Long working hours and symptoms of anxiety and depression: a 5-year follow-up of the Whitehall II study

Unpaid overtime and mental health in the Canadian working population

BACKGROUND

Unpaid overtime-describing a situation where extra hours are worked but not paid for-is a common feature of the labor market that, together with other forms of wage theft, costs workers billions of dollars annually. In this study, we examine the association between unpaid overtime and mental health in the Canadian working population. We also assess the relative strength of that association by comparing it against those of other broadly recognized work stressors.

METHODS

Data were drawn from a survey administered to a heterogeneous sample of workers in Canada (n = 3691). Generalized linear models quantified associations between unpaid overtime, stress, and burnout, distinguishing between moderate (1-5) and excessive (6 or more) hours of unpaid overtime.

RESULTS

Unpaid overtime was associated with higher levels of stress and burnout. Relative to those working no unpaid overtime, men working excessive unpaid overtime were 85% more likely to report stress (prevalence ratios [PR]: 1.85, 95% confidence interval [CI]: 1.26-2.72) and 84% more likely to report burnout (PR: 1.84, 95% CI: 1.34-2.54), while women working excessive unpaid overtime were 90% more likely to report stress (PR: 1.90, 95% CI: 1.32-2.75) and 52% more likely to report burnout (PR: 1.52; 95% CI: 1.12-2.06). The association of excessive unpaid overtime with mental health was comparable in magnitude to that of shift work and low job control.

CONCLUSIONS

Unpaid overtime may present a significant challenge to the mental health of working people, highlighting the potential role of wage theft as a neglected occupational health hazard.

What we learned from the infection control and what we need in the future: A quantitative and qualitative study on hospital infection prevention and control practitioners (HIPCPs) in Tianjin, China

BACKGROUND

In December 2022, the epidemic prevention and control policy was upgraded, and China entered a different stage of epidemic control. This study aims to identify implications for better infection control and health care supply during the epidemic.

METHODS

A longitudinal quantitative and qualitative study was performed based on 2 comprehensive questionnaire surveys among 497 hospital infection prevention and control practitioners (HIPCPs) before and during the epidemic peak in Tianjin, China.

RESULTS

The workload (8.2 hours vs 10.14 hours, P = 0) and self-reported mental health problems (23.5% vs 61.8%, P < .05) among the HIPCPs increased significantly in the peak period. Ward reconstruction and resource coordination were the most needed jobs in hospital infection control, and rapidly increased medical waste during the epidemic needs to be considered in advance. Community support for health care personnel and their families, maintaining full PPE to reduce simultaneous infection of medical staff, and clinical training of infectious diseases for medical staff, especially doctors, in advance are the most important things we learned.

CONCLUSION

Although it has been 4 years since the first outbreak of coronavirus disease 2019, more improvements should be made to prepare for the next epidemic of potential diseases.

The association between economic uncertainty and suicide in Japan by age, sex, employment status, and population density: an observational study

Background

Suicide is one of the ten leading causes of death globally, and previous research has revealed a link between economic conditions and mental health. However, the literature has focused primarily on recessions and unemployment, i.e. actual economic developments, as opposed to uncertainty, which relates to economic developments that have not (yet) materialised. This study examines the differential association between economic uncertainty and suicide in Japan, depending on age, sex, employment status, and population density, in order to identify the groups that are affected the most.

Methods

Using monthly prefectural suicide mortality data from the Ministry of Health, Labour and Welfare and a monthly economic uncertainty index for the period 2009 to 2019, we employed a fixed effects panel data approach to examine the association between uncertainty and suicide by population group.

Findings

We found that a 1% increase in economic uncertainty is associated with a 0.061 increase in the monthly number of suicides per 100,000 people per prefecture, on average (coefficient: 6.08; 95% CI: 5.07-7.08), which constitutes a 3.62% increase. Self-employed people, as well as men in their 50s and unemployed men, experience the highest additional risk of suicide when uncertainty increases. The association was approximately three times stronger for males than for females, and a strong association was observed for self-employed males living in more densely-populated areas.

Interpretation

Uncertainty appears to relate to suicides for most groups, but self-employed people, males, and those living in more densely populated areas appear to be more at risk of suicide in periods of increased economic uncertainty. Our results provide an indication of which groups mental health services and prevention strategies can focus on in times of economic uncertainty.

Funding

None.

Masculine depression and its problem behaviors: use alcohol and drugs, work hard, and avoid psychiatry!

The gender role influences vulnerability to mental illness. Substance use, even critical in scale, is perceived as masculine, just like hard (over-)work, while not seeking help. With the ongoing separation between gender and sex, masculine norms become more relevant also to females' mental health. The male depression concept highlights the role of male symptoms in affective disorders. However, the empirical evidence is still limited. Here, we use the denomination 'masculine depression' to open the category for female patients and tested substance use patterns, health services' utilization, and working hours as predictors in a case-control study of 163 depressed in-patients (44% women; masculine vs. non-masculine depression according to a median split of the Male Depression Rating Scale-22) and 176 controls (51% women). We assessed higher depression severity in patients with masculine (vs. non-masculine) depression. Masculine depression (vs. non-masculine depression and vs. no depression) was predicted by more frequent and critical use of alcohol (including binge drinking), tobacco, and illicit drugs, and by longer working times. Moreover, fewer health services contacts due to mental complaints during the previous year were associated with masculine (vs. non-masculine) depression. Alarmingly, even critical substance misuse was not significantly associated with more frequent health services contacts; however, the higher the depression severity, the more contacts the patients reported. Here, we provide evidence that patients with masculine depression are highly burdened and undertreated, which applies equally to female and male patients. This study identified promising targets to establish specialized care offers.

The relationship between working time mismatch and depression according to actual hours worked

OBJECTIVES

The effect of the combination of working hours and working time mismatch on depression is unknown. This study was undertaken to confirm the relationship between working time mismatch and depression with respect to hours worked.

MATERIAL AND METHODS

The data of 45 514 adult workers that participated in the 6th Korean Working Conditions Survey (KWCS-VI 2020) were reviewed. Depression was defined using the World Health Organization 5 Well-Being Index (WHO-5) cut-off score of 50. Working time mismatch was defined as a difference between actual and desired working hours. To identify associations between working hour mismatch and depression according to weekly hours worked, stratification analysis was conducted by dividing the study subjects into 3 groups based on actual hours worked weekly (<40 h, 40-<52 h, or ≥52 h). Multiple logistic regression analysis adjusted for potential confounders was performed to calculate odds ratios of depression.

RESULTS

In the <40 h, 40-<52 h, and ≥52 h groups, the odds ratios (OR) of working more hours than desired were 1.51, 95% CI: 1.20-1.92 (<40 h), 1.70, 95% CI: 1.58-1.84 (40-<52 h), and 1.55, 95% CI: 1.41-1.69 (≥52 h), respectively, compared to a matched actual versus desired working hours group (the matched group). On the other hand, the odds ratios of working fewer hours than desired were 1.17, 95% CI: 1.07-1.27 (<40 h), 1.38, 95% CI: 1.20-1.60 (40-<52 h), and 1.98, 95% CI: 1.24-3.17 (≥52 h), respectively. The risk of depression was found to increase significantly with working time mismatch within all 3 working hour groups.

CONCLUSIONS

Working time mismatch increases the risk of worker depression regardless of hours worked. Int J Occup Med Environ Health. 2023;36(6):788-97.

Long working hours and all-cause mortality in China: A 26-year follow-up study

OBJECTIVES

The relationship between long working hours and the risk of mortality has been debated in various countries. This study aimed to investigate the association between long working hours and all-cause mortality in a large population-based cohort in China.

METHODS

This retrospective cohort study (N=10 269) used a large, nationally representative data set [the China Health and Nutrition Surveys (CHNS)] from 1989 to 2015. Long working hours (≥55 hours per week) were compared to standard working hours (35-40 hours per week). The outcome measure was all-cause mortality. Hazard ratio (HR) for all-cause mortality was calculated from Cox proportional hazards regression models, with stratified analyses to assess differences in mortality risk among subgroups.

