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Hagenaars LL, Schmidt LA, Groeniger JO, Bekker MPM, Ter Ellen F, de Leeuw E, van Lenthe FJ, Oude Hengel KM, Stronks K. Why we struggle to make progress in obesity prevention and how we might overcome policy inertia: Lessons from the complexity and political sciences. Obes Rev 2024; 25:e13705. [PMID: 38424004 DOI: 10.1111/obr.13705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 12/18/2023] [Accepted: 01/18/2024] [Indexed: 03/02/2024]
Abstract
Despite evidence for the effectiveness of policies that target obesogenic environments, their adoption remains deficient. Using methods and concepts from complexity and political science (Stock-and-Flow analysis and Punctuated Equilibrium Theory) and a qualitative literature review, we developed system maps to identify feedback loops that hinder policymaking on mitigating obesogenic environments and feedback loops that could trigger and sustain policy change. We found numerous self-reinforcing feedback loops that buttress the assumption that obesity is an individual problem, strengthening the biomedical and commercial weight-loss sectors' claim to "ownership" over solutions. That is, improvements in therapies for individuals with obesity reinforces policymakers' reluctance to target obesogenic environments. Random events that focus attention on obesity (e.g., celebrities dismissing soda) could disrupt this cycle, when actors from outside the medical and weight-loss sector (e.g., anti-weight stigma activists) successfully reframe obesity as a societal problem, which requires robust and politically relevant engagement with affected communities prior to such events taking place. Sustained prioritization of policies targeting obesogenic environments requires shared problem ownership of affected communities and nonhealth government sectors, by emphasizing cobenefits of policies that target obesogenic environments (e.g., ultraprocessed food taxation for raising revenue) and solutions that are meaningful for affected communities.
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Affiliation(s)
- Luc L Hagenaars
- Department of Public Health, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Philip R. Lee Institute for Health Policy Studies, School of Medicine, University of California, San Francisco, USA
| | - Laura A Schmidt
- Philip R. Lee Institute for Health Policy Studies, School of Medicine, University of California, San Francisco, USA
| | - Joost Oude Groeniger
- Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Erasmus School of Social and Behavioural Sciences, Erasmus MC, Rotterdam, The Netherlands
| | - Marleen P M Bekker
- Health and Society Group, Wageningen University & Research, Wageningen, The Netherlands
| | - Fleur Ter Ellen
- Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Evelyne de Leeuw
- Urban Health and Policy, University of New South Wales, Sydney, Australia
- École de Santé Publique, Université de Montréal, Montréal, Canada
| | - Frank J van Lenthe
- Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Utrecht, The Netherlands
| | - Karen M Oude Hengel
- Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Work Health Technology, Netherlands Organisation for Applied Scientific Research TNO, The Hague, The Netherlands
| | - Karien Stronks
- Department of Public Health, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
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van Elk F, Loef B, Proper KI, Burdorf A, Robroek SJW, Oude Hengel KM. Sleep quality, sleep duration, and sleep disturbances among hospital night workers: a prospective cohort study. Int Arch Occup Environ Health 2024; 97:179-188. [PMID: 38153566 PMCID: PMC10876714 DOI: 10.1007/s00420-023-02033-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/22/2023] [Indexed: 12/29/2023]
Abstract
PURPOSE This study aimed to assess among hospital night workers (i) to what extent sleep quality, sleep duration and sleep disturbances overlap, and (ii) associations between sociodemographic factors, lifestyle factors and work characteristics and sleep components. METHODS Data were used from 467 hospital night workers participating in the Klokwerk + study, a prospective cohort study with two measurements. Sleep quality was measured by the Pittsburgh Sleep Quality Index, sleep duration and sleep disturbances were measured by the Medical Outcomes Study Sleep Scale. The overlap between the three sleep measures was visualized with a Venn diagram and the proportions of overlap was calculated. Associations between independent variables (sociodemographic factors, lifestyle factors and work characteristics) and the three sleep outcomes were estimated using between-within Poisson regression models. RESULTS About 50% of the hospital night workers had at least one poor sleep outcome. Overlap in poor sleep outcomes was apparent for 36.8% of these workers, while the majority had a poor outcome in one of the sleep components only (63.1%). Former smoking had a significant association with poor sleep quality. For most independent variables no associations with poor sleep outcomes were observed. CONCLUSION Our findings suggest that sleep quality, sleep duration and sleep disturbances are separate entities and should be studied separately. Lifestyle factors and work characteristics were generally not associated with poor sleep. Since these factors can have an acute effect on sleep, future research should consider ecological momentary assessment to examine how exposure and outcomes (co)vary within-persons, over time, and across contexts. Trial registration Netherlands Trial Register trial number NL56022.041.16.
