Occupational Medicine-Oxford最新文献

Background: Work-related fatigue, combined with shift work and prolonged work hours, has a significant effect, contributing to increasing accident rate by 50-100%.

Aims: To assess the level of work-related fatigue over a 4-week work period among offshore rig oil and gas workers in Indonesia.

Methods: This cohort study evaluated acute fatigue, chronic fatigue, and intershift recovery scores among offshore oil and gas rig workers using the Occupational Fatigue Exhaustion Recovery 15 (OFER15) questionnaire. Fatigue levels were assessed weekly throughout the study duration, which was 4-week work period. Additionally, at the fourth week, participants were asked about psychosocial factors that could be potentially related to fatigue.

Results: Of 67 participants, the average scores of acute and chronic fatigue were 30.0 and 33.3, and the scores had significantly increased over 4 weeks (P < 0.001). The intershift recovery scores statistically significantly decreased over 4 weeks (P < 0.001), and the differences between weeks (Week 1 versus 2, Week 1 versus 3 and Week 1 versus 4) were also statistically significant (P < 0.001). Acute and chronic fatigue scores had a significant positive correlation with psychological job demands and negatively correlated with influence at work and job satisfaction. Over 4 weeks, acute fatigue augmented chronic fatigue, while acute and chronic fatigue demanded a longer recovery.

Conclusions: Workers at the offshore rig experienced work fatigue during their on-duty periods, with the level of fatigue significantly increasing over the 4 weeks. Comprehensive fatigue management at offshore rigs is vital to mitigate work fatigue and minimize the risk of work-related accidents.

Background: Pilot Peer Support Programs (PPSP) have been introduced in Europe as a measure to facilitate commercial pilots' mental health help-seeking in a confidential and non-punitive manner. However, research is scarce regarding what promotes and prevents pilots from approaching PPSP.

Aims: To investigate if, and in which way, different organizational and individual factors are associated with pilots' attitudes towards approaching PPSP, and to examine the prevalence of possible cases of depression and anxiety disorders among commercial pilots in Europe.

Methods: Data were collected using an anonymous web-based survey (n = 4494), covering pilots' work conditions, health and flight safety. Logistic regression was used to determine the impact of objective and psychosocial work environment factors, mental health factors, and demographic factors.

Results: Key findings were that just culture (odds ratio [OR] = 2.65, 95% confidence interval [CI] 1.97, 3.56), type of employment (OR = 0.60, 95% CI 0.46, 0.78), minimum guaranteed pay (OR = 1.98, 95% CI 1.48, 2.65), and symptoms of depression (OR = 0.62, 95% CI 0.50, 0.76) and anxiety (OR = 0.66, 95% CI 0.54, 0.80) significantly predicted pilots' attitude towards approaching PPSP. The prevalence of pilots scoring above threshold for possible depression (18%) and anxiety disorders (23%) were determined.

Conclusions: Pilot Peer Support in its current form appears to be an insufficient means to facilitate pilots' mental health help-seeking, but could have an important preventive purpose. The findings could assist authorities and operators in developing measures to facilitate pilots' help-seeking, and improve mental health and flight safety.

Background: Personal protective equipment (PPE) is vital for firefighters' safety and effectiveness during daily operations. However, concerns have emerged about its potential impact on firefighters' anaerobic fitness (AF), which is crucial for their operational readiness. The Physical Ability Test (PAT) is used to assess readiness, but there is inconsistency among fire departments regarding whether PAT is conducted with full PPE or regular exercise clothing. This variation in testing conditions may exacerbate the stress on firefighters' AF.

Aims: To analyse differences in firefighters' AF performance while wearing full PPE compared to regular exercise clothing.

Methods: We studied two cohorts totalling 62 firefighters from specific fire departments in South Florida. We conducted occupation-specific AF tests, including handgrip dynamometry (HG), vertical jump (VJ), Margaria-Kalamen (MK), and a 300-yard shuttle run (300YD), both with full PPE (WPPE) and without PPE (NPPE). We adjusted AF variables for body weight (e.g. NPPE) and occupational weight (e.g. WPPE) and used a repeated-measures design in Jamovi (P < 0.05).

Results: Wearing WPPE significantly reduced relative HG strength by 59%, VJ peak power by 11%, and MK mean power by 49%, while increased 300YD completion time by 18%.

