Scandinavian journal of work, environment & health最新文献

Objectives: We investigated associations between bioaerosol exposures and work-shift changes in lung function and inflammatory markers among recycling workers.

Methods: Inhalable dust was measured with personal samplers and analyzed for endotoxin, bacteria, and fungi (incubated at 25 °C and 37 °C) levels. Lung function (FEV1, FVC) was measured before and after work-shifts and serum concentrations of inflammatory markers (CRP, SAA, CC16, IL1B, IL2, IL4, IL5, IL6, IL8, IL10, IL13, and TNF) after the shift. Associations were explored by linear mixed-effects models.

Results: We included 170 measurements from 88 production workers exposed to inhalable dust, endotoxin, bacteria, and fungi (25 °C and 37 °C) at geometric mean levels of 0.6 mg/m3, 10.7 EU/m3, 1.6×104 CFU/m3, 4.4×104 CFU/m3, and 103 CFU/m3, respectively, and 14 administrative workers exposed at 7-fold lower levels. No associations were observed between bioaerosol exposures and work-shift change in lung function. IL2, IL6, IL10, and TNF concentrations were positively associated with inhalable dust levels, SAA and IL6 with bacteria, CRP, SAA, IL8, and TNF with fungi (25 °C or 37 °C), with the latter being the only statistically significant finding (exp(β) 1.40, 95% confidence interval 1.01-1.96).

Conclusions: This study of recycling workers exposed to bioaerosol levels generally below those of farmers and compost workers and above background levels did not indicate any acute effect on lung function. Several inflammatory markers tended to increase with exposure, suggesting a systemic effect. Future research should combine data from bioaerosol-exposed workers to uncover health risks that may form the basis for health-based occupational exposure limits.

Objective: The aging population of European countries highlights the need for extended working lives. This study aims to investigate facilitators and barriers for working beyond the statutory pension age (SPA).

Methods: Using data from waves 1, 2, 4-9 of the Survey of Health, Ageing and Retirement in Europe (SHARE) (2004-2022), we followed 9131 workers with a mean age of 56.9 [standard deviation (SD) 3.5] years from 26 European countries until they surpassed the SPA for their respective country, sex and year of participation. Using robust Poisson regression, we modelled the prospective association of work factors, lifestyle, health, and demographics at baseline with working at least one year beyond the SPA.

Results: Participants were followed for 9.5 (SD 3.9) years. After surpassing the SPA by at least one year, 18% were still working. Among the work factors, opportunities for skill development [risk ratio (RR) 1.20, 95% confidence interval (CI) 1.07-1.34] and recognition at work (RR 1.13, 95% CI 1.01-1.26) facilitated working beyond SPA, while time pressure (RR 0.89, 95% CI 0.81-0.97) and poor prospects for job advancement (RR 0.76, 95% CI 0.70-0.83) were barriers. For the other factors, smoking was negatively associated with working beyond the SPA, while living in the northern part of Europe, higher level of education, and being divorced or separated were positively associated with working beyond the SPA.

Conclusion: This prospective cohort study across 26 European countries identified four modifiable work factors that influenced working beyond the SPA. Addressing modifiable barriers and facilitators at the workplace and through public health initiatives could help extend working lives in Europe.

Objectives: This study aimed to examine (i) if work-to-family conflicts (WtFC) and family-to-work conflicts (FtWC) are associated with sickness absence due to mental disorders and (ii) whether these associations are different among health and social care (HSC) employees compared to other municipal employee sectors.

Methods: The Helsinki Health Study survey data collected in 2017 among 19-39-year-old female municipal employees (N=2557) were prospectively linked to administrative Social Insurance Institution of Finland register data on long-term sickness absence due to mental disorders (SA-MD) covering a follow-up of up to five years. The associations of WtFC and FtWC and SA-MD were analyzed using Cox regression models stratified by employment sector (HSC, education, other), adjusting for sociodemographic and health-related covariates.

Results: Of HSC employees, 16% had SA-MD during the follow-up, which surpassed the figures for employees in education (12%) and other (11%) sectors. In the HSC sector, the youngest employees had the highest prevalence of SA-MD and, among HSC employees, prior SA-MD was the most common. In Kaplan-Meier curves, the steepest increase in SA-MD was observed for HSC employees. WtFC [hazard ratio (HR) 1.84, 95% confidence interval (CI) 1.39-2.45] and FtWC (HR 1.78, 95% CI 1.32-2.40) were associated with SA-MD among HSC employees. The associations were rather similar for employees in education and other sectors. Adjusting for work-related factors and health history somewhat attenuated the associations.