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Affiliation(s)
- Fleur van Elk
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Bette Loef
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Karin I Proper
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Alex Burdorf
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Suzan J W Robroek
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Karen M Oude Hengel
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
- Department of Work Health Technology, Netherlands Organisation for Applied Scientific Research TNO, Leiden, The Netherlands.
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Cillekens B, van Eeghen E, Oude Hengel KM, Coenen P. Within-individual changes in physical work demands associated with self-reported health and musculoskeletal symptoms: a cohort study among Dutch workers. Int Arch Occup Environ Health 2023; 96:1301-1311. [PMID: 37743372 PMCID: PMC10560189 DOI: 10.1007/s00420-023-02008-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 09/04/2023] [Indexed: 09/26/2023]
Abstract
PURPOSE This study aimed to investigate changes in physical work demands in association with self-rated health and musculoskeletal symptoms. METHODS Data from five waves over the period 2019-2021 of the Netherlands Working Conditions Survey COVID-19 were available for 7191 participants aged 19-64 years who worked (partly) on-site during at least two consecutive waves. Logistic generalized estimated equations (GEE) were used to estimate the odds ratios (OR) with 95% confidence interval (CI) for changes (increase or decrease compared to no change) in physical work demands between two waves and poor self-rated health and musculoskeletal symptoms in the following wave, adjusted for the health outcome at the first wave, age, educational level, working hours and hours worked from home. RESULTS In females, a statistically significant association was found between an increase in physical work demands compared to no change and musculoskeletal symptoms (OR 1.39, 95% CI 1.17-1.65). A decrease in physical work demands in females was not statistically significantly associated with musculoskeletal symptoms (OR 0.93, 95% CI 0.80-1.08). Similar trends were found for poor self-rated health, although non-statistically significant. For males, comparable but attenuated associations were found. CONCLUSION While our study showed that increasing physical work demands are associated with adverse health (self-reported and musculoskeletal), it did not appear to benefit worker's health to reduce work demands. Future research with multiple measurements in a shorter period and additionally using devices to measure physical work demands will be needed to confirm our study results.
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Affiliation(s)
- Bart Cillekens
- Department of Public and Occupational Health, Amsterdam UMC, Location VU University Medical Center (VUmc), Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Societal Participation & Health, Amsterdam, The Netherlands
| | - Emma van Eeghen
- Department of Public and Occupational Health, Amsterdam UMC, Location VU University Medical Center (VUmc), Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - Karen M Oude Hengel
- Department of Work Health Technology, TNO, Sylviusweg 71, 2333 BE, Leiden, The Netherlands
| | - Pieter Coenen
- Department of Public and Occupational Health, Amsterdam UMC, Location VU University Medical Center (VUmc), Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
- Amsterdam Public Health Research Institute, Societal Participation & Health, Amsterdam, The Netherlands.
