employee. Associations with autoimmune rheumatic diseases were assessed by Poisson regression analyses.

Results: The results show that employees in occupations with higher decision authority and, to some degree, possibilities for development at work, have lower risks of autoimmune rheumatic diseases, while employment in occupations with high risk of physical violence involves a higher risk of rheumatoid arthritis. No association was observed for job insecurity or role conflicts at work. The results on quantitative demands, emotional demands and the psychosocial index were less conclusive.

Conclusion: These findings generally do not support that psychosocial work environment exposures are major risk factors for autoimmune rheumatic diseases, but low decision authority, possibilities for development at work, physical violence and possibly the sum of recent adverse psychosocial exposure may be of importance.

Objectives: This study aimed to evaluate one-year effects of a team-level participatory workplace intervention on need for recovery and satisfaction of the needs for autonomy, competence and relatedness among long-term care workers by means of a randomized controlled trial.

Methods: Teams of long-term care workers were randomly assigned to the intervention group (ten teams; N=78) or the wait-list control group (ten teams; N=58). The intervention consisted of a problem inventory, related to the needs for autonomy, competence and relatedness, a brainstorm towards solutions and an action plan divided over three meetings guided by a facilitator. The primary outcome was need for recovery and secondary outcomes were the satisfaction of the needs for autonomy, competence and relatedness. Outcomes were measured at baseline and after 6, 9 and 12 months. Linear mixed model analyses were performed in R.

Results: There was no significant difference in need for recovery between groups over time. The intervention group did show a slight improvement of the satisfaction of the need for relatedness over time, while in contrast, the control group showed a decrease over time. The satisfaction of the need for autonomy and competence did not significantly differ between both groups over time.

Conclusions: The approach had no significant effect on the primary outcome need for recovery. The intervention did have a significant positive impact on the satisfaction of the need for relatedness, possibly because, after a period of being unable to be close, it provided opportunity to gather and work together as a team.

Objectives: This study investigated the association between combined exposures and hyperglycemia incidence, as well as the dose-response relationship between the duration of night work and hyperglycemia among long-term night workers.

Methods: In this prospective cohort study, 12 716 night workers from the nationwide population were recruited. Hyperglycemia incidence was based on the one-year change in fasting blood glucose levels. Occupational noise exposure was defined as exposure to 8-hour time-weighted average sound levels of ≥85 decibels. Personal factors, including body mass index, and work-related factors, like monthly night work duration, were assessed. Multivariable logistic and linear regression models were used to explore the association.

Results: In the multivariate logistic analyses, each additional day of night work was associated with an increased risk of hyperglycemia [adjusted odds ratio 1.05, 95% confidence interval (CI) 1.02-1.07]. In the normal fasting glucose group, each additional day of night work was associated with a linear increase of +0.07% (95% CI +0.03% - +0.12%) in the change in fasting glucose levels, and noise exposure was associated with a linear increase of +1.34% (95% CI +0.55% - +2.12%) increase in fasting glucose levels. Furthermore, the population exposed to noise and working ≥10 days of night work had a significantly higher increase of fasting glucose levels (β +5.71%, 95% CI +4.48% - +6.95%), with significant interaction effects (P for interaction <0.01).

Conclusions: The possible dose-response relationship between duration of night work and changes in fasting glucose levels was found. The combined exposure to night work and noise posed a higher risk for hyperglycemia than exposure to night work alone.