Scandinavian journal of work, environment & health最新文献

Objectives: Excess incidence of prostate cancer (PC) is frequently observed among firefighters; however, the association with specific occupational exposures of firefighting, as well as the influence of a medical surveillance bias, remains unclear. Our aim was to study PC risk within a firefighter cohort, applying indicators of exposures.

Methods: We used indicators of various firefighting exposures to examine PC risk among men in the Norwegian Fire Departments Cohort (N=4251). Incident PC cases, including clinical characteristics, were obtained from the Cancer Registry of Norway (1960-2021). Cox regression was used to estimate hazard ratios (HR) by cumulative exposure in tertiles (reference: lowest) for all, aggressive, and indolent PC, with adjustment for age and birth cohort. The cumulative incidence of PC across birth cohorts and diagnostic periods was examined.

Results: No clear associations emerged for any of the exposure indicators, although we observed an HR of 1.31 [95% confidence interval (CI) 0.63-2.72] for aggressive PC in the highest tertile of fire exposure score and 1.31 (95% CI 0.60-2.89) for indolent PC in the highest tertile of inhalation score. Assessment of cumulative incidence demonstrated a greater number of diagnoses at younger ages after 1990, particularly for indolent and unclassifiable PC.

Conclusions: We found little support for an association between firefighting exposures and PC risk. However, our study had few cases in analyses by clinical stage. Challenges in studies of firefighters' PC risk remain, including difficulties in exposure characterization and the unclear magnitude of a medical surveillance bias.

Objectives: This study aimed to investigate the association between working behaviors and sensorineural hearing loss (SNHL).

Methods: A cross-sectional analysis was conducted (N=90 286) to assess the association between working behaviors (including shift work, night shift work and physically demanding work) and the occurrence (yes/no), laterality (unilateral/bilateral), and severity (mild/severe) of SNHL. A prospective analysis was conducted to explore the association between new-onset SNHL and working behaviors (N=8341). Multivariable logistic regression and Cox regression models were performed. Subgroup analyses were further carried out, stratified by age, sex, and chronotype. Furthermore, a polygenic risk score (PRS) was calculated to assess the influence of genetic susceptibility on the relationship.

Results: Cross-sectional analysis indicated that shift work, night shift work and physically demanding work were all associated with an increased risk of SNHL (all P<0.05). These working behaviors were also associated with increased severity of SNHL (all P<0.05) and a higher likelihood of bilateral SNHL (all P<0.05). In prospective studies, the trends were generally consistent with the aforementioned results. Furthermore, the relationship between night shift work and SNHL was particularly pronounced among individuals with morning chronotype (P-interaction=0.007), or with ≤5 years noisy work environments (P-interaction=0.026). Importantly, regardless of the level of genetic risk of PRS, a positive association remained between night shift work and physically demanding work with SNHL.

Conclusions: Both cross-sectional and prospective analysis indicated that shift work, night shift work, and physically demanding work were associated with increased risk of occurrence, laterality and severity of SNHL, regardless of PRS for SHNL.

Objectives: Understanding memory function's role in early workforce exit is key in supporting sustainable employment among ageing workers. This study examined the impact of memory function on early exit from paid employment, analyzed changes in memory function before, during and after such transitions, and assessed memory function trajectories in relation to the presence or absence of effort-reward imbalance at work.

Methods: This study included 16 339 respondents from the Survey of Health, Ageing, and Retirement in Europe (SHARE) between age 50 and the country-specific retirement age. The effects of objective and subjective memory functioning on early exit were assessed using Cox proportional hazards with Fine-Gray sub distribution models. Changes in memory function before and after a transition to non-employment were assessed using generalized linear mixed-effects models. These changes were described and compared based on exposure to job effort-reward imbalance.

Results: Workers with poor subjective memory were 2.3 times more likely to exit employment prematurely due to disability ([sub-distribution hazard ratio (SHR) 2.30, 95% confidence interval (CI) 1.77-3.00] and 1.3 times more likely to exit through unemployment (SHR 1.29, 95% CI 1.06-1.55). Workers with low objective memory were 1.6 times more likely to exit through unemployment (SHR 1.56, 95% CI 1.30-1.87). Subjective memory generally declined prior to, and during early exit from paid employment. While subjective memory generally improved post-exit, objective memory function declined after exiting. An accelerated decline in objective memory functioning was noted among early retirees who had been exposed to effort-reward imbalance at work (β -0.45, standard error 0.16).