RESULTS

Among the participants, 411 deaths (3.52 per 1000 person-years) occurred during a median follow-up of 11.0 (range 4.0-18.0) years. After adjusting for covariates, long working hours were associated with a significantly increased risk of all-cause mortality [HR 1.49, 95% confidence intervals (CI) 1.02-2.18]. Stratified analyses revealed that this association was present only among men (HR 1.78, 95% CI 1.15-2.75) and smoking participants (HR 1.57, 95% CI 1.05-2.57).

CONCLUSION

This study provides evidence of an association between long working hours and all-cause mortality, which is specifically observed among men and smokers. Targeted interventions should be implemented to reduce excessive working hours and identify individuals at elevated risk, with support from labor organizations, policymakers, and employers.

Association between overtime and depressive symptoms among Chinese employees

Objectives

This study examines the correlation between overtime and depressive symptoms, and analyzed the moderating effect of age, education level, and income level on their correlation by using a nationally representative sample from the Chinese Family Panel Studies (CFPS) in 2018.

Methods

Participants are divided into three groups: 30-44 h/week, 44.1-61.9 h/week (defined as overtime group), and ≥ 62 h/week (heavy overtime group). The multiple ordered logistic regression models are conducted to estimate the association between overtime and depressive symptoms. The interaction term of overtime and moderators including age, education level, and income level are introduced into the models to test the moderating effect.

Results

The overtime group have an increased probability of depressive symptoms (OR = 1.11, 95% CI 1.04-1.20) compared with those who reported working hours 30-44 h/week, after controlling for important confounders. What's more, the worsening of depressive symptoms is more pronounced in the heavy overtime group (OR = 1.32, 95% CI 1.22-1.44). The moderating effect results show that younger employees, employees with high education levels, and those with high income level are more likely to be affected by the negative effects of overtime.

Conclusion

Working overtime increased the likelihood of depressive symptoms. Younger employees, high-educated employees and employees with high income level are more vulnerable to the negative effects of overtime on mental health.

Insomnia and common mental disorder among patients with pre-existing chronic non-communicable diseases in southern Ethiopia: a survey during COVID-19 pandemic

Background

COVID-19 has been causing significant mental health problems and other health-related issues. Despite the fact that COVID-19 has a significant impact on chronic disease patients, there is scant research on insomnia, common mental health disorders (CMD), and their associated factors among chronic disease patients.

Objective

The purpose of this study was to assess the prevalence of insomnia and common mental disorders (CMD) and their associated factors among patients with pre-existing chronic NCDs in Sidama, southern Ethiopia.

Methods

A multicenter cross-sectional study was undertaken between June 1 and September 1, 2021. The study included 633 participants. CMD and insomnia were assessed using a 20-item Self-Reported Questionnaire (SRQ-20) and a 7-item Insomnia Severity Index (ISI) scale, respectively. To describe the various variables, descriptive statistics were used. We performed multivariable logistic regression analysis to identify independent factors associated with CMD and insomnia. A value of p < 0.05 was considered statistically significant at a 95% confidence interval.

Results

The prevalence of insomnia and CMD was found to be 39.3% and 46.8%, respectively. Being merchant (AOR = 0.33; 95% CI = 0.13, 0.82), having a diagnosis of diabetes mellitus (AOR = 1.89; 95% CI = 1.04, 3.46), comorbid diagnosis (AOR = 3.96; 95% CI = 2.27, 6.89), low social support (poor (AOR = 3.37; 95% CI = 1.51, 7.57) and moderate (AOR = 3.13; 95% CI = 1.46, 6.69)), symptoms of insomnia (AOR = 12.08; 95% CI = 7.41, 19.72) and poor quality of life (QOL) (AOR = 1.67; 95% CI = 1.04, 2.72) were independent predictors of CMD. We also found out that, having cardiovascular disorders (CVDs) (AOR = 2.48; 95% CI = 1.18, 5.19), CMD (AOR = 12.09; 95% CI = 7.46, 19.61), and poor QOL (AOR = 2.04; 95% CI = 1.27, 3.26) were significantly associated with insomnia symptoms.

Conclusion

Our study suggests that substantially high prevalence of CMD and insomnia. Significant association between CMD and occupation, diagnosis, comorbidity, social support, insomnia, and QOL were found. We also revealed that having CVDs, CMD, and poor QOL were significantly associated with insomnia symptoms. Therefore, dealing with the mental health problems of patients with chronic NCDs is an essential component of public health intervention during the COVID-19 pandemic.

The role of effort-reward imbalance and depressive symptoms in the relationship between long working hours and presenteeism among Chinese village doctors: a moderated mediation model

BACKGROUND

Long working hours and effort-reward imbalance (ERI) among medical workers may contribute to poor mental health and reduced productivity. However, the potential mechanisms among them are not well understood. This study aimed to explore the role of depressive symptoms and ERI in the relationship between long working hours and presenteeism among village doctors.

METHODS

We conducted a cross-sectional study in Jiangsu Province, eastern China. 705 village doctors were assessed for working hours, ERI (the Effort-Reward Imbalance Questionnaire, ERI questionnaire), presenteeism (6-item Stanford Presenteeism Scale, SPS-6 Scale), and depressive symptoms (12-item General Health Questionnaire, GHQ-12). A moderated mediation model was used to test the role of depressive symptoms (M), and ERI (W) in the relationship between long working hours (X) and presenteeism (Y).

RESULTS

45.11% of the village doctors worked more than 55 h per week, and 55.89% were exposed to ERI. The prevalence of depressive symptoms among Chinese village doctors was 40.85%. Long working hours (≥ 55 h per week) were significantly associated with presenteeism behaviors (β = 2.17, P < 0.001). Mediation analysis demonstrated that depressive symptoms (GHQ score > 3) could partly mediate the relationship between long working hours and presenteeism (indirect effect β = 0.64, P < 0.001). Moderated mediation further indicated that the interaction of long working hours and ERI was significantly and positively associated with depressive symptoms, which in turn predicted elevated presenteeism behaviors.

CONCLUSIONS

Depressive symptoms had a mediating role in the association of long working hours with presenteeism behaviors among Chinese village doctors and ERI augment their negative effects.

Statement by the Korean Society of Occupational and Environmental Medicine on the proposed reform of working hours in South Korea

The current 52-hour workweek in South Korea consists of 40 hours of regular work and 12 hours of overtime. Although the average working hours in South Korea is declining, it is still 199 hours longer than the Organisation for Economic Co-operation and Development average of 1,716 hours per year. In view to this, the South Korean government has now proposed to reform the workweek, mainly intending to increase the workweek to 69 hours when the workload is heavy. This reform, by increasing the labor intensity due to long working hours, goes against the global trend of reducing work hours for a safe and healthy working environment. Long working hours can lead to increased cerebrovascular and cardiovascular diseases, industrial accidents, mental health problems, and safety accidents due to lack of concentration. In conclusion, the Korean government's working hour reform plan can have a negative impact on workers' health, and therefore it should be thoroughly reviewed and modified.

A narrative review of the physiology and health effects of burnout associated with veterinarian-pertinent occupational stressors

Chronic workplace stress and burnout are serious problems in veterinary medicine. Although not classified as a medical condition, burnout can affect sleep patterns and contributes to chronic low grade systemic inflammation, autonomic imbalance, hormonal imbalances and immunodeficiencies, thereby increasing the risks of physical and psychological ill health in affected individuals. Cultural misconceptions in the profession often lead to perceptions of burnout as a personal failure, ideas that healthcare professionals are somehow at lower risk for suffering, and beliefs that affected individuals can or should somehow heal themselves. However, these concepts are antiquated, harmful and incorrect, preventing the design of appropriate solutions for this serious and growing challenge to the veterinary profession. Veterinarians must first correctly identify the nature of the problem and understand its causes and impacts before rational solutions can be implemented. In this first part of two companion reviews, burnout will be defined, pathophysiology discussed, and healthcare and veterinary-relevant occupational stressors that lead to burnout identified.