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van Veen M, Schelvis RM, Hoekstra T, Bongers PM, Boot CR, Oude Hengel KM. Work characteristics and emotional exhaustion among young workers: a latent class analysis. BMJ Open 2023; 13:e074386. [PMID: 37852771 PMCID: PMC10603524 DOI: 10.1136/bmjopen-2023-074386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 09/27/2023] [Indexed: 10/20/2023] Open
Abstract
OBJECTIVES This study aims to assess the heterogeneity of psychosocial working conditions of young workers by identifying subgroups of work characteristic configurations within young workers and to assess these subgroups' associations with emotional exhaustion. DESIGN Latent class analysis. Groups were formed based on 12 work characteristics (8 job demands and 4 job resources), educational level and sex. Differences in emotional exhaustion between subgroups were analysed using analysis of variance and post hoc comparisons. SETTING Data from the 2019 wave of the Netherlands Working Conditions Survey. PARTICIPANTS 7301 individuals between the age of 18 and 30 years, who worked more than 16 hours per week. MAIN OUTCOME MEASURE Emotional exhaustion. RESULTS Five subgroups of work characteristics could be identified and were labelled as: (1) 'low-complexity work' (24.4%), (2) 'office work' (32.3%), (3) 'manual and non-interpersonal work' (12.4%), (4) 'non-manual and interpersonal work' (21.0%), and (5) 'manual and interpersonal work' (9.9%). Mean scores for emotional exhaustion in the two interpersonal work groups (M=3.11, SD=1.4; M=3.45, SD=1.6) were significantly higher than in the first three groups (M=2.05, SD=1.1; M=1.98, SD=1.0; M=2.05, SD=1.1) (all 95% CIs excluding 0). Further, mean scores for emotional exhaustion were significantly higher in the 'manual and interpersonal work' group than in the 'non-manual and interpersonal work' group (95% CI 0.24, 0.45). All results could be replicated in the 2017 and 2021 waves of the Netherlands Working Conditions Survey. CONCLUSIONS Young workers reported heterogeneous work characteristic configurations with substantial differences in degrees of emotional exhaustion between the identified subgroups. Preventing emotional exhaustion should focus on the two interpersonal work subgroups, which showed a high degree of emotional exhaustion. In prevention efforts, these groups' configurations of work characteristics should be taken into account.
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Affiliation(s)
- Malte van Veen
- Amsterdam Public Health, Societal Participation & Health, Amsterdam UMC, Amsterdam, The Netherlands
- Unit Healthy Living & Work, TNO Location Leiden Sylviusweg, Leiden, The Netherlands
- Body@Work, Amsterdam, The Netherlands
- Public and Occupational Health, Amsterdam UMC, location VUmc, Amsterdam, Netherlands
| | - Roosmarijn Mc Schelvis
- Amsterdam Public Health, Societal Participation & Health, Amsterdam UMC, Amsterdam, The Netherlands
- Body@Work, Amsterdam, The Netherlands
- Public and Occupational Health, Amsterdam UMC Location AMC, Amsterdam, The Netherlands
| | - Trynke Hoekstra
- Department of Health Sciences and Amsterdam Public Health research institute, Faculty of Science, VU University Amsterdam, Amsterdam, The Netherlands
| | - Paulien M Bongers
- Unit Healthy Living & Work, TNO Location Leiden Sylviusweg, Leiden, The Netherlands
- Body@Work, Amsterdam, The Netherlands
- Public and Occupational Health, Amsterdam UMC, location VUmc, Amsterdam, Netherlands
| | - Cécile Rl Boot
- Amsterdam Public Health, Societal Participation & Health, Amsterdam UMC, Amsterdam, The Netherlands
- Body@Work, Amsterdam, The Netherlands
- Public and Occupational Health, Amsterdam UMC, location VUmc, Amsterdam, Netherlands
| | - Karen M Oude Hengel
- Unit Healthy Living & Work, TNO Location Leiden Sylviusweg, Leiden, The Netherlands
- Body@Work, Amsterdam, The Netherlands
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5
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Oude Hengel KM, Soeter M, In der Maur M, van Oostrom SH, Loef B, Hooftman WE. Perimenopause: Symptoms, work ability and health among 4010 Dutch workers. Maturitas 2023; 176:107793. [PMID: 37393659 DOI: 10.1016/j.maturitas.2023.107793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 05/31/2023] [Accepted: 06/17/2023] [Indexed: 07/04/2023]
Abstract
OBJECTIVE In this study we examined the associations between menopausal symptoms and work ability and health among a general population of Dutch female workers. STUDY DESIGN This nationwide cross-sectional study was a follow-up of the Netherlands Working Conditions Survey 2020. In 2021, 4010 Dutch female employees aged 40-67 years completed an online survey on a variety of topics, including menopausal symptoms, work ability and health. METHODS Linear and logistic regression analyses were performed to investigate the association between the degree of menopausal symptoms with work ability, self-rated health and emotional exhaustion, after adjustment for potential confounders. RESULTS Almost one-fifth of participants were in the perimenopause (n = 743). Of these women, 80 % experienced menopausal symptoms: 27.5 % 'often' and 52.5 % 'sometimes'. Experiencing menopausal symptoms was associated with lower work ability, poorer self-rated health, and more emotional exhaustion. These associations were most pronounced among perimenopausal women 'often' experiencing symptoms. CONCLUSIONS Menopausal symptoms threaten the sustainable employability of female workers. Interventions and guidelines are needed to support women, employers and (occupational) health professionals.
