Journal of Occupational Medicine and Toxicology最新文献

Background: Employees in social work exhibit high rates of sick leave due to mental health issues. Additionally, work-related demands in youth welfare have increased in recent years. Particularly in light of the escalating shortage of skilled professionals in this field, this trend becomes especially critical. The aim of this study is to systematically examine health-relevant working conditions, coping strategies, and health indicators in youth welfare. A special focus is placed on a differentiated analysis of job-related characteristics in the context of outpatient and residential youth welfare.

Methods: Mean values, standard deviations and the reliability of scales are measured. In addition to descriptive statistics, t-tests for analyzing mean differences, as well as correlation analyses and odds ratios as measures of association, are computed.

Results: A total of N = 1044 employees in youth welfare participated in the online survey. Among them, 671 individuals belonged to the field of residential youth welfare, and 373 to outpatient youth welfare. The results indicate that, in youth welfare in general, a variety of emotional, social, qualitative, and quantitative demands exhibit high levels. The comparison between outpatient and residential youth welfare reveals differences in half of the demands. The significant differences are observed for social demands and aggression from clients, which are statistically significant higher in the residential setting. Regarding resources, the most significant difference is observed for autonomy, which is higher in the outpatient setting. Overall, the association patterns reveals more similarities than differences between outpatient and residential settings. In both settings working conditions seem to have deteriorated during the pandemic.

Conclusions: In conclusion, the identified job-related characteristics in outpatient and residential youth welfare exhibit more similarities than differences. Nevertheless, the identified differences provide insights into the specific features of each work context, offering valuable starting points for targeted health promotion in practice.

Trial registration: This trial is recorded at the Hamburg University Ethics Committee (AZ 2022_027).

Background: Almost all paramedics encounter workplace violence (WPV) during their careers. The most common form of WPV is verbal, and the perpetrator is usually the patient. It is known that paramedics suffer from post-traumatic stress disorder and other mental health problems, and WPV is one of the reasons behind that. Nevertheless, little is known about the recovery processes paramedics have had after encountering WPV. The research question was: What kind of recovery processes have paramedics had after encountering WPV?

Methods: A qualitative, narrative interview study was done. Data was collected in individual interviews with Finnish paramedics (n = 18). Paramedics were from different parts of Finland, and their ages varied from 24 to 49 years. They had been working in EMS for an average of 10.5 years (range 1.5 to 25 years). Interviews were conducted with a narrative approach, which enabled paramedics to narrate their experiences and speak on their own terms about the subject to the extent of their choosing. The data was analyzed using thematic analysis.

Results: Ten recovery process themes were identified: Strong psychological and physical reactions in a short time frame, Questioning one's profession and actions, Various support structures aided in recovery, Dysfunctional processes hindered recovery, Personal resources provided support, The support of the workcommunity as a lifeline, Left to cope alone, Permanent changes to work routines, Resulting in professional growth and Eternal crack in the shell.

Conclusions: Many internal and external factors affect paramedics' recovery processes. While some receive adequate help, others struggle to get appropriate support, especially from their organization and supervisors. The findings of this study suggest that clear protocols should be established to help paramedics recover after encountering WPV and that an individual aspect should be kept in mind, as not everybody reacts in the same way.

Background: Due to climate change, the increasing frequency of hot summer days and heat waves can result in occupational heat strain, especially in non-air-conditioned workplaces. Healthcare workers (HCW) engaged in patient care are particularly affected, as they are additionally exposed to physical stress. The use of personal protective equipment (PPE) can aggravate heat strain in HCW. This study aimed to examine the subjective well-being of HCW when exposed to heat and PPE under controlled conditions.

Methods: This study was designed as a randomized crossover trial. Participants performed standardized healthcare tasks in a climatic chamber for approximately 3.5 h at different indoor temperatures (22 °C and 27 °C) and varied working conditions (with or without PPE). The effects on participants' subjective well-being, encompassing thermal, physiological and psychological stress were assessed using a customized questionnaire.

Results: Heat had a greater effect than PPE on thermal, physical and psychological stress. Conversely, PPE had a greater effect on physical demand and effort. For the majority of outcomes, combined exposure to heat and PPE resulted in the highest perceived discomfort. Furthermore, the participants reported increased sweating and other discomforts when working at elevated temperatures or with PPE.

Conclusions: In this study, heat and PPE, but particularly the combination of both factors, were identified as unfavorable working environments. Although the trials were conducted in a controlled environment, the outcomes provide valuable information about the effect of heat and PPE on HCW in a real-life setting. Furthermore, the design used in this study can be beneficial in evaluating the effect of mitigation strategies.