The Functional States of the Participants of a Marine Arctic Expedition with Different Levels of Vitamin D in Blood

(1) Background: The vitamin D level in blood is one of the markers of the functional reserves of the human body and can contribute to more successful adaptation in the Arctic. (2) Methods: The study involved 38 participants in the project "Arctic Floating University-2021". The determination of vitamin D content was carried out at the beginning of the expedition. A dynamic study was carried out for 20 days in the morning and in the evening. The functional state parameters of the participants were assessed using psychophysiological and questionnaire methods. Statistical methods: Mann-Whitney U-test and correlation analysis. (3) Results: It was found that at the beginning of the expedition, the functional state of participants with more severe vitamin D deficiency is characterized by a shorter average duration of RR intervals (p = 0.050) and reduced SDNN values (p = 0.015). The higher the content of vitamin D, the greater increase in speed (r = 0.510), the higher the increase in projective performance (r = 0.485), and the smaller the increase in projective stress (r = -0.334). Significant relationships between the subjective characteristics of functional states and the vitamin D of participants have not been established. (4) Conclusion: With an increase in the severity of vitamin D deficiency in the blood, the adaptive capabilities of participants decrease during an expedition to the Arctic.

Mentally Demanding Work and Strain: Effects of Study Duration on Fatigue, Vigor, and Distress in Undergraduate Medical Students

AIMS

The impact of the extent of mentally demanding work on the next-day's strain is largely unknown, as existing studies generally investigate consequences of extended versus normal workdays. The present study sought to fill this gap by investigating how short work periods of mentally demanding academic work impact strain reactions in medical students preparing for an exam, using days of no work as reference category.

METHOD

The observational design involved students repeatedly self-reporting fatigue, vigor, distress, and the preceding day's study duration. Hours of nocturnal sleep, attending paid work and compulsory classes, gender, and proximity to the exam were controls in the linear model (generalized estimating equations). Forty-nine students provided 411 self-reports (M = 8.6, SD = 7.0 self-reports/student).

RESULTS

Engaging in mentally demanding work was associated with increased distress and work periods > 4 h with increased fatigue. Distress, vigor loss, and fatigue increased in proximity to the exam.

CONCLUSION

Despite students' high control of their schedule, even short periods of mentally highly demanding work may impair next-day's well-being when task motivation is high. Freelancers and students might require health-promoting scheduling of work and leisure to avoid an accumulation of strain.

Does workplace telepressure get under the skin? Protocol for an ambulatory assessment study on wellbeing and health-related physiological, experiential, and behavioral concomitants of workplace telepressure

BACKGROUND

The daily working life of many employees requires the use of modern information and communication technology (ICT) devices such as computers, tablets, and smartphones. The double-edged nature of digital work environments has been increasingly highlighted. Benefits such as increased flexibility come at a personal cost. One of the potential downsides is workplace telepressure, i.e., the experience of urge and preoccupation to quickly reply to work-related messages and demands using ICT. There is initial - mainly survey-based-evidence that workplace telepressure may have negative effects on a variety of wellbeing and health outcomes.

AIMS AND HYPOTHESES

Adopting the Effort-Recovery Model and the concept of allostatic load as theoretical frameworks, the present study aims to investigate the hypothesis that workplace telepressure is significantly associated with increased "wear and tear", in the form of more psychosomatic complaints, worse sleep quality (self-reported and actigraphy-based), worse mood, and biological alterations (lower cardiac vagal tone, lower anabolic balance defined as the ratio of salivary dehydroepiandrosterone to salivary cortisol, and higher salivary alpha-amylase). Additionally, the study aims to investigate the hypothesis that connection to work defined as work-related workload and work-related perseverative cognition plays a significant role in the mediation of these relationships.

METHODS

To test our hypotheses, we will conduct an ambulatory assessment study with a convenience sample of 120 healthy workers regularly using ICTs for job communication. For one week, participants will be asked to complete electronic diaries assessing their level of workplace telepressure, psychosomatic complaints, sleep quality, mood, work-related workload, and work-related perseverative cognition. They will also continuously wear the Bittium Faros 180L ECG monitor, the wrist-worn actigraph MotionWatch 8, and perform saliva sampling five times per day.

DISCUSSION

This study will be the most comprehensive ambulatory investigation of workplace telepressure and its psychophysiological concomitants to date and constitutes an important step towards understanding how high levels of workplace telepressure may lead in the long term to secondary alterations (e.g., hypertension, chronic inflammation) and disease (e.g., heart disease). The findings of this study are also anticipated to contribute to guiding the development and implementation of interventions, programs, and policies relevant to employees' digital wellbeing.

Characteristics of long working hours and subsequent psychological and physical responses: JNIOSH cohort study

OBJECTIVES

This study aimed to examine the prospective association among objectively measured average working hours (AWHs), frequency of long working hours (FLWHs; defined as ≥205 working hours/month (≥45 hours/week)) for 6 months, and workers' self-reported psychological and physical health.

METHODS

The study included 15 143 workers from 5 Japanese companies. We collected monthly attendance records over 6 months before distributing a questionnaire survey on psychological/physical stress responses and work-related demographics. We then evaluated the associations of those attendance records with psychological/physical measures using analysis of covariance adjusted for sex, age, employment, job type, working conditions, work site and experience of emergency state due to COVID-19.

RESULTS

Irritability, anxiety and depression were significantly greater at ≥180 hours (≥45 hours/week), and fatigue and lack of vigour were greater at ≥205 hours than those of the normal working-hour group (140-180 hours/month [35-45 hours/week]). Psychological indices increased significantly with FLWH, with ≥3 times for irritability, depression and fatigue; ≥2 times for lack of vigour; and ≥1 time for anxiety when compared with no long working hours. No significant associations were observed between AWH or FLWH and physical stress responses.

CONCLUSIONS

Longer AWH was associated with higher levels of psychological stress responses. The effects of FLWH in the past 6 months varied among the psychological stress responses and did not occur for physical complaints. Under circumstances requiring long hours, workers' mental health should be protected through minimising the frequency of long work hours.

Association between long working hours and mental health among nurses in China under COVID-19 pandemic: based on a large cross-sectional study

OBJECTIVE

Nurses were more likely to experience mental disorders due to long working hours and irregular schedules. However, studies addressing this issue are scarce; therefore, we aimed to investigate the association between long working hours and mental health in Chinese nurses during the coronavirus disease pandemic.

METHODS

A cross-sectional study was conducted with 2,811 nurses at a tertiary hospital in China from March to April 2022. We collected data on demographic, psychological characteristics, dietary habits, life, and work-related factors using a self-reported questionnaire and measured mental health using Patient Health Questionnaire-9 and General Anxiety Disorder-7. Binary logistic regression to determine adjusted odds ratios and 95% confidence intervals.

RESULTS

The effective response rates were 81.48%, 7.80% (219), and 6.70% (189) of the respondents who reported depression and anxiety, respectively. We categorized the weekly working hours by quartiles. Compared with the lowest quartile, the odds ratios and 95% confidence intervals across the quartiles for depression after adjustment were 0.98 (0.69, 1.40), 10.58 (2.78, 40.32), and 1.79 (0.81, 3.97) respectively, the P for trend was 0.002. The odds ratios across the quartiles for anxiety after adjustment were 0.87 (0.59, 1.30), 8.69 (2.13, 35.46), and 2.67 (1.26, 5.62), respectively, and the P for trend was 0.008.

CONCLUSIONS

This study demonstrated that extended working hours increased the risk of mental disorders among nurses during the coronavirus disease pandemic, particularly in those who worked more than 60 h per week. These findings enrich the literature on mental disorders and demonstrate a critical need for additional studies investigating intervention strategies.

Impact of Reduced Working Hours and Night Work Hours on Metabolic Syndrome: A Quasi-Experimental Study

Objectives

Epidemiological evidence linking long working hours and shift work to metabolic syndrome remains inadequate. We sought to evaluate the impact of reducing working hours on metabolic syndrome.