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Affiliation(s)
- Karen M Oude Hengel
- Netherlands Organization for Applied Scientific Research TNO, Sylviusweg 71, 2333 BE Leiden, the Netherlands.
| | - Marieke Soeter
- Netherlands Organization for Applied Scientific Research TNO, Sylviusweg 71, 2333 BE Leiden, the Netherlands
| | - Merel In der Maur
- Netherlands Organization for Applied Scientific Research TNO, Sylviusweg 71, 2333 BE Leiden, the Netherlands
| | - Sandra H van Oostrom
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, P.O Box 1, 3720 BA Bilthoven, the Netherlands
| | - Bette Loef
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, P.O Box 1, 3720 BA Bilthoven, the Netherlands
| | - Wendela E Hooftman
- Netherlands Organization for Applied Scientific Research TNO, Sylviusweg 71, 2333 BE Leiden, the Netherlands
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van der Feltz S, Schlünssen V, Basinas I, Begtrup LM, Burdorf A, Bonde JPE, Flachs EM, Peters S, Pronk A, Stokholm ZA, van Tongeren M, van Veldhoven K, Oude Hengel KM, Kolstad HA. Associations between an international COVID-19 job exposure matrix and SARS-CoV-2 infection among 2 million workers in Denmark. Scand J Work Environ Health 2023; 49:375-385. [PMID: 37167299 PMCID: PMC10790132 DOI: 10.5271/sjweh.4099] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Indexed: 05/13/2023] Open
Abstract
OBJECTIVES This study investigates the associations between the Danish version of a job exposure matrix for COVID-19 (COVID-19-JEM) and Danish register-based SARS-CoV-2 infection information across three waves of the pandemic. The COVID-19-JEM consists of four dimensions on transmission: two on mitigation measures, and two on precarious work characteristics. METHODS The study comprised 2 021 309 persons from the Danish working population between 26 February 2020 and 15 December 2021. Logistic regression models were applied to assess the associations between the JEM dimensions and overall score and SARS-CoV-2 infection across three infection waves, with peaks in March-April 2020, December-January 2021, and February-March 2022. Sex, age, household income, country of birth, wave, residential region and during wave 3 vaccination status were accounted for. RESULTS Higher risk scores within the transmission and mitigation dimensions and the overall JEM score resulted in higher odds ratios (OR) of a SARS-CoV-2 infection. OR attenuated across the three waves with ranges of 1.08-5.09 in wave 1, 1.06-1.60 in wave 2, and 1.05-1.45 in those not (fully) vaccinated in wave 3. In wave 3, no associations were found for those fully vaccinated. In all waves, the two precarious work dimensions showed weaker or inversed associations. CONCLUSIONS The COVID-19-JEM is a promising tool for assessing occupational exposure to SARS-CoV-2 and other airborne infectious agents that mainly spread between people who are in close contact with each other. However, its usefulness depends on applied restrictions and the vaccination status in the population of interest.
