Scandinavian journal of work, environment & health最新文献

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: 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.

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.

Objectives: This study aimed to describe how minority stress and employment discrimination are associated with job quality (ie, employment type and income) among sexual- and gender-minority (SGM) workers.

Methods: We conducted a pooled cross-sectional analysis of the 2021 and 2022 surveys from a national study of SGM adults in the United States. Using multinomial logistic regression models and stratification by six gender groups, we examined associations of minority stress and past-year employment discrimination with job quality.

Results: Among 4221 workers, 22.0% experienced precarious employment and 6.8% were unemployed. Approximately half earned ≤US$50 000. The mean minority stress score was 14.41, indicating moderate-to-severe minority stress. A one-standard-deviation increase in minority stress was associated with higher odds of precarious employment [adjusted odds ratio (OR_adj) 1.17, 95% confidence interval (CI) 1.08-1.26], unemployment [OR_adj 1.36 (95% CI 1.19-1.56)], earning ≤$20 000 USD [OR_adj 1.57 (95% CI 1.36-1.80)], and earning US$20 001-50 000 [OR_adj 1.48 (95% CI 1.32-1.66)]. Employment discrimination was reported by 14.4% of all workers and was associated with precarious employment [OR_adj 1.25 (95% CI 1.01-1.54)], unemployment [OR_adj 2.11 (95% CI 1.54-2.89)], and earning US$20 001-50 000 compared to ≥US$100 001 [OR_adj 1.45 (95% CI 1.07-1.96)]. Transgender and gender-diverse (TGD) workers faced poorer job quality, greater minority stress, and employment discrimination than cisgender sexual minority workers.

Conclusions: Higher minority stress levels and employment discrimination were associated with worse job quality among SGM workers. Future labor market reforms should reduce minority stress and employment discrimination, as well as improve job quality, for SGM workers.

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: Many employees combine their work with informal care responsibilities for family and friends, potentially impacting their well-being and sustained employability. This study aimed to investigate the effectiveness of a workplace participatory approach (PA) intervention in supporting working caregivers to prevent and solve problems related to balancing work, private life, and informal care tasks.

Methods: We conducted a two-armed randomized controlled trial (ISRCTN15363783) in which working caregivers either received the PA (N=57), under guidance of an occupational professional serving as process facilitator, or usual care (N=59). We recruited 125 working caregivers from four Dutch organizations. Questionnaire-based measurements were assessed at baseline, 4, and 7 months. The primary outcome was work-life imbalance. Secondary outcomes were perceived social support from supervisors and colleagues, role overload, distress and perceived burden of combining work and informal care. Intervention effects were analyzed using intention-to-treat analysis and linear mixed models.

Results: The PA was not effective in reducing work-life imbalance, improving support from colleagues or reducing role overload, distress and perceived burden of combining work and informal care. However, the PA significantly improved perceived social support from supervisors at 4 months [β=0.54, 95% confidence interval (CI) 0.21-0.88] and 7 months (β=0.36, 95% CI 0.02-0.70). Interaction effects indicated that improvement in supervisor support varied depending on the organization.

Conclusion: The PA improved supervisor support but not work-life imbalance. Further research should explore PA effects on working caregivers with and without balance issues and the role of supervisor support in reducing work-life conflict.

Objective: This systematic review and meta-analysis aimed to identify risk factors for unemployment among middle-aged workers.

Methods: Searches were carried out in PubMed, Web of Science and Google Scholar until November 2024, focusing on observational longitudinal studies that involved workers aged 40-64 years. Three reviewers evaluated the quality of the studies. A random-effects meta-analysis was employed, and heterogeneity and publication bias were assessed.

Results: Out of 10 432 reports, 19 longitudinal studies (N=374 585 participants) were included in the review. The meta-analysis identified multiple risk factors associated with unemployment, including suboptimal self-rated general health [hazard ratio (HR) 1.44, 95% confidence interval (CI) 1.21-1.70], mental health conditions [HR 1.48, 95% CI 1.30-1.68, particularly depressive symptoms (HR 1.42, 95% CI 1.14-1.76)], low job control (HR 1.30, 95% CI 1.17-1.43), and lack of physical activity (HR 1.56, 95% CI 1.13-2.15). Additionally, a higher risk of unemployment was observed among individuals with ≤12 years of education (HR 1.17, 95% CI 1.00-1.36), those who are unmarried, separated, or widowed (HR 1.43, 95% CI 1.14-1.79), and immigrants (HR 1.26, 95% CI 1.11-1.44). Age, gender, smoking, alcohol consumption, musculoskeletal disorders, cardiovascular and respiratory diseases, digestive diseases, diabetes, neoplasm, and limitations in daily activities did not increase unemployment risk.

Conclusions: This meta-analysis highlights the impact of mental health conditions, low job control, and lack of leisure-time physical activity on unemployment risk among middle-aged workers. Interventions aimed at improving mental health and increasing job control and physical activity could reduce unemployment risk.

Objectives: This individual participant data meta-analysis investigates the association between occupational physical activity (OPA) and both cardiovascular mortality and all-cause mortality across different cardio-respiratory fitness (CRF) groups among male workers.

Methods: Data were pooled from five European cohort studies. OPA was categorized into three levels and CRF into low, moderate, and high tertiles. OPA was assessed using self-reports and CRF through objective measurements. Two-stage meta-analyses were conducted. First, we analyzed each cohort using Cox-regression models then we pooled results with random effects model to evaluate the associations between OPA and both cardiovascular and all-cause mortality, stratified by CRF. Models were adjusted for age, body mass index, smoking status, leisure-time physical activity, and educational level.

Results: Among 9922 men (mean age 46.8, standard deviation 6.7, years), 55.7% died during an average 25.6-year follow-up, of which 29.3% died from cardiovascular causes. Individuals with low CRF and high levels of OPA showed increased risks of cardiovascular [hazard ratio (HR) 1.27, 95% confidence interval (CI) 1.04-1.55] and all-cause mortality (HR 1.22, 95% CI 1.07-1.40) compared to those with low CRF and low levels of OPA. High CRF mitigated cardiovascular mortality risk (HR 1.08, 95% CI 0.79-1.48) but not all-cause mortality (HR 1.27, 95% CI 0.98-1.83) for those with high OPA.

Conclusions: Our findings for cardiovascular mortality suggest that high CRF levels may protect workers with physically demanding jobs from adverse cardiovascular outcomes, supporting the 'fit for work' principle. However, this protective effect was not observed for all-cause mortality.