Methods

We compared the prevalence of metabolic syndrome among male manual workers in a manufacturing company (N = 371) before and after the introduction of policy to reduce daily work hours from 10 to 8 hours. Components of metabolic syndrome were measured in periodic health examinations before the intervention, 6-9 months after, and 1.5-2 years after the intervention. Generalized estimating equation models were used to estimate changes in the prevalence of metabolic syndrome. Analyses were stratified by day work versus shift work.

Results

The results showed a significantly decreased prevalence of metabolic syndrome 6-9 months following the intervention in day workers (risk ratio = 0.68, 95% confidence interval 0.52-0.88), but the benefit disappeared after 1.5-2 years. Shift workers showed a decreased prevalence of metabolic syndrome for the whole follow-up duration after the intervention, although the change was not statistically significant.

Conclusion

Reducing working hours was associated with short-term improvement in metabolic syndrome in male manual workers.

Performance-Based Pay System and Job Stress Related to Depression/Anxiety in Korea: Analysis of Korea Working Condition Survey

The adoption rate of performance-based pay systems has increased in recent years, and the adverse effects of systems have been emphasized. However, no study has analyzed the increase in the risk of depression/anxiety symptoms caused by the pay system in Korea. This study aimed to reveal the association between performance-based pay systems and symptoms of depression/anxiety, using data from the fifth Korean Working Conditions Survey. Depressive/anxiety symptoms were assessed using "yes" or "no" questions regarding medical problems related to depression/anxiety. The performance-based pay system and job stress were estimated using self-response answers. Logistic regression analyses were conducted to determine the association between performance-based pay systems, job stress, and symptoms of depression/anxiety using data from 27,793 participants. The performance-based pay system significantly increased the risk of the symptoms. Additionally, risk increments were calculated after grouping by pay system and job stress. Workers with two risk factors had the highest risk of symptoms of depression/anxiety for both sexes (male: OR 3.05; 95% CI 1.70-5.45; female: OR 2.15; 95% CI 1.32-3.50), implying synergistic effect of performance-based pay system and job stress on depression/anxiety symptoms. Based on these findings, policies should be established for early detection and protection against the risk of depression/anxiety.

Impact of Long Working Hours on Mental Health: Evidence from China

Although previous studies have examined the impact of long working hours on mental health in China, they have not addressed the initial value and reverse causality issues. To bridge this gap in the literature, I conducted a dynamic longitudinal analysis to investigate the association between long working hours and the risk of mental illness nationwide. Using three-wave longitudinal data from the China Family Panel Studies conducted in 2014, 2016, and 2018, I adopted dynamic regression models with lagged long working hours variables to examine their association with the risk of mental illness. The results indicate that long working hours have positive and significant (p < 0.01 or p < 0.05) associations with the risk of mental illness (OR: 1.12~1.22). The effect is more significant for women, white-collar workers, and employees in micro-firms, compared with their counterparts (i.e., men, pink- and blue-collar workers, employees of large firms, and self-employed individuals). The results provide empirical evidence of the effects of long working hours on mental health in China, confirming the need to enforce the regulations regarding standard working hours and monitor regulatory compliance by companies, as these factors are expected to improve mental health.

Physical activity (PA) influences the risk of depression associated with long working hours

BACKGROUND

Growing evidences showed that long working hours is associated with depression epidemic, but few studies investigate whether physical activity (PA) could modify the risk of depression associated with long working hours, which was the purpose of the present study.

METHODS

A cross-sectional data obtained from the National Health and Nutrition Examination Survey 2015-2018. According to the criteria of International Labour Organization, long working hours was defined as >40 h/wk. The Nine-item Patient Health Questionnaire (PHQ-9) was used to identify depression. Binary logistic regression and restricted cubic spline (RCS) models were used to estimate the associations between long working hours and depression, furthermore to estimate the association of PA.

RESULTS

5958 participants were included in the study. The results indicated that 3074 (51.6 %) of participants worked >40 h/wk. The prevalence of depression was 7.7 %. Logistic regression analysis indicated a positive association between long working hours and depression [OR = 1.738, 95 CI (1.427, 2.117)], and the results were still robust after controlling other confounding factors. RCS models indicated that the high intensity PA group had the lowest risk of depression, followed by low intensity PA group and no PA group.

CONCLUSION

Long working hours probably be associated with depression, while PA can modify the risk to some degree.

The Association of Experienced Long Working Hours and Depression, Anxiety, and Suicidal Ideation Among Chinese Medical Residents During the COVID-19 Pandemic: A Multi-Center Cross-Sectional Study

Background

Long working hours are common among medical residents and may increase the risk of mental disorders. We aimed to investigate the association between experienced long working hours and depression, anxiety, and suicidal ideation among Chinese medical residents during the COVID-19 pandemic.

Methods

This study was conducted in September 2022; 1343 residents from three center in Northeastern China were included in the final analysis (effective response rate: 87.61%). The data were collected from participants via online self-administered questionnaires. Depression and anxiety were measured by the Patient Health Questionnaire (PHQ-9) and the General Anxiety Disorder (GAD-7) scale, respectively. Adjusted odds ratios and 95% confidence intervals were determined after adjusting for potential confounders by binary unconditional logistic regression.

Results

The effective response rate was 87.61%. Among the 1343 participants, 12.88% (173), 9.90% (133), and 9.68% (130) had experienced major depression, major anxiety, and suicidal ideation, respectively. We found that longer weekly worktime increased the risk of major depression, particularly in those who worked for more than 60 hours per week (≥ 61 hours vs ≤ 40 hours, OR=1.87, P for trend = 0.003). However, this trend was not observed for either major anxiety or suicidal ideation (P for trend > 0.05 for both).

Conclusion

This study revealed that there was a considerable incidence of poor mental health among medical residents; furthermore, the longer weekly worktime was associated with a higher risk of major depression, especially for those who worked more than 60 hours per week, but this association was not observed in either major anxiety or suicidal ideation. This may help policymakers to develop targeted interventions.

Overtime work, job autonomy, and employees' subjective well-being: Evidence from China

Introduction

Chinese workers suffer more from overtime than in many countries. Excessive working hours can crowd out personal time and cause work-family imbalance, affecting workers' subjective well-being. Meanwhile, self-determination theory suggests that higher job autonomy may improve the subjective well-being of employees.

Methods

Data came from the 2018 China Labor-force Dynamics Survey (CLDS 2018). The analysis sample consisted of 4,007 respondents. Their mean age was 40.71 (SD = 11.68), and 52.8% were males. This study adopted four measures of subjective well-being: happiness, life satisfaction, health status, and depression. Confirmation factor analysis was employed to extract the job autonomy factor. Multiple linear regression methods were applied to examine the relationship between overtime, job autonomy, and subjective well-being.

Results

Overtime hours showed weak association with lower happiness (β = -0.002, p < 0.01), life satisfaction (β = -0.002, p < 0.01), and health status (β = -0.002, p < 0.001). Job autonomy was positively related to happiness (β = 0.093, p < 0.01), life satisfaction (β = 0.083, p < 0.01). There was a significant negative correlation between involuntary overtime and subjective well-being. Involuntary overtime might decrease the level of happiness (β = -0.187, p < 0.001), life satisfaction (β = -0.221, p < 0.001), and health status (β = -0.129, p < 0.05) and increase the depressive symptoms (β = 1.157, p < 0.05).

Conclusion

While overtime had a minimal negative effect on individual subjective well-being, involuntary overtime significantly enlarged it. Improving individual's job autonomy is beneficial for individual subjective well-being.

The association of job fatigue with mental disorders among bus drivers

OBJECTIVE

Mental disorders are a global problem with growing importance. However, the contribution of work factors to the development of mental disorders is inconclusive. This study aimed to assess the impact of fatigue and job stress on mental disorders in a prospective cohort of bus drivers.