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Affiliation(s)
- Sophie van der Feltz
- Department of Occupational Medicine, Danish Ramazzini Center, Aarhus University Hospital, Palle Juul-Jensens Boulevard 35, 8200 Aarhus N, Denmark.
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Rhodes S, Beale S, Wilkinson J, van Veldhoven K, Basinas I, Mueller W, Oude Hengel KM, Burdorf A, Peters S, Stokholm ZA, Schlünssen V, Kolstad H, Pronk A, Pearce N, Hayward A, van Tongeren M. Exploring the relationship between job characteristics and infection: Application of a COVID-19 job exposure matrix to SARS-CoV-2 infection data in the United Kingdom. Scand J Work Environ Health 2023; 49:171-181. [PMID: 36537299 PMCID: PMC10621898 DOI: 10.5271/sjweh.4076] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE This study aimed to assess whether workplace exposures as estimated via a COVID-19 job exposure matrix (JEM) are associated with SARS-CoV-2 in the UK. METHODS Data on 244 470 participants were available from the Office for National Statistics Coronavirus Infection Survey (CIS) and 16 801 participants from the Virus Watch Cohort, restricted to workers aged 20-64 years. Analysis used logistic regression models with SARS-CoV-2 as the dependent variable for eight individual JEM domains (number of workers, nature of contacts, contact via surfaces, indoor or outdoor location, ability to social distance, use of face covering, job insecurity, and migrant workers) with adjustment for age, sex, ethnicity, index of multiple deprivation (IMD), region, household size, urban versus rural area, and health conditions. Analyses were repeated for three time periods (i) February 2020 (Virus Watch)/April 2020 (CIS) to May 2021), (ii) June 2021 to November 2021, and (iii) December 2021 to January 2022. RESULTS Overall, higher risk classifications for the first six domains tended to be associated with an increased risk of infection, with little evidence of a relationship for domains relating to proportion of workers with job insecurity or migrant workers. By time there was a clear exposure-response relationship for these domains in the first period only. Results were largely consistent across the two UK cohorts. CONCLUSIONS An exposure-response relationship exists in the early phase of the COVID-19 pandemic for number of contacts, nature of contacts, contacts via surfaces, indoor or outdoor location, ability to social distance and use of face coverings. These associations appear to have diminished over time.
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Affiliation(s)
- Sarah Rhodes
- Division of Population Health, Health Services Research & Primary Care, University of Manchester, Manchester, UK.
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Eekhout I, van Tongeren M, Pearce N, Oude Hengel KM. The impact of occupational exposures on infection rates during the COVID-19 pandemic: a test-negative design study with register data of 207 034 Dutch workers. Scand J Work Environ Health 2023; 49:259-270. [PMID: 36913703 DOI: 10.5271/sjweh.4086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023] Open
Abstract
OBJECTIVE This study aimed to investigate the effects of occupational exposures on the risk of a positive COVID-19 test, and whether this differed across pandemic waves. METHODS Data from 207 034 workers from The Netherlands with test data on COVID-19 from June 2020 until August 2021 were available. Occupational exposure was estimated by using the eight dimensions of a COVID-19 job exposure matrix (JEM). Personal characteristics, household composition and residence area were derived from Statistics Netherlands. A test-negative design was applied in which the risk of a positive test was analyzed in a conditional logit model. RESULTS All eight dimensions of occupational exposure included in the JEM increased the odds of a positive test for the entire study period and three pandemic waves [OR ranging from 1.09, (95% confidence interval (CI) 1.02-1.17) to 1.77 (95% CI 1.61-1.96)]. Adjusting for a previous positive test and other covariates strongly reduced the odds to be infected, but most dimensions remained at elevated risk. Fully adjusted models showed that contaminated work spaces and face covering were mostly relevant in the first two pandemic waves, whereas income insecurity showed higher odds in the third wave. Several occupations have a higher predicted value for a positive COVID-19 test, with variation over time. Discussion Occupational exposures are associated with a higher risk of a positive test, but variations over time exist in occupations with the highest risks. These findings provide insights for interventions among workers for future pandemic waves of COVID-19 or other respiratory epidemics.