Conclusions: The study reveals that PPE substantially impairs firefighters' anaerobic performance during occupation-specific tests. This emphasizes the need for tailored AF training programs to support the anaerobic system and related performance while wearing PPE, acknowledging the significance of occupational specificity in assessing firefighters' fitness components.

Background: The high prevalence of burnout among Swedish physicians may have several possible effects on individuals and society. However, further investigations of work-related factors associated with the risk of burnout among Swedish physicians are needed.

Aims: We aimed to study the associations between psychosocial work factors, based on the effort-reward imbalance (ERI) model, and the risk of burnout among Swedish physicians.

Methods: A representative sample of 7200 Swedish physicians was invited in 2021. Data were gathered through questionnaires, with a response rate of 41%. Logistic regression models were used to study the associations between exposure to ERI and the risk of burnout.

Results: Approximately 62% of Swedish physicians were exposed to a high ERI. Exposure to a high ERI was associated with 11 times increased risk (95% confidence interval 6.5-20.0) of burnout in adjusted models. Large variations in the prevalence of ERI and risk of burnout across sociodemographic and occupational factors were identified, particularly across different clinical specialties.

Conclusions: A majority of Swedish physicians were exposed to high levels of work-related stress, strongly associated with an increased risk of burnout. This population-based cross-sectional study underlines the need to further study variations of work-related stress across clinical specialties and to monitor occupational health among physicians longitudinally.

Background: Previous studies have suggested that firefighters, police officers and civil servants in the education sector, particularly in Western countries, are vulnerable to mental stress and disorders; however, evidence for this association in South Korea is lacking.

Aims: This study aimed to identify whether firefighters, police officers and teachers are at a higher risk for occupational mental health disorders.

Methods: We used workers' compensation claims from civil servants (2009-18). Our target population comprised 46 209 civil servants (9009 civil servants in administrative and technical positions, 23 107 police officers, 4417 firefighters and 8676 civil servants in the educational sector). Occupational and environmental medicine physicians and medical doctors defined and confirmed mental disorders. We conducted Cox proportional hazards regression analyses to evaluate civil servants' risk of occupational mental health disorders.

Results: Compared with the civil servants in administrative and technical positions, civil servants in the education sector (hazard ratio [HR] = 2.16; 95% confidence interval [CI]:1.65-2.84) showed a statistically significant increased risk of mental disorders; conversely, firefighters did not (HR = 0.80; 95% CI 0.51-1.27). Police officers had a significantly decreased mental disorder risk compared with civil servants in administrative and technical positions (HR = 0.17; 95% CI 0.11-0.25).

Conclusions: The risk of occupational mental health disorders was higher in civil servants in the education sector but lower in police officers and firefighters than civil servants in administrative and technical positions. Further studies on civil servants' mental health awareness are required to confirm our results.

Background: The World Health Organization recommends systematic chest X-ray (CXR) screening for tuberculosis (TB) in silica-exposed workers. However, evidence on the accuracy of CXR screening in such populations is lacking.

Aims: To measure the accuracy of CXR screening for active TB in silica-exposed miners, in a population with a high prevalence of silicosis, post-TB lung disease and HIV.

Methods: A secondary analysis of data from a miner screening programme in Lesotho was undertaken. We measured the performance of CXR (in participants with and without cough) for 'abnormalities suggestive of TB' against Xpert MTB/RIF (Xpert). The sample size was 2572 and positive Xpert prevalence was 3%.

Results: CXR alone had high sensitivity (0.93, 95% confidence interval [CI] 0.87-0.99), but low specificity (0.41, 95% CI 0.39-0.42). Requiring cough and a positive CXR increased specificity (0.79, 95% CI 0.77-0.81), resulting in reduced sensitivity (0.41, 95% CI 0.30-0.52). There was no difference in CXR accuracy by HIV status. However, specificity was markedly reduced in the presence of silicosis (from 0.70, 95% CI 0.68-0.72, to 0.03, 95% CI 0.02-0.04) or past TB history (from 0.59, 95% CI 0.56-0.62 to 0.27, 95% CI 0.25-0.29). Throughout, positive predictive value remained very low (5%) and negative predictive value very high (99%).