METHODS

The Taiwan Bus Driver Cohort Study (TBDCS) recruited 1652 bus drivers from a bus company in 2005. Participants self-completed a structured questionnaire in 2007, which included the Demand-Control-Support (DCS) model questions and the Swedish Occupational Fatigue Inventory-Chinese (SOFI-C). Psychiatric care visits and admissions were obtained from the National Health Insurance Research Dataset (NHIRD) from 2003 to 2016 for as a proxy for psychiatric diagnoses. Drivers with a history of psychiatric disorders before the questionnaire survey time were excluded (N=69). During the follow-up period, a new diagnosis with a psychiatric disorder was defined as an event. Cox proportional hazards model was used to estimate the hazard ratio (HR) for new one-set psychiatric disorders, adjusting for age, body mass index, marital status, education, alcohol consumption, smoking, exercise, bus driving experience, shift work, and chronic diseases.

RESULTS

Among the 896 bus drivers retained for analysis, 85 were newly diagnosed with a psychiatric disorders. DCS score was not associated with the risk of developing a psychiatric disorders, but bus drivers with high SOFI-C scores (≥5) had an elevated risk for anxiety or mood disorders (HR 3.35, 95% confidence interval 1.23-9.09).

CONCLUSIONS

Among bus drivers, occupational fatigue, as indicated by high a SOFI-C score, might result in an elevated risk of anxiety or mood disorders. Health service organizations should provide recommendations and guidance for drivers with high fatigue levels to avoid anxiety or mood disorders.

Work stress, technological changes, and job insecurity in the retail organization context

The study intends to investigate the relationship between work stress and job insecurity, as well as technological changes and job insecurity, with job satisfaction acting as a mediator. The study was conducted among Pakistani retail industry employees using survey questionnaires distributed online and in stores. The sample was composed of 262 retail workers from the FMCG and shopping mall industries. The responses were screened using the statistical software tool SPSS, and hypotheses were examined through SMART-PLS. The findings show that work stress has a strong relationship with job insecurity; additionally, the relationship appears to be statistically significant (β = 55.7%, p &lt; 0.05), indicating that there is an increased level of job insecurity if work stress is increased. However, technological advancements showed less influence on job insecurity and had statistically insignificant results (β = 5.9%, p &gt; 0.05). This demonstrates that many technological changes cause high levels of job insecurity because employees fear that they will be unable to cope with the changing environment. Furthermore, the mediating mechanism of job satisfaction was found to be significant, as employees with lower levels of satisfaction reported higher levels of insecurity, aiding in the narrowing of the gap in this section of the study. The study also has practical implications because the results show that the retail industry needs to act quickly to make sure workers do not worry about losing their jobs, especially now that COVID-19 is spreading like wildfire.

Status and Determinants of Symptoms of Anxiety and Depression among Food Delivery Drivers in Shanghai, China

(1) Background: The psychological status of employees, especially vulnerable populations, has received considerable research attention. However, as a newly emerging and popular occupation in the gig industry, food delivery drivers have received little attention. The majority of these workers are immigrants who are already in a precarious position due to a lack of available jobs, inadequate medical care, poor diets, and communication and acculturation difficulties even before they take these jobs, which involve long working hours and exposure to the elements. (2) Methods: To examine the anxiety and depression symptoms of these workers and possible influencing factors, a cross-sectional study was conducted with a sample of food delivery drivers working for the Meituan Company (one of the largest e-platform companies in China). Anxiety and depression scales were adapted from the GAD-7, and the PHQ-9 was used to assess participants' related symptoms. Differences were compared in terms of sociodemographic, work situation, and lifestyle variables. Binary logistic regressions were conducted to analyze the effects of various factors on the two psychological dimensions. (3) Results: Among the 657 participants, the proportions of participants reporting anxiety and depression symptoms were 46.0% and 18.4%, respectively. Lack of communication with leaders (OR_AN = 2.620, 95% CI: 1.528-4.493, p < 0.001; OR_DE = 1.928, 95% CI: 1.039-3.577, p = 0.037) and poor sleep quality (OR_AN = 2.152, 95% CI: 1.587-2.917, p < 0.001; OR_DE = 2.420, 95% CI: 1.672-3.504, p < 0.001) were significant risk factors for both anxiety and depression symptoms. Women (OR = 2.679, 95% CI: 1.621-4.427, p < 0.001), those who climbed ≥31 floors per day (OR = 2.415, 95% CI: 1.189-4.905, p = 0.015), and those with a high frequency of breakfast consumption (OR = 3.821, 95% CI: 1.284-11.369, p = 0.016) were more likely to have anxiety symptoms. Participants who earned less than 5000 RMB (OR = 0.438, 95% CI: 0.204-0.940, p = 0.034), were unwilling to seek medical help (OR = 3.549, 95% CI: 1.846-6.821, p < 0.001), or had a high frequency of smoking (OR = 5.107, 95% CI: 1.187-21.981, p = 0.029) were more likely to be depressive. (4) Conclusion: The existence of communication channels with leaders and good sleep quality are protective factors for anxiety and depression symptoms. Participants who were female, climbed ≥31floors per day, and had a high frequency of eating breakfast were more likely to have anxiety symptoms, while earning less, unwillingness to seek medical help, and a high frequency of smoking were risk factors for depression symptoms.

Atypical working hours are associated with tobacco, cannabis and alcohol use: longitudinal analyses from the CONSTANCES cohort

BACKGROUND

This study examined prospective associations between atypical working hours with subsequent tobacco, cannabis and alcohol use as well as sugar and fat consumption.

METHODS

In the French population-based CONSTANCES cohort, 47,288 men and 53,324 women currently employed included between 2012 and 2017 were annually followed for tobacco and cannabis use. Among them, 35,647 men and 39,767 women included between 2012 and 2016 were also followed for alcohol and sugar and fat consumption. Three indicators of atypical working hours were self-reported at baseline: working at night, weekend work and non-fixed working hours. Generalized linear models computed odds of substance use and sugar and fat consumption at follow-up according to atypical working hours at baseline while adjusting for sociodemographic factors, depression and baseline substance use when appropriate.

RESULTS

Working at night was associated with decreased smoking cessation and increased relapse in women [odds ratios (ORs) of 0.81 and 1.25], increased cannabis use in men [ORs from 1.46 to 1.54] and increased alcohol use [ORs from 1.12 to 1.14] in both men and women. Weekend work was associated with decreased smoking cessation in women [ORs from 0.89 to 0.90] and increased alcohol use in both men and women [ORs from 1.09 to 1.14]. Non-fixed hours were associated with decreased smoking cessation in women and increased relapse in men [ORs of 0.89 and 1.13] and increased alcohol use in both men and women [ORs from 1.12 to 1.19]. Overall, atypical working hours were associated with decreased sugar and fat consumption.

CONCLUSIONS

The potential role of atypical working hours on substance use should be considered by public health policy makers and clinicians in information and prevention strategies.

Development and validation of a nomogram for predicting the risk of mental health problems of factory workers and miners

OBJECTIVE

A nomogram for predicting the risk of mental health problems was established in a population of factory workers and miners, in order to quickly calculate the probability of a worker suffering from mental health problems.

METHODS

A cross-sectional survey of 7500 factory workers and miners in Urumqi was conducted by means of an electronic questionnaire using cluster sampling method. Participants were randomly assigned to the training group (70%) and the validation group (30%). Questionnaire-based survey was conducted to collect information. A least absolute shrinkage and selection operator (LASSO) regression model was used to screen the predictors related to the risk of mental health problems of the training group. Multivariate logistic regression analysis was applied to construct the prediction model. Calibration plots and receiver operating characteristic-derived area under the curve (AUC) were used for model validation. Decision curve analysis was applied to calculate the net benefit of the screening model.

RESULTS

A total of 7118 participants met the inclusion criteria and the data were randomly divided into a training group (n=4955) and a validation group (n=2163) in a ratio of 3:1. A total of 23 characteristics were included in this study and LASSO regression selected 12 characteristics such as education, professional title, age, Chinese Maslach Burnout Inventory, effort-reward imbalance, asbestos dust, hypertension, diabetes, working hours per day, working years, marital status and work schedule as predictors for the construction of the nomogram. In the validation group, the Brier score was 0.176, the calibration slope was 0.970 and the calibration curve of nomogram showed a good fit. The AUC of training group and verification group were 0.785 and 0.784, respectively.

