Documents Occupational Medicine 58 results

"Background
Emerging cross-sectional reports find that the COVID-19 pandemic and related social restrictions negatively affect lifestyle behaviours and mental health in general populations.
Aims
To study the longitudinal impact of COVID-19 on work practices, lifestyle and well-being among desk workers during shelter-at-home restrictions.
Methods
We added follow-up after completion of a clinical trial among desk workers to longitudinally measure sedentary behaviour, physical activity, sleep, diet, mood, quality of life and work-related health using validated questionnaires and surveys. We compared outcomes assessed before and during COVID-19 shelter-at-home restrictions. We assessed whether changes in outcomes differed by remote working status (always, changed to or never remote) using analysis of covariance (ANCOVA).
Results
Participants (N = 112; 69% female; mean (SD) age = 45.4 (12.3) years; follow-up = 13.5 (6.8) months) had substantial changes to work practices, including 72% changing to remote work. Deleterious changes from before to during shelter-at-home included: 1.3 (3.5)-h increase in non-workday sedentary behaviour; 0.7 (2.8)-point worsening of sleep quality; 8.5 (21.2)-point increase in mood disturbance; reductions in five of eight quality of life subscales; 0.5 (1.1)-point decrease in work-related health (P < 0.05). Other outcomes, including diet, physical activity and workday sedentary behaviour, remained stable (P ≥ 0.05). Workers who were remote before and during the pandemic had greater increases in non-workday sedentary behaviour and stress, with greater declines in physical functioning. Wake time was delayed overall by 41 (61) min, and more so in workers who changed to remote.
Conclusions
Employers should consider supporting healthy lifestyle and well-being among desk workers during pandemic-related social restrictions, regardless of remote working status."

"Background
The association between occupational titles and lung function has mostly been examined through cross-sectional studies. Preventive measures are expected to mitigate adverse effects; hence, updated estimates are necessary.
Aims
To study change in lung function measured by spirometry across occupations.
Methods
This population-based prospective cohort study comprised 5618 working adult participants of the Trøndelag Health Study (HUNT3, 2005–07), Norway. Among these, 3800 individuals (43% men, mean age 42 years, range 20–55) also attended HUNT4 (2017–19). We analysed longitudinal decline in forced expiratory volume in 1 second (FEV1) z-score during the 11-year follow-up by occupation (white-collar workers as reference category), in mixed models, adjusting for age, sex and smoking. We assessed the prevalence of self-reported respiratory symptoms and disease in the working population in HUNT4 (n = 32 124) and HUNT3 (n = 32 070).
Results
Compared with white-collar workers, agricultural workers and ‘drivers and mobile plant operators', had larger declines in FEV1z-score during follow-up. In sex-stratified analyses, men defined as agricultural workers and ‘drivers and mobile plant operators' had larger declines than white-collar workers. Among women, who were underrepresented in many blue-collar jobs, workers classified as ‘machine operators and assemblers' experienced greater declines. In the working population in HUNT4, the prevalence of respiratory symptoms in connection with work was 8%, and lower among white-collar workers (6%) than blue-collar workers (14%).
Conclusions
Although certain workers in Norway remain at risk for occupational lung function decline, there were modest differences between occupations. The findings encourage continuous efforts to implement preventive measures in high-risk jobs."

This article is available under the Creative Commons CC-BY-NC license and permits non-commercial use, distribution and reproduction in any medium, provided the original work is properly cited.

"Background
Occupational exposure to solar ultraviolet (UV) is known to cause malignant melanoma (MM) and non-melanoma skin cancer (NMSC). However, knowledge of the causal associations has developed erratically.
Aims
This review aims to identify when it was accepted that workplace solar UV exposure could cause skin cancer and when it was recognized that there was a risk for outdoor workers in Britain, identifying the steps employers should have taken to protect their workers.
Methods
Informative reviews, published since 1974, were located through a systematic literature search. These were used to chart changes in summative knowledge of the role of occupational solar UV exposure in causing skin cancer. An assessment was made of the identified hazards of skin cancer and the recognition of risks for outdoor workers in Britain.
Results
From at least 1975, it has been accepted that occupational solar UV exposure could cause squamous cell carcinoma, and from around 2011 for MM and basal cell carcinoma. From 2004, repeated sunburn at work was identified as a likely cause of MM. From 1999, it was accepted that occupational solar UV exposure causes NMSC amongst British workers, and from 2012 there was limited evidence for an MM risk for outdoor workers in northern European countries.
Conclusions
Skin cancer risks for British outdoor workers should be actively managed and they should have health surveillance. Outdoor workers who have skin cancer should be eligible for compensation."