Conclusion: Workers with poor memory function are at higher risk of early involuntary exit from paid employment. Promoting memory function and balancing job efforts and rewards may help mitigate the risk of a premature exit.

Objective: This study investigates the association between parental precarious employment (PE) and the mental health of their adolescent children, with a particular focus on how the association differs based on whether the mother or father is in PE.

Methods: This register-based study used the Swedish Work, Illness, and Labor-market Participation (SWIP) cohort. A sample of 117 437 children aged 16 years at baseline (2005) were followed up until 2009 (the year they turned 20). A multidimensional construct of PE (SWE-ROPE 2.0) was used to classify parental employment as either precarious, substandard or standard. The outcome, adolescents' mental disorders, was measured as a diagnosis of a mental disorder using ICD-10 codes or by prescribed psychotropic drugs using ATC codes. Crude and adjusted Cox regression models produced hazard ratios (HR) with 95% confidence intervals (CI) to estimate the association between parental PE and adolescents' mental health.

Results: Adolescents with parents in PE exhibited a higher risk of developing mental disorders. The association was more pronounced for paternal PE (HR 1.22, 95% CI 1.10-1.35) compared to maternal PE (HR 1.11, 95% CI 1.00-1.21). These associations largely persisted after adjusting for important confounders, including parental mental health.

Conclusion: This study addresses a significant gap in the literature on parental PE and adolescents' mental health. As PE is growing more common across countries, this study provides relevant insights into the intergenerational role that parental low-quality employment may have in terms of mental health within families.

Objective: Previous research has linked job insecurity to health deterioration. The risk accumulation model suggests that health effects of job insecurity may persist even after job security is restored, yet long-term empirical analyses are scarce. Our study evaluates the long-term effects of accumulated exposures to affective job insecurity on mental and physical health among the working-age population in Germany.

Method: Using data from the German Socioeconomic Panel (12 624 individuals; 84 219 observations), we applied panel regression models with individual fixed effects to assess short- and long-term health changes associated with affective job insecurity. Job insecurity was measured by respondents' worries about job security. Mental and physical health was recorded with the SF-12 scale.

Results: Job insecurity correlated with short-term worsening in mental and physical health. However, after job insecurity ceased, health recovery was incomplete resulting in a long-term health deterioration. The long-term effects were larger among respondents who accumulated more instances of job insecurity, and showed a similar pattern for mental and physical health. An additional analysis documented stronger health effects of job insecurity among lower educated persons.

Conclusion: Our study is one of the first to empirically demonstrate the negative long-term health effects of job insecurity. Our findings for a well-protected labor market like Germany's, suggest that the health risks associated with job insecurity may be substantial and potentially underestimated by studies that focus solely on short-term effects.

Objective: Knee pain is highly prevalent and disabling among the general and working population. This systematic review explored the effectiveness of workplace-based interventions on knee pain among workers.

Methods: A PICO-guided systematic search was performed in PubMed and Web of Science Core Collection for articles published from 2003 until January 2023. Eligible articles included randomized and non-randomized controlled trials assessing the effect of workplace-based interventions on knee pain among currently employed adult workers. The quality assessment and evidence synthesis adhered to the systematic review approach, which the Institute for Work & Health developed, and was focused on developing practical recommendations for stakeholders.

Results: Of the 13 identified studies, 11 medium- and high-quality studies were entered into the evidence synthesis. Importantly, none of the included studies specifically aimed at reducing of knee pain. Still, among the included studies, a strong level of evidence suggested no benefit of workplace-based physical exercise/activity intervention on knee pain. The level of evidence was deemed too uncertain to guide current policy/practices for ergonomic and multifaceted interventions. No intervention types were associated with negative effects on knee pain.

Conclusions: The current evidence-base pertaining to workplace-based prevention and management of knee pain is insufficient to guide effective preventive workplace practice or policy development. Considering the global prevalence and health impact of knee pain, development and implementation of effective workplace interventions aimed at prevention and management of knee pain is needed.