CONCLUSION

The nomogram combining these 12 characteristics can be used to predict the risk of suffering mental health problems, providing a useful tool for quickly and accurately screening the risk of mental health problems.

Influence of the COVID-19 pandemic on pain and oral health-related quality of life in women with temporomandibular disorder

Objective:

This study aimed to evaluate and compare pain intensity and Oral Health-related Quality of Life (OHRQoL) in women with temporomandibular disorder (TMD) before (T1) and during (T2) COVID-19 pandemic.

Materials and Methods:

Sample was composed of forty-one female participants with painful TMD, who presented for TMD treatment. Subjects were asked to indicate their pain intensity and to answer the Oral Health Impact Profile-14 (OHIP-14). Participants data were collected twice: T1 (evaluation of medical records fulfilled before COVID-19 pandemic) and T2 (by means of an online form). Socio-demographic data were assessed in T1. Statistical analysis was performed with a significance level of 5% (Wilcoxon, chi-square or Fisher’s exact tests, multiple linear regressions).

Results:

No difference was found in pain intensity (p=0.26) and OHIP-14 global scores (p=0.53). Physical pain (p=0.03) and social disability (p=0.05) domains improved. In T1, subject’s occupation was associated with OHIP-14 global score, physical pain, and physical disability domains. In T2, age was associated with OHIP-14 global scores as well as physical pain, psychological discomfort, and psychological disability domains.

Conclusion:

COVID-19 pandemic did not worsen pain intensity and OHRQoL in women with painful TMD, and it is suggested that socio-demographic characteristics influenced TMD patients coping skills during pandemic.

The Effects of Long Working Hours on Mental Health Among Resident Physicians in Saudi Arabia

Purpose

To examine the effect of long working hours on anxiety and depression among resident physicians working in Makkah, Saudi Arabia.

Methods

This is a cross-sectional study using an anonymous and confidential self-administered electronic questionnaire. Mental health status (depression and anxiety) is measured using hospital anxiety and depression scale. A multi-stage stratified sampling technique was used. Data were analyzed using the SPSS version 24.0. The Chi-square test and ordinal logistic regression (OLR) were used to test the association.

Results

A total of 258 medical residents participated in the study. The prevalence of anxiety was 39.5% (n=102) and depression was 20.9% (n=54). In multivariate OLR against anxiety, working more than 64 hours per week was significantly associated (p=0.013) with an increase in the odds of observing a higher level of anxiety (odds ratio=2.91, 95% confidence interval (CI):1.25–6.77) compared with working up to 40 hours per week after adjusting for age, amount of sleep and exposure to injustice. For the depression multivariate OLR, it would increase the odds of observing a higher level of depression for working 41–48, 49–64 and more than 64 hours per week by 2.21 (95% CI:1.07–4.58, P=0.033), 2.07 (95% CI:1.01–4.27, P=0.049) and 2.37 (95% CI:1.03–5.50, P=0.044) respectively, compared with working up to 40 hours per week and adjusting for the amount of sleep and exposure to injustice.

Conclusion

Resident physicians are at increased risk of developing anxiety and depression which is influenced by long working hours and a variety of other factors. Therefore, attention needs to be paid to this association. The implementation of interventions for the prevention and screening of physicians’ mental health disorders is needed.

Influence of coexposure to long working hours and ergonomic risk factors on musculoskeletal symptoms: an interaction analysis

OBJECTIVES

This study explores the interaction between ergonomic risk factors and long working hours on musculoskeletal symptoms by additive and multiplicative scales.

DESIGN

We used the data of the fifth Korean Working Condition Survey (KWCS). The KWCS is a cross-sectional study.

SETTING

To represent the entire Korean working population, the probability proportion stratified cluster sampling method was used. The face-to-face interview was carried out with a structured questionnaire.

MAIN OUTCOMES AND MEASURES

To assess the combined effect of ergonomic risk factors and long working hours on musculoskeletal symptoms, the relative excess risk due to interaction (RERI) and the ratio of ORs were calculated using multiple survey-weighted logistic analysis and postestimation commands.

RESULTS

The OR for musculoskeletal symptoms was 1.75 (95% CI 1.28 to 1.39) for exposure to long working hours, 3.49 (95% CI 3.06 to 3.99) for exposure to ergonomic risk factors and 5.07 (95% CI 4.33 to 5.93) for coexposure to long working hours and ergonomic risk factors. The RERI was 0.82 (95% CI 0.11 to 1.53) and the ratio of ORs was 0.83 (95% CI 0.50 to 1.14) CONCLUSION: Our findings suggest that coexposure to both ergonomic risk factors and long working hours has a supra-additive interaction effect on musculoskeletal symptoms. Regulations on working hours and workplace interventions might reduce the musculoskeletal diseases of workers.

The Effect of Employee-Oriented Flexible Work on Mental Health: A Systematic Review

The effect of flexible work on mental health is not well known. The aim of this systematic review was to assess the effects of employee-oriented flexible work on mental health problems and associated disability. Literature searches were conducted in the PubMed, Scopus, Web of Sciences, Cochrane Library, PsycINFO, ProQuest and EconPapers databases from their inception through October-November 2020. Sixteen studies on the associations of worktime control, working from home, or flexible working arrangements with mental health related outcomes were included in the review: one cluster randomized controlled trial, two non-randomized controlled trials, two cross-over studies, and 11 prospective cohort studies. Three reviewers independently assessed the met-hodological quality of the included studies and extracted the data. The included studies differed in design, intervention/exposure, and outcome, so meta-analysis was not carried out and qualitative results were reported. A few prospective cohort studies found that low employees’ control over worktime increases the risk of depressive symptoms, psychological distress, burnout, and accumulated fatigue. One cross-over and a few cohort studies found small beneficial effects of working partly from home on depressive symptoms, stress, and emotional exhaustion. A small number of controlled trials, cross-over or cohort studies found that flexible working arrangements increase employees’ control over working hours, but have only modest beneficial effects on psychological distress, burnout, and emotional exhaustion. This systematic review suggests that employee-oriented flexible work may have small beneficial effects on mental health. However, randomized controlled trials and quasi-experimental studies are needed to identify the health effects of flexible work.

Health and occupation: the limits to older adults' work hours

More people are working into older age, raising questions about how many hours they can work before their health becomes compromised. This paper models work-hour tipping points for mental health and vitality among older Australian workers aged 50–70 years. We use longitudinal data from the Household, Income and Labour Dynamics in Australia (HILDA) survey, 2005–2016 (about 44,900 observations), and bootstrapping Three Stage Least Squares (3SLS) estimation techniques to adjust for reverse and reciprocal relationships between wages, work hours and health. Our approach corrects for heteroscedasticity in the system equation error terms, and we estimate models on the relatively healthy older adults who have remained employed into older age. Among these older workers we observe weekly thresholds of 39–40 hours beyond which mental health and vitality decline. This average, however, hides variability in work-hour limits linked to overall health and occupation. Thus, weekly tipping points for blue- and pink-collar jobs are 7–9 hours lower compared to white-collar jobs, and even wider gaps (11 hours) are apparent for workers with poorer physical functioning, which becomes common as people age. Our modelling reveals that age is not the biggest limiting factor for how many hours older adults can work, rather their health and the types of jobs are critical, and likely widen the gap in who ages successfully or not.

Working Hours, Sleep Disturbance and Self-Assessed Health in Men and Women: A Multilevel Analysis of 30 Countries in Europe

Objectives

This study examined the gender and cross-country differences in the relationship between working hours and self-assessed health among working men and women in Europe, and further explored the moderating role of sleep disturbance in the relationship.