This article is available under the Creative Commons CC-BY-NC-ND license and permits non-commercial use of the work as published, without adaptation or alteration provided the work is fully attributed.

"Background Little research has explored changes in workers' psychosocial hazard exposures, work-related stress and stress-related absence associated with the onset of unprecedented severe economic recession. Knowledge of these could inform psychosocial risk management measures appropriate to austere economic times.

Aims To examine civil servants' psychosocial hazard exposures, work-related stress and stress-related absence during a period of economic recession, relative to levels prior to the onset of this period.

Methods Analyses compared the findings of two surveys of employees of the Northern Ireland Civil Service conducted in 2005 (n = 17?124), prior to the onset of recession, and in 2009 (n = 9913), during a period of economic recession.

Results Psychosocial hazard exposures were significantly worse during the recession than prior to it. These results are considered in relation to UK government exposure targets. Work-related stress and absence ascribed to work-related stress were significantly greater during recession than prior to it.

Conclusions This study demonstrates adverse changes in psychosocial hazard exposures, work-related stress prevalence and stress-related sickness absence associated with the onset of an unprecedented economic recession. Its findings indicate the need for a concerted focus on psychosocial risk management activities during austere economic times as a means by which to promote worker health and minimize sickness absence."

"Background
To improve occupational health public policies and to facilitate coordinated research within the European Union to reduce the incidence of occupational diseases (ODs), it is important to know what OD surveillance systems exist and how they compare. Monitoring trends in occupational diseases and tracing new and emerging risks in a network (Modernet) participants are well placed to provide this information as most either contribute data to and/or are involved in the management of OD systems.
Aims
To identify and describe OD surveillance systems in Modernet countries with the longer-term objective of identifying a core template to be used on a large scale.
Methods
A questionnaire sent to Modernet participants, seeking structured information about the OD surveillance system(s) in their country.
Results
Overall 14 countries (70%) provided information for 33 OD systems, among them 11 compensation-based (CB) systems. Six countries provided information for non-CB systems reporting for any type of OD. The other systems reported either only ODs from a prescribed list, or specific diagnoses or diagnostic groups, with reports to most schemes being physician-based. Data collected varied but all systems collected diagnosis, age, gender, date reported and occupation (and/or industry) and most collected information on exposure.
Conclusions
This review provides information beneficial to both policy makers and researchers by identifying data sources useable to measure OD trends in European countries and opening the way to future work, both on trend comparisons within Europe and on the definition of a core template to extend OD surveillance on a larger scale.."

"BACKGROUND: Work organization in Spain has traditionally been based on a high proportion of passive work. Changes in the labour market in Europe and the economic crisis that began in 2008 may have had an impact on the pace of work in Spain.



AIMS: To estimate the prevalence of exposure to high-strain work and passive work in 2010 compared with 2005 and to analyse the distribution by gender, age and occupation of workers exposed to high strain and iso-strain in 2010 compared with 2005.



METHODS: Two representative samples of the Spanish working population were compared. Unweighted and weighted prevalences in 2010 were calculated and compared with those in 2005.



RESULTS: In the 2010 sample of 5110 workers, 29% (95% CI 27.8; 30.7) were exposed to high strain (of whom 83% had low social support). There was an increase of 6% (95% CI 3.8; 7.1) in high strain, and of 7% (95% CI 5.2; 8.3) to iso-strain, compared with 2005 (n = 7612). In 2010, as in 2005, the proportion of manual workers exposed to strain and iso-strain was more than double the corresponding proportion in non-manual workers.



CONCLUSIONS:There has been an intensification of work, reduction in social support and a notable increase in exposure to high strain and iso-strain. The class inequalities reflect the segmentation of the Spanish labour market."