Conclusions: Better possibilities to combine work and family life might aid in preventing SA-MD in all employment sectors.

Objective: In this discussion paper, we close our 2024 series reflecting on the successes, failures, and promises of occupational health and safety research in celebration of the 50th anniversary of the Scandinavian Journal of Work, Environment & Health (SJWEH). This paper aims to elaborate on the future of our research field.

Methods: We conducted a narrative review of lessons learned in the series, examining insights gained and key takeaways. Additionally, we explored the current and anticipated agendas of major institutions, including the World Health Organization and the European Union, on occupational health and safety, as well as potential developments in the academic publishing industry.

Results: Occupational health and safety research has significantly evolved over the last 50 years, emphasizing longitudinal study designs, enriching observational data with registry-based information, and expanding the scope of hazardous determinants impacting workers` health. Novel statistical approaches have further enabled researchers to address complex associations, such as mediation effects, and to strengthen causal inference in observational studies. At the same time, the publishing business is changing rapidly, with artificial intelligence poised to reshape both research practices and the landscape of academic publishing.

Conclusion: In the changing landscape of research and academic publishing, our goal is for SJWEH to continue to be a leading source of high-quality research dedicated to protecting and improving workers' health. We are curious and excited to see where all these current and anticipated changes will lead in the years to come.

Objective: This study systematically reviewed and meta-analyzed the differential attrition and utilization of occupational mental health interventions, specifically examining delivery methods (internet-based versus in-person).

Methods: The research, with papers spanning 2010-2024, involved filtering criteria and comprehensive searches across PubMed, Scopus, and Web of Science Core (PROSPERO registration n. CRD42022322394). Of 28 683 titles, 84 records were included in the systematic review, with 75 in meta-analyses. Risk of bias was assessed through the revised Cochrane risk of bias tool for randomized control trials and funnel plots. Differential attrition across studies was meta-analysed through a random-effects model with limited maximum-likelihood estimation for the degree of heterogeneity.

Results: Findings reveal higher mean differential attrition in the intervention group, indicating a potential challenge in maintaining participant engagement. The attrition rates were not significantly influenced by the mode of intervention delivery (internet versus in-person). Compensation for participation and year of publication could potentially influence differential attrition from baseline to follow-up measurements.

Conclusions: These results suggest a need for cautious consideration of attrition in occupational mental health intervention study designs and emphasize the importance of adapting statistical analyses to mitigate potential bias arising from differential attrition.

Objectives: This study aimed to investigate the reach of a large-scale health assessment delivered by the occupational health service in Sweden for almost 30 years.

Methods: A total of 418 286 individuals who participated in a health assessment (Health Profile Assessment, HPA) between 1995-2021 were included. A comparative sample was obtained from Statistics Sweden, comprising the entire working population for each year (4 962 127-6 011 829 unique individuals per time period). Sociodemographic and work organization characteristics were compared between the HPA and comparative population for six different periods. Under- and overrepresented groups in the private and public sectors were identified using the most recent data (2015-2021).

Results: With negative per cent indicating underrepresentation, the most notable changes over time in representation in the HPA population compared to the comparative were observed for women (-1.2% to -12.8%), private sector employees (-9.4% to 14.9%), individuals with ≥3 years of employment (14.5% to 0.9%), in personal care (0.8% to -8.8%) and manufacturing (0.7% to 6.4%) occupations. Consistently overrepresented groups (median representation across periods) included individuals who had a single income source (6.3%) and were middle-aged (10.8%), born in Sweden (5.9%), associate professionals (8.7%), and employed in companies with high operating profit (17.9%) and low staff turnover (14.3%). Conversely, individuals with low income (-34.0%) and employed in small companies/organizations (-10.9%) were consistently underrepresented. Middle-aged women in education occupations were most underrepresented in the public sector, while in the private sector, it was young women in service and shop sales occupations.

Conclusions: This health assessment has reached many professionals, including hard-to-reach groups, but did not fully represents the Swedish workforce throughout the years.

Objectives: This study aimed to develop and evaluate a job-exposure matrix (JEM) specific to healthcare workers, JEM Soignances, based on self-reported data.