Methods

We used cross-sectional data from the 6th European Working Condition Survey on 14,603 men and 15,486 women across 30 countries in Europe. A multivariate logistic regression was applied to evaluate the relationship between working hours, sleep disturbance, and self- assessed health. In addition, we employed a two-stage multilevel logistic regression to assess the cross-country variations in the relationship between working hours and self-assessed health.

Results

The study showed a slightly U-shaped relationship between working hours and less-than-good self-assessed health among working adults in Europe (<31 h: aOR = 1.11; 95% CI: 1.00-1.25, 41-50 h: aOR = 0.98; 95% CI: 0.84-1.15, and 50+ h: aOR = 1.31; 95% CI: 1.07-1.59). However, working men had higher odds of reporting less-than-good self-assessed health as compared to women when they devote longer hours to paid work. The results further showed that there are cross-country variations in the association between working hours and less-than-good self-assessed health for both men and women, and that men had slightly lower variations as compared to women. Contrary to expectation, sleep disturbance did not moderate the relationship between working hours and less-than-good self-assessed health for both men and women in Europe.

Conclusions

Although there are gender differences and cross-country variations in the association between working hours and less-than-good self-assessed health, sleep disturbance did not moderate the associations. These findings underscore the importance for strict work time regulation and generous work-family policies that may promote good working conditions and health.

Temporal Dimensions of Job Quality and Gender: Exploring Differences in the Associations of Working Time and Health between Women and Men

Research shows strong links between working time organization and workers’ health outcomes. Working time is also known to be highly gendered, with men and women working to different schedules. This article merges these two strands of research and takes a gender-based approach to investigating the relationship between temporal job quality and self-reported health in Europe. First, the sixth European Working Conditions Survey (EWCS) is used to establish the relationship between temporal dimensions of job quality and health and well-being outcomes for employed women and men. This is then corroborated using larger samples and more restricted measures of job quality drawn from micro-data from the 2019–2020 EU Labor Force Survey (LFS). The analyses show that good temporal job quality is positively associated with health and subjective well-being for both women and men, but this effect is significantly stronger for women, who are also at a greater risk of exposure to low control over working time and time under-employment. The findings highlight the importance of studying the impact of working and employment conditions on health from gender perspective, and the need for further exploration of job quality due to changes in the spatio-temporal organization of work during and beyond the COVID-19 pandemic.

Long Working Hours and Risk of Depression by Household Income Level: Findings From the Korea National Health and Nutrition Examination Survey (KNHANES)

OBJECTIVES

To investigate the relationship between working hours and the risk of depression according to household income level.

METHODS

We used the data from the Korea National Health and Nutrition Examination Survey. The information on working hours was obtained from the questionnaire, and depression was assessed by The Patient Health Questionnaire-9. After stratifying by household income level, the risk of depression for long working hour group (more than or equal to 52 hours a week), compared with the 30 to 51 working hour group as a reference, were calculated using multiple logistic regression.

RESULTS

It was found that long working hours associated with high risk for depression in the group with the highest income, but not in the group with the lowest income.

CONCLUSIONS

The relationship between long working hours and the risk of depression varied by household income level.

Prevalence and related factors of depression and anxiety in a cohort of Chinese elderly caregivers in the nursing home

BACKGROUND

The heavy care burden, the long-term dependence of the disabled elderly, and the changing social roles can put elderly caregivers at high risk for mental disorders. This study aimed to explore the prevalence and related factors of depression and anxiety among elderly caregivers and examine the role of resilience in depression and anxiety.

METHODS

A multicentre cross-sectional survey was designed. A total of 953 elderly caregivers in nursing homes were recruited in three provinces in China using convenience sampling. Depression and anxiety were measured by self-rating depression scale (SDS) and self-rating anxiety scale (SAS). Multivariate logistic regression analysis was used to explore the key factors associated with depression and anxiety.

RESULTS

The median SDS score was 40 (interquartile interval 34-48), and the median SAS score was 48 (interquartile interval 38-56). In this cohort, 19.4% reported depression and 44.0% anxiety. Working hours, sensitive personality and health status were related factors for depression symptom. In terms of anxiety symptoms, its related factors included working hours, health status and higher monthly income. Furthermore, resilience was associated with depression and anxiety among caregivers.

LIMITATIONS

A selection bias may be caused by convenience sampling and voluntary participation.

CONCLUSION

Depression and anxiety symptoms were common in the cohort of Chinese elderly caregivers in the nursing home. The factors explored in this study may contribute to the development of individualized interventions for depression and anxiety symptoms.

Long Working Hours, Precarious Employment and Anxiety Symptoms Among Working Chinese Population in Hong Kong

This study aimed to examine the association between working hours and anxiety of a working population in Hong Kong. We used a cross sectional data from a population-based household survey of Hong Kong Chinese adults. Key measures included employment status, skill level, working hours, length of stay at current job and anxiety level. Symptoms of anxiety were assessed using the Depression Anxiety Stress Scale (DASS-21). The data were analysed using logistic regression. Chinese adults who had long working hours (≥ 72 h per week) had higher odds of developing symptoms of anxiety than those who worked for ≤ 36 h per week (odds ratio [OR] 5.94, 95% confidence interval [CI]: 1.82‒19.41). Compared with short period (< 1 year), long period of stay at current job (≥ 5 years) was found as a protective factor from anxiety (OR 0.38, 95% CI: 0.20‒0.73). We found that a working period of 72 h per week was a significant threshold to cause anxiety to workers. Stable job arrangement was a protective factor to workers from anxiety. Implementation of labour market regulations, such as standard working hour policy and stable job arrangement, was also significant to mitigate risk of anxiety for working people in Hong Kong.

Working hours are closely associated with depressive mood and suicidal ideation in Korean adults: a nationwide cross-sectional study

Long working hours have been presumed to negatively influence health. However, evidence is lacking regarding any associations of working hours with depressive mood or suicidal ideation. We investigated the relationships of working hours with depressive mood and suicidal ideation in a representative sample of the Korean general population. We analyzed data collected by the Korea National Health and Nutrition Examination Surveys VI and VII (2013–2018). Depressive mood and suicidal ideation were identified through self-reporting. We divided participants into four groups according to weekly working hours: 30–40, 41–50, 51–60, and > 60 h/week. Sampling weights were applied to obtain estimates for the general Korean population. We analyzed 14,625 participants, of whom 5383 (36.8%), 4656 (31.8%), 2553 (17.5%), and 2033 (13.9%) worked 30–40, 41–50, 51–60, and > 60 h/week, respectively. In these groups, 3.6%, 4.4%, 5.2%, and 6.3% of the participants reported depressive mood, while 1.8%, 1.9%, 2.2%, and 3.6% reported suicidal ideation. In multiple regression analyses, compared with the 30–40 h/week group, the adjusted odds ratios of the 41–50, 51–60, and > 60 h/week groups for depressive mood were 1.35 (1.08–1.69), 1.5 (1.14–1.97), and 1.6 (1.19–2.14). A similar trend was evident for suicidal ideation (odds ratios 1.16 [0.82–1.63], 1.48 [0.99–2.21], and 2.29 [1.53–3.42]). Long working hours are significantly associated with depressive mood and suicidal ideation.

Factors related to depressive symptoms in Korean self-employed workers

Background

We examined factors related to depressive symptoms in Korean self-employed workers.

Methods

This secondary analysis examined data of 14,454 self-employed individuals from the fifth Korean Working Conditions Survey (2017). Multiple logistic regression analysis was used to assess the relationship of depressive symptoms with different variables.

Results

Self-employed workers who had a good work-life balance, a good subjective health, and worked 40 to 48 hours or 48 to 60 hours/week were less likely to report depressive symptoms (all p < 0.05). However, those who always interacted with angry clients, had severe exposure to ergonomic risk factors, and were exposed to moderate or severe abusive behaviors were more likely to report depressive symptoms (all p < 0.05). Age, gender, weekly work days, and working at very fast speed were unrelated to depressive symptoms.

Conclusions

Several factors known to be related to depressive symptoms do not lead to depression in self-employed individuals. Different interventions may therefore be needed to prevent depression in self-employed workers.