This updated guideline replaces the "Guideline for the application of heart rate and heart rate variability in occupational medicine and occupational health science" first published in 2014. Based on the older version of the guideline, the authors have reviewed and evaluated the findings on the use of heart rate (HR) and heart rate variability (HRV) that have been published in the meantime and incorporated them into a new version of this guideline.This guideline was developed for application in clinical practice and research purposes in the fields of occupational medicine and occupational science to complement evaluation procedures with respect to exposure and risk assessment at the workplace by the use of objective physiological workload indicators. In addition, HRV is also suitable for assessing the state of health and for monitoring the progress of illnesses and preventive medical measures. It gives an overview of factors influencing the regulation of the HR and HRV at rest and during work. It further illustrates methods for measuring and analyzing these parameters under standardized laboratory and real workload conditions, areas of application as well as the quality control procedures to be followed during the recording and evaluation of HR and HRV.

Background: Hip osteoarthritis (HOA) is a leading cause of disability increasing with age and is more prevalent in women and in various physically demanding occupations. This systematic review identifies and summarises occupational exposures for women in physically demanding occupations and discusses sex differences and consequences.

Methods: In this systematic review, we searched various electronic databases for reports published between date of database inception and October 2022. We included cohort studies and case-control studies that assessed the association between exposure to physically demanding occupations and the development of HOA. We then assessed the methodological quality of selected studies, extracted relative effects, compared the risk for women and men and meta-analytically reviewed the effects of physically demanding occupations. All steps were based on a study protocol published in PROSPERO (CRD42015016894).

Results: We included six cohort studies and two case-control studies in this systematic review. These studies showed a considerably increased risk of developing HOA in both sexes. Women working in traditionally female-dominated occupations such as cleaning, sales, catering, childcare and hairdressing that are physically demanding, have a higher risk of developing HOA than men in similarly physically demanding occupations. Conversely, in traditionally male-dominated occupations with a high heterogeneity of work activities, such as agriculture, crafts, construction, as well as in low-skilled occupations, the risk was higher for men. One exception are health occupations, which are grouped together with a wide range of other technical occupations, making it difficult to draw conclusions.

Conclusions: Existing studies indicate an association between various occupations with a high physical workload and an increased risk of developing HOA. Occupational prevention and individual health promotion strategies should focus on reducing the effects of heavy physical workloads at work. The aforementioned as well as early detection should be specifically offered to women in female-dominated occupations and to people working in elementary occupations.

Introduction: Sedentary behavior (including prolonged sitting) is a form of physical inactivity that has a negative impact on health, possibly including musculoskeletal complaints (MSCs). The purpose of this study was to determine the extent to which time spent sitting at work is associated with the one-year prevalence of MSCs in the neck, shoulder, upper back/thoracic spine, and lower back among workers from the Study of Mental Health in the Workplace (S-MGA). In addition, the study also examined whether leisure time, physical activity, and sex modify the relationship between occupational sitting and MSCs.

Methods: For this analysis, we used the S-MGA, a 5-year prospective study in Germany. The S-MGA is a nationwide representative employee cohort study with a baseline survey in 2012 and a follow-up survey in 2017. Sitting at work was measured using a question asked at baseline. The Nordic Musculoskeletal Questionnaire was used to determine the one-year prevalence of MSCs in the neck, shoulder, upper back, and lower back pain (yes/no). The assessment of MSCs was only conducted at the 2017 follow-up. Adjusted Poisson regression models were used to determine the association of baseline level of weekly hours spent sitting at work with MSCs during follow-up. In addition to unadjusted models, models were adjusted for demographic (age, sex, body mass index and occupational skill level), occupational (heavy lifting at work), psychological disorders and lifestyle factors (smoking status and leisure time physical activity), as well as preexisting musculoskeletal conditions reported at baseline. To examine whether the relationship between sitting time and pain was modified by sex and leisure time physical activity, the models were stratified for both these variables.

Results: Among the participants analyzed (n = 2,082), 49.8% were male, while 50.2% were female, and more than 60% of the study population spent over half of their working hours in a sitting position. Exposure to increased sitting at work reported at baseline was not consistently associated with 12-month prevalence of MSCs in the upper body at follow-up. However, differences in the association between occupational sitting and MSCs were dependent on the intensity of leisure time physical activity. Prevalence ratios (PRs) indicated an increased prevalence of MSC in the neck (PR = 1.46; 95% CI = 1.18-1.80) and shoulder (PR = 1.30; 95% CI = 1.03-1.64) in workers without leisure time physical activity who spent 25 to < 35 weekly working hours sitting.

Discussion: These findings suggest that leisure time physical activity interacts with the relationship between sitting at work and MSCs. The relationship between sitting at work and musculoskeletal pain needs further investigation, but we found indications that leisure time physical activity may counter the effects of sitting at work.