Objectives: Working outside the workplace and ordinary work hours has become common for a larger part of the working population. The objective of the current study was to examine the relationship between working after-hours and employee burnout, musculoskeletal pain, detachment and work-home conflict, delineating the independent effect of four different types of after-hours work, and the moderating role of work-time control.

Methods: The data comprised longitudinal questionnaire data from 1465 full-time employees in Norway across four waves (2021-2022). We examined the link between four types of after-hours work: (i) long daily work hours (>10 hours); (ii) late evening work (after 21:00 hours); (iii) quick returns (<11 hours continued rest); and (iv) long weekly work hours (>40 hours a week) and employee health and wellbeing (ie, work-home conflict, detachment, burnout, and musculoskeletal pain), in fixed effects models. We stratified the analyses by working-time control.

Results: The results support a link between late evening work, long daily and weekly work, and higher work-home conflict and lower detachment as well as between weekly work hours and higher burnout. The findings yielded limited support for work-time control as a moderating factor; the link between quick returns and burnout was only evident for employees with below-average work-time control.

Conclusions: The four types of after-hours work were all independently related to at least one employee outcome, although the link with quick returns was only evident when work-time control was below average. The results are important for practitioners aiming to implement family-friendly and healthy practices.

Hypertension is the foremost risk factor for cardiovascular disease (CVD), which is the leading cause of death globally. In some countries, such as the US, the prevalence of hypertension and working-age CVD mortality are increasing. CVD is also the most common work-related disease worldwide. Long working hours and other psychosocial stressors at work are important modifiable risk factors for hypertension and CVD. However, there has been inadequate attention paid to the primary prevention of work-related hypertension and CVD. The state-of-the art method for blood pressure (BP) measurement is 24-hour ambulatory BP (ABP), necessary for accurate clinical decision making and to assess risk factors for BP elevation. Thus, ABP should be used in workplace screening and surveillance programs (along with surveys) to identify occupational risk factors, high-risk job titles, worksites and shifts, and evaluate programs designed to improve work organization. For example, after 30 months of an organizational intervention designed to lower psychosocial stressors at work among >2000 public sector white-collar workers in Quebec, Canada, BP and prevalence of hypertension significantly decreased in the intervention group, with no change in the control group, and a significant difference between the intervention and control groups. Further research is also needed on mechanisms linking work-related factors to hypertension and CVD, the cardiovascular effects of understudied work stressors, high-CVD risk worker groups, potential "upstream" intervention points, and country differences in working conditions, hypertension and CVD. Important organizational interventions, such as collective bargaining, worker cooperatives, or legislative and regulatory-level interventions, need to be evaluated.

Objectives: Low-quality and precarious employment have been associated with adverse mental health and wellbeing. More evidence is needed on how the quality of employment trajectories - including transitions in and out of unemployment, inactivity, and employment of varying quality - are associated with individuals' mental health over time. This paper aimed to derive a typology of multidimensional employment trajectories and assess associations with mental health in the UK.

Methods: Data from waves 1-9 of the UK Household Longitudinal Study were used (2009-2019). Individuals aged 30-40 at baseline were included (N=1603). Using multichannel sequence and clustering analyses, we derived a typology of employment trajectories across employment statuses and four employment quality indicators. We assessed associations with subsequent psychological distress, accounting for baseline mental health. Changes in average General Health Questionnaire scores are described.

Results: A typology of five trajectory clusters highlighted stable and secure and precarious/low-quality trajectories for both men and women. Women who reported being economically inactive at most waves had higher odds of experiencing psychological distress than did women in 'standard' trajectories, regardless of baseline mental health. Women's scores of psychological distress in the 'precarious' group on average increased along their trajectories characterized by instability and transitions in/out of unemployment, before a move into employment. Men who likely moved in and out of unemployment and economic inactivity, with low probability of paid employment, reported increased psychological distress at the end of follow-up. This may partly be due to pre-existing mental ill-health.

Conclusion: This paper shows the importance of high-quality employment for individuals' mental health over time. Researchers need to consider dynamic associations between employment quality and mental health across the life-course.