"BACKGROUND: Although psychosocial work factors are recognized as major occupational risk factors, little information is available regarding the prevalence of exposure to these factors and the differences in exposure between countries.
AIMS: To explore the differences in various psychosocial work exposures between 31 European countries.
METHODS: The study was based on a sample of 14,881 male and 14,799 female workers from the 2005 European Working Conditions Survey. Eighteen psychosocial work factors were studied: low decision latitude (skill discretion and decision authority), high psychological demands, job strain, low social support, iso-strain, physical violence, sexual harassment, bullying, discrimination, work-family imbalance, long working hours, high effort, job insecurity, low job promotion, low reward and effort-reward imbalance. Covariates were age, number of workers in household, occupation, economic activity, self-employed/employee, public/private sector and part/full time work. Statistical analysis was performed using multilevel logistic regression analysis.
RESULTS: Significant differences in all psychosocial work factors were observed between countries. The rank of the countries varied according to the exposure considered. However, some countries, especially Denmark, Netherlands and Norway, displayed a significantly lower prevalence of exposure to four factors or more, while some Southern and Eastern countries, especially Czech Republic, Greece, Lithuania and Turkey, had a higher prevalence.
CONCLUSIONS: Differences in psychosocial work exposures were found between countries. This study is the first to compare a large set of psychosocial work exposures between 31 European countries. These findings may be useful to guide prevention policies at European level."

"Background Needlestick injuries (NSIs) are a common occupational hazard with potential physical health effects, including viral infections such as hepatitis and HIV. Less appreciated are the psychiatric consequences of NSIs, potentially including post-traumatic stress disorder (PTSD) and adjustment disorder (AD). Aims To study psychiatric consequences of NSIs by diagnosis, duration and severity of depressive symptoms. Methods Case control study from patients referred to a psychiatric trauma clinic diagnosed according to ICD-10 diagnostic research criteria guidelines. The Beck Depression Inventory (BDI) was administered to measure depressive symptomatology and assess differences in depression severity between psychiatric trauma patients who had or had not experienced an NSI, and for relationships between the severity of depression and time since NSI using linear models. Results There were 17 NSI cases and 125 controls. NSI patients had moderately severe depressive symptoms (mean BDI score 22.7 15), which was similar to 125 non-NSI trauma patients. 13 of these 17 cases had AD and four had PTSD. None contracted infections from their NSI, but most described secondary effects of psychiatric illness on occupational, family and sexual functioning. Severity of depressive symptoms declined with time after NSI, but psychiatric illness lasted 1.78 months longer for every month a NSI patient waited for seronegative test results (P < 0.05). Conclusions Enduring psychiatric illness can result from NSIs with a severity similar to other psychiatric trauma. Swift delivery of test results may reduce the duration of depression associated with NSI. Occupational health professionals need to be aware of the psychiatric and physical effects of NSIs."

"Background: This review provides an overview of the range of methods that have been developed for the assessment of exposure to risk factors for work-related musculoskeletal disorders. Methods: Relevant publications and material on exposure assessment techniques have been gathered for inclusion in this review. Results: The methods have been categorized under three main headings: (1) self-reports from workers can be used to collect data on workplace exposure to both physical and psychosocial factors by using methods that include worker diaries, interviews and questionnaires; (2) observational methods that may be further subdivided between (a) simpler techniques developed for systematically recording workplace exposure that enable an observer to assess and record data on a number of factors using specifically designed pro-forma sheets for establishing priorities for workplace intervention; and (b) advanced techniques developed for the assessment of postural variation for highly dynamic activities that record data either on videotape or are computer analysed using dedicated software; (3) direct measurements using monitoring instruments that rely on sensors attached directly to the subject for the measurement of exposure variables at work. Conclusions: The choice between the methods available will depend upon the application concerned and the objectives of the study. General, observation-based assessments appear to provide the levels of costs, capacity, versatility, generality and exactness best matched to the needs of occupational safety and health practitioners (or those from related professions) who have limited time and resources at their disposal and need a basis for establishing priorities for intervention. "(Author's abstract)