Methods: The JEM was constructed using data from healthcare workers within the CONSTANCES cohort (N=12 489). Job titles and sectors of activity (eg, hospital activities) defined occupational groups. We assessed 24 exposures covering organizational, psychosocial, physical, chemical and biological factors. Several methods (group-based frequency, CART, random forest, extreme gradient boosting machine) were applied using a 70% training sample. Performance was evaluated on the remaining 30% using area under the ROC curve (AUC) and Cohen's Kappa (κ). Two alternative JEM were proposed using only job titles or adding healthcare establishment size and type (public/private) to define occupational groups.

Results: All methods offered similar discriminatory power (AUC). We selected the group-based frequency method as it was the most understandable and easiest to implement. Of the 24 included exposures, 15 demonstrated satisfactory performance, with nine showing good discriminatory power and fair-to-moderate agreement, such as physical effort at work (AUC=0.861, κ=0.556), ionizing radiation exposure (AUC=0.865, κ=0.457), carrying heavy loads (AUC=0.840, κ=0.402), shift work (AUC=0.807, κ=0.383), and formaldehyde exposure (AUC=0.847, κ=0.289). The remaining nine exposures mainly showed poor-to-moderate discriminatory power and poor agreement. Compared to JEM Soignances, the job title-only JEM performed poorly, while the one incorporating healthcare establishment size and type showed similar results.

Conclusions: JEM Soignances provides good internal performance and validity. Future research will assess its external validity by comparing it with existing JEM and examining its predictive validity regarding known associations between exposures and health outcomes (eg, long working hours and strokes).

Objective: This study aimed to investigate whether physical work demands modify the effect of the selfBACK app, which is designed to support self-management of low-back pain.

Methods: In a secondary analysis of the selfBACK trial with 346 employed participants, we stratified into low (N=165) and high physical work demands (N=181). Outcomes included the Roland-Morris Disability Questionnaire (0-24), a numeric rating scale for low-back pain intensity (0-10), the Pain Self-Efficacy Questionnaire (0-60), and work ability (0-10). Intervention effects were assessed at three- and nine-month follow-ups using a linear mixed model.

Results: At three months, high physical demand workers with selfBACK showed a significant reduction in pain intensity [-0.8, 95% confidence interval (CI) -1.3- -0.2] compared to usual care. By nine months, the high physical demands workers with selfBACK reported reduced pain-related disability (-1.4, 95% CI -2.7- -0.1), improved pain self-efficacy (3.5, 95% CI 0.9-6.0), and lower pain intensity (-1.0, 95% CI -1.6- -0.4) compared to usual care. Low physical demands workers with selfBACK also improved pain self-efficacy [2.8 (95% CI 0.3-5.3)] compared to usual care. The impact of selfBACK was more noticeable among workers with high physical demands compared to their low physical demand counterparts, but no statistically significant differences were found in any outcome.

Conclusions: The selfBACK intervention had consistent effects across workers with high and low physical work demands, indicating that these demands did not modify its impact. Both groups experienced similar positive effects, highlighting the intervention's effectiveness across varying levels of physical work demands.

Objectives: Return to work (RTW) of workers with mental disorders is often a process of gradually increasing work hours over time, resulting in a RTW trajectory. This study aimed to investigate 2-year RTW trajectories by mental disorder diagnosis, examining the distribution of age, sex and contracted work hours across the diagnosis-specific RTW trajectories.

Methods: Sickness absence episodes diagnosed within the ICD-10 chapter V (mental and behavioral disorders) and ICD-10 Z73.0 (burnout) were retrieved from a Dutch occupational health service register, together with age, sex and contracted work hours. Sickness absence episodes due to adjustment disorders (N=25 075), anxiety disorders (N=1335), burnout (N=3644), mood disorders (N=5076), and post-traumatic stress disorders (N=2393) were most prevalent and included in latent class growth analysis (LCGA) to estimate 23-month RTW trajectories.

Results: Four main RTW trajectories were identified for all mental disorder diagnoses: fast full RTW [range 82.4% (mood disorders) to 92.0% (adjustment disorders) of the study population], slow full RTW [3.5% (burnout) to 6.1% (mood disorders)], slow partial RTW [0.6% (adjustment disorders) to 1.6% (mood disorders)] and no RTW [2.2% (adjustment disorders) to 9.7% (mood disorders)]. Trajectories with a late onset of fast full RTW included higher percentages of women and lower percentages of full-time workers.

Conclusions: RTW trajectories were similar for different mental disorder diagnoses although the distribution differed across diagnoses, with more partial and no RTW trajectories among workers with mood disorders. To better guide workers back to work, more knowledge is needed of factors associated with late, partial, or no RTW.