Conclusions: CXR screening accurately identifies TB-negative CXRs in this population, but post-TB lung disease and silicosis would result in a high proportion of Xpert-negative referrals and an increased risk of unneeded empirical treatment. Adapted screening algorithms, practitioner training and digital access to previous mining CXRs are needed.

Background: Individuals with severe mental illness experience greater unemployment and barriers to workforce re-entry. However, less is known about additional indicators of employment stability for individuals across mental illness severity.

Aims: This study aims to examine associations between mental illness severity, use and adequacy of mental health treatment, and indicators of employment stability.

Methods: In this repeated cross-sectional study, 2010-2019 data from the U.S. National Survey of Drug Use and Health were used to construct multivariate logistic regression models predicting the odds of part-time employment, past-year work interruption, number of past-year employers, and past-month health-related work absence by mental illness severity and adequacy of mental health treatment.

Results: Compared to individuals with no mental illness, those with any and severe mental illness had significantly higher odds of part-time employment (adjusted odds ratios [AORs] = 1.51 and 2.16, 95% confidence intervals [CIs] 1.4-1.6 and 2.0-2.3), multiple past-year employers (AORs = 1.78 and 2.34, CIs 1.7-1.9 and 2.1-2.6), past-year work interruption (AORs = 1.69 and 2.20, CIs 1.6-1.8 and 2.1-2.4), and >7 days of past-month work absence (AORs = 2.51 and 3.82, CIs 2.3-2.8 and 3.3-4.5). Among respondents with mental illness, perceived inadequacy of mental treatment predicted higher odds of all adverse employment outcomes.

Conclusions: Compared to those with no mental illness, individuals with mental illness of any severity have higher odds of employment instability. Policy and programmatic support aimed at addressing the needs of individuals with mental illness, including access to adequate mental health treatment, are needed to facilitate continued, competitive employment.

Background: To date, studies have been focused on sleep disturbances of nurses working during night shifts. There is a lack of understanding regarding the sleep quality of nurses working in the rapid rotation system for each type of shift work.

Aims: To determine the relationship between chronotype and sleep quality according to shift type (i.e. day, evening and night shifts) in nurses working 8-hour rotating shifts.

Methods: A cross-sectional, descriptive study was conducted from two tertiary hospitals in South Korea from December 2021 to September 2022, including nurses working 8-hour rotating shifts (N = 74). They completed questionnaires to measure general, occupational and sleep-related characteristics, chronotype, insomnia severity and daytime sleepiness. Additionally, sleep parameters were collected from actigraphy and sleep diaries for 7 days.

Results: A total of 64% of nurses had an evening chronotype and 37% of nurses had an intermediate chronotype. Nurses had significantly less total sleep time and worsened sleep latency and efficiency during the day shift compared to other shift types. Compared to nurses with an intermediate chronotype, those with an evening chronotype had poorer sleep quality during day shift work.

Conclusions: Strategies to enhance nurses' sleep quality during day shifts should consider a two-level approach: individual approaches, such as improving sleep hygiene, and administrative approaches, such as establishing a chronotype-based shift system for scheduling.

Background: Women increasingly work beyond age 50+ but their occupational health is under-researched.

Aims: To investigate what jobs older contemporary women do, when they exit their jobs and what factors predict job exit.

Methods: Data came from the Health and Employment After Fifty cohort, which recruited women aged 50-64 at baseline in 2013-14 and has followed them up annually collecting: demographic, lifestyle and work information. Exits from employment were mapped longitudinally over five follow-ups. Time-to-first event Cox regression analyses were used to identify risk factors for job exit.

Results: At baseline, 4436 women participated, 64% of whom were working. The proportions of women working at 50-54, 55-60 and over 60 years were 86%, 79% and 38%, respectively. Amongst all women, after adjustment for age, managing comfortably financially and not coping with the mental demands of the job were associated with exit. Risk factors for job exit differed in the age bands: 50-54; 55-59 and >60 years, reflecting socio-economic status, markers of health (musculoskeletal pain and poor self-rated health) and work factors (under-appreciation, job dissatisfaction, temporary/permanent contracts, coping with work's physical demands).

Conclusions: Factors contributing to exit from work among older women differ by age group, after controlling for perceived financial position, age and mental demands of the job. A number of work characteristics predict job exit and suggest that employers can play an important role in supporting women to continue working until older ages. Identification and treatment of musculoskeletal pain could also enable work amongst older women.