Documents Härmä, Mikko 9 results

"The increasing societal costs of the expanding retired population are forcing industrialized countries to find new ways to extend life-long work careers. Work careers can be extended in the beginning, middle, or end of the traditional working life, utilizing solutions on the borders of main-life transitions between education, labour market, unemployment, disability, private household, and old age pension. While the central political debate focuses on pressures to delay the general retirement age and the development of economic incentives, policymakers are also interested in increasing participation in working life through disability prevention."

"In 2007, the International Agency for Research on Cancer classified shift work involving circadian disruption as probably carcinogenic to humans (group 2A), primarily based on experimental and epidemiologic evidence for breast cancer. In order to examine options for evidence-based preventive actions, 16 researchers in basic, epidemiological and applied sciences convened at a workshop in Copenhagen 26-27 October 2011. This paper summarizes the evidence from epidemiological and experimental studies and presents possible recommendations for prevention of the effects of night work on breast cancer. Among those studies that quantified duration of shift work, there were statistically significant elevations in risk only after about 20 years working night shift. It is unclear from these studies whether or not there is a modest but real elevated risk for shorter durations. Hence, restriction of the total number of years working night shift could be one future preventive recommendation for shift workers. The diurnal secretion of melatonin by the pineal gland with peak in secretory activity during the night is a good biochemical marker of the circadian rhythm. Disruption of the diurnal melatonin secretion pattern can be diminished by restricting the number of consecutive night shifts. Reddish light and reduced light intensity during work at night could potentially help diminish the inhibitory activity of light with strong intensity on the melatonin secretion, but further mechanistic insight is needed before definite recommendations can be made. Earlier or more intensive mammography screening among female night shift worker is not recommended because the harm-benefit ratio in this age group may not be beneficial. Preventive effects of melatonin supplementation on breast cancer risk have not been clearly documented, but may be a promising avenue if a lack of side effects can be shown even after long-term ingestion. Women with previous or current breast cancer should be advised not to work night shifts because of strong experimental evidence demonstrating accelerated tumor growth by suppression of melatonin secretion. Work during the night is widespread worldwide. To provide additional evidence-based recommendations on prevention of diseases related to night shift work, large studies on the impact of various shift schedules and type of light on circadian rhythms need to be conducted in real work environments."

"In many developed countries, policies are enacted to increase labor force participation among older workers and to extend the age of statutory retirement in response to the ageing of society. Within Europe, the employment rate among 55–65-year olds has increased in the past decade, but there are large differences among countries, for example, reported participation among men varies from 41% in France to 73% in Sweden (1). Hence, in most countries, it will already be a large societal challenge to support workers to maintain their ability to work until the age of 65. The increase in the statutory retirement age to 67 years and beyond will require additional societal efforts to ensure that older workers can continue to contribute to a productive workforce. ..."

"Objectives The change in systolic blood pressure (SBP) over an 8-year period was explored in groups defined according to exposure to shift work, occupational noise, and physical workload. The impact of baseline SBP and its increase in relation to coronary heart disease (CHD) risk due to these exposures was also studied.Methods The study cohorts (N=1288 for CHD follow-up, N=884 for SBP follow-up) consisted of industrially employed middle-aged men from the Helsinki Heart Study. Shiftwork status was obtained from a questionnaire, and other exposures were determined with the Finnish job-exposure matrix. SBP was measured in the Helsinki Heart Study, and CHD end points were obtained from official Finnish registers. The joint effects of baseline SBP, its change, and the exposure in question were estimated via Cox´s regression models.Results During the SBP follow-up, the steepest SBP gradient was found for physical workload only and physical workload combined with noise; shift work alone or combined with noise primarily entailed a lower mean SBP level than no such exposure. However, the shift workers had a relative risk of 1.71 [95% confidence interval (95% CI) 1.01–2.87] even without an increase in SBP, but, with a baseline SBP of =140 mmHg and an additional increase, their relative risk rose to 4.62 (95% CI 2.31–9.24) when they were compared with day workers with an SBP of <140 mmHg and no increase.Conclusions In general, shift workers do not develop higher SBP levels than day workers, but, if they do, it entails high CHD risk. Noise shows a similar pattern. In contrast, physical workload entails a significant increase in SBP, and SBP is a key pathway to CHD risk."

"Objective
This paper discusses the past and present highlights of working hours and health research and identifies key research needs for the future.
Method We analyzed over 220 original articles and reviews on working hours and health in the Scandinavian Journal of Work, Environment & Health published during the last 50 years. Key publications from other journals were also included.
Results
The majority of identified articles focussed on the effects of shift and night work, with fewer studying long and reduced working hours and work time control. We observed a transition from small-scale experimental and intensive field studies to large-scale epidemiological studies utilizing precise exposure assessment, reflecting the recent emergence of register-based datasets and the development of analytic methods and alternative study designs for randomized controlled designs. The cumulative findings provide convincing evidence that shift work and long working hours, which are often associated with night work and insufficient recovery, increase the risk of poor sleep and fatigue, sickness absence, occupational injuries, and several chronic health conditions such as cardiovascular diseases and cancer. The observed risks are strongly modified by individual and work-related factors.
Conclusions
Although the observed health risks of shift work and long working hours are mostly low or moderate, the widespread prevalence of exposure and the hazardousness of the many associated potential outcomes makes such working time arrangements major occupational health risks. Further research is needed to identify exposure–response associations, especially in relation to the chronic health effects, and to elucidate underlying pathways and effective personalized intervention strategies."