Relationship between long work hours and self-reported sleep disorders of non-shift daytime wage workers in South Korea: data from the 5th Korean Working Conditions Survey

Background

Studies have investigated the relationship between long work hours and sleep disorders; however, they have focused on shift workers or specific workers who are at high risk of industrial accidents rather than wage workers in general. The purpose of this study is to investigate the effects of long work hours on sleep disorders among non-shift daytime wage workers.

Methods

We conducted a secondary analysis of data from the 5th Korean Working Conditions Survey. From the 50,205 total participants, we included 26,522 non-shift daytime wage workers after excluding self-employed people, business owners, unpaid family employees, and wage workers who work nights and shifts. Sleep disorders were categorized into “difficulty in falling asleep,” “frequent waking,” and “waking up with fatigue.” Logistic regression analysis was used to evaluate the influence of long work hours on sleep disorders, and the odds ratios (ORs) were calculated.

Results

The OR of working > 52 hours per week was 1.183 (95% confidence interval [CI]: 1.002–1.394) for the risk of developing insomnia compared with working ≤ 40 hours per week. The OR of waking up with fatigue was 1.531 (95% CI: 1.302–1.801). Long work hours showed no significant relationship with difficulty in falling asleep or with frequent waking.

Conclusions

Working for extended hours was associated with increased fatigue upon waking in non-shift daytime wage workers.

Abusive leadership, psychological well-being, and intention to quit during the COVID-19 pandemic: a moderated mediation analysis among Quebec's healthcare system workers

Purpose

To examine the effects from work-organization conditions, abusive leadership, and their interaction on Quebec healthcare system workers’ psychological well-being and intention to quit during the COVID-19 pandemic.

Methods

Mediation and moderated mediation analyses were performed using MPlus software on a sample of 921 Quebec healthcare system workers.

Results

Skill utilization, decision authority, social support from co-workers and supervisors, and recognition were associated directly and positively with psychological well-being, while psychological and physical demands were associated directly and negatively with psychological well-being. Skill utilization, irregular work schedule, and recognition were associated directly and negatively with intention to quit, while psychological demands were associated directly and positively with intention to quit. Moreover, the results demonstrated that abusive leadership attenuated the effects from recognition and decision authority on psychological well-being (moderation effects), contributing to greater intention to quit among workers (moderated mediation effects).

Conclusions

The obtained results underline the importance of work-organization conditions and leadership style on healthcare system workers’ psychological health and their intention to quit their jobs during a pandemic. In particular, and given their key role, leaders/managers must be sensitized concerning leadership style and its possible effects on their employees’ psychological well-being and intention to quit. Therefore, training programs should be offered to leaders/managers to prevent adoption of abusive leadership styles.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00420-021-01790-z.

Association of weekly working hours with poor psychological well-being and moderation by employment status in Korean workers

We examined the association of weekly working hours with poor psychological wellbeing in Korean workers and the moderating effect of employment status. This secondary analysis examined data from the fifth Korean Working Conditions Survey (2017). There were 30,108 waged employees and 14,459 self-employed individuals. The two groups were compared using a moderated regression model with Hayes' PROCESS macro for SPSS. The self-employed had a greater mean age than the waged employees. Higher percentages of the self-employed had short weekly working hours (<40), excessively long weekly working hours (≥60), and poor psychological well-being. After controlling for age, gender, education, monthly income, and occupational class, the interaction between weekly working hours and employment status on psychological well-being was significant (p<0.001). Among the self-employed, the well-being score was lowest in the short working hour group (<40 h/week), highest in the long working hour (48-59 h/week) groups, and intermediate in the excessively long working hours (≥60 h/week) group. For waged employees, psychological wellbeing was the greatest in the short working hour group and decreased continuously as the number of weekly working hours increased. In conclusion, employment status (employee vs. self-employed) moderated the relationship between weekly working hours and psychological well-being.

Impact of long working hours on health based on observations in China

BACKGROUND

Health should be a key focus in considerations of long working hours. Little is known about for which groups of people working longer hours is more harmful to their health. Additionally, the definition of long working hours varies slightly due to country differences in working hours systems. Therefore, this study aims to explore the association between long working hours and the self-rated health (SRH) level, taking into account gender and educational differences.

METHOD

Data were collected from two waves (2016 and 2018) of the China Family Panel Studies (CFPS). A total of 6972 workers were available for analysis. Descriptive statistical analysis, an ordered probit (oprobit) model and conditional mixed process (CMP) regression analyses were used to analyze the data. Furthermore, I conducted a stratified analysis by gender and education groups.

RESULT

This study observed a negative association between long working hours and SRH. Compared to other education groups, labor with long working hours had a more negative impact on the SRH of those with higher education. Long working hours had a more negative influence on the SRH of male workers. In contrast, no clear association was found among female workers.

CONCLUSION

This study estimates SRH of those with long working hours in China. Among workers, long working hours have a negative impact on the health of workers with college degrees or beyond. One possible explanation is that they do not exercise, their diet is unreasonable, and their working conditions involve chronic exposure to computer radiation. The negative health effects of long working hours on males are four times greater than those on females. This study provides valuable insights into the health of the workforce, working time regulations and overtime rules.

US Army Drill Sergeants: Stressors, Behavioral Health, and Mitigating Factors

INTRODUCTION

The role of the drill sergeant is one of the most challenging within the US Army, involving unusually long hours and little time off, for a minimum of 2 years. The current study sought to examine the behavioral health of this population and identify risk factors that might be addressed by policy changes.

MATERIALS AND METHODS

In total, 856 drill sergeants across all Army basic training sites completed surveys from September to November of 2018. Drill sergeants identified factors that had caused stress or worry during their assignment. Rates were measured for behavioral health outcomes including depression, insomnia, anxiety, burnout, functional impairment, alcohol misuse, aggression, and low morale. Potential risk and resilience factors included time as a drill sergeant, sleep, route of assignment, general leadership, health-promoting leadership, and drill sergeant camaraderie. The study was approved by the Walter Reed Army Institute of Research Institutional Review Board.

RESULTS

The most commonly experienced stressors were finding time to exercise, lack of sleep, and long work hours. Percentages of drill sergeants meeting behavioral health screening criteria were 19% for depression, 27% for moderate-to-severe insomnia, 14% for generalized anxiety disorder, 48% for high burnout, 32% for functional impairment, 35% for moderate alcohol misuse, 32% for off-duty aggression, and 25% for low morale. Rates for most outcomes were associated with time spent as a drill sergeant, with behavioral health issues peaking during 13-18 months. Poorer outcomes were also associated with fewer hours of sleep and initial unhappiness regarding involuntary assignment to the role of drill sergeant, while better outcomes were associated with higher ratings of general leadership, health-promoting leadership, and drill sergeant camaraderie.

CONCLUSIONS

This study is the first to examine behavioral health and morale of drill sergeants and to identify risk and resilience factors. Suggestions for policy changes include increasing the number of drill sergeants to decrease workload and allow sufficient time for recovery and sleep.

Associations Between Workplace Factors and Depression and Anxiety in Australian Heavy Vehicle Truck Drivers

INTRODUCTION

A number of health issues have been identified as prevalent within the Australian heavy vehicle driving population. Mental illnesses, such as depression and anxiety, are among those disorders that have been regularly reported, however, the contributing factors are yet to be elucidated.

METHODS

This study aimed to assess the associations between workplace factors such as years of employment, social interaction and shift length, with depressive and anxious symptomology in a cohort of 60 Australian heavy vehicle drivers.

RESULTS

Significant positive associations were identified between depression and alcohol use (P = 0.044), coffee consumption (P = 0.037), number of accidents during career (P = < 0.004), and number of hours driving per shift (P ≤ 0.001). Anxiety was found to be positively associated with a number of hours driving per week (P ≤ 0.001), and the number of accidents or near misses during a driving career (P = 0.039).

CONCLUSION

Several workplace factors were identified as being correlated to depression or anxiety within this cohort, suggesting potential changes to rostering systems and education regarding alcohol use may benefit the mental health of this driver population.