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Affiliation(s)
- Iris Eekhout
- Netherlands Organisation for Applied Scientific Research TNO, Unit Healthy Living, Sylviusweg 71, 2333 BE Leiden, The Netherlands.
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9
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van Elk F, Robroek SJW, Burdorf A, Oude Hengel KM. Impact of the COVID-19 pandemic on psychosocial work factors and emotional exhaustion among workers in the healthcare sector: a longitudinal study among 1915 Dutch workers. Occup Environ Med 2023; 80:27-33. [PMID: 36424169 PMCID: PMC9763172 DOI: 10.1136/oemed-2022-108478] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 10/12/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This study aims to investigate across subgroups of healthcare workers (1) the changes in psychosocial working conditions and emotional exhaustion during the pandemic compared with the situation before, and (2) the impact of different stages of the COVID-19 pandemic in terms of hospital pressure on psychosocial working conditions and emotional exhaustion. METHODS Five questionnaire measurements during 2 years from 1915 healthcare workers in the longitudinal study 'the Netherlands Working Conditions Survey-COVID-19' were used. At each measurement, three subgroups were defined: working with patients with COVID-19, working with other patients and not working with patients. For each measurement, hospital pressure was determined by number of hospitalisations per day. Linear mixed models were fitted to analyse differences across subgroups of healthcare workers. RESULTS During COVID-19, psychosocial working conditions deteriorated among healthcare workers working with patients, in particular with patients with COVID-19, compared with healthcare workers not working with patients after correcting for the situation before COVID-19. No changes were observed for emotional exhaustion in any of the subgroups. An increasing hospital pressure improved job autonomy and reduced emotional demands among healthcare workers in COVID-19 wards, but had no influence on other psychosocial working conditions and emotional exhaustion. CONCLUSION Psychosocial working conditions deteriorated for healthcare workers working with (COVID-19) patients during the pandemic, while emotional exhaustion did not change among all groups of healthcare workers.
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Affiliation(s)
- Fleur van Elk
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Suzan J W Robroek
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Alex Burdorf
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
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van Veen M, Oude Hengel KM, Schelvis RMC, Bongers PM, Ket JCF, van der Beek AJ, Boot CRL. Psychosocial work factors affecting mental health of young workers: a systematic review. Int Arch Occup Environ Health 2023; 96:57-75. [PMID: 35976432 PMCID: PMC9823059 DOI: 10.1007/s00420-022-01907-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 06/30/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE For the general working population, robust evidence exists for associations between psychosocial work exposures and mental health. As this relationship is less clear for young workers, this systematic review aims at providing an overview of the evidence concerning psychosocial work factors affecting mental health of young workers. METHODS The electronic databases used were PubMed, Web of Science, and PsycINFO and were last searched in October 2021. The eligible outcomes included depression-, stress-, burnout- and anxiety-related complaints, and fatigue, excluding clinical diagnoses and suicide-related outcomes. Only studies with workers aged 35 years or younger were included, which reported at least one association between a psychosocial work factor as exposure and a mental health complaint as outcome. Studies had to be in English, German or Dutch. Risk of bias was assessed using an instrument from the National Heart, Lung, and Blood Institute. Data synthesis was conducted using GRADE. RESULTS In total 17 studies were included in this systematic review, including data from 35,600 young workers in total. Across these studies 86 exposure-outcome associations were reported. Nine exposure-outcome associations could be synthesised. The application of the GRADE framework led to one "low" assessment for the association between psychosocial job quality and mental health. The certainty of evidence for the other eight associations in the synthesis was very low. CONCLUSIONS The current systematic review disclosed a high degree of uncertainty of the evidence due to conceptually fuzzy outcomes and exposures as well as large heterogeneity between studies.
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Affiliation(s)
- Malte van Veen
- Netherlands Organisation for Applied Scientific Research TNO, Unit Healthy Living, Leiden, The Netherlands. .,Amsterdam UMC location Vrije Universiteit Amsterdam, Public and Occupational Health, Boelelaan 1117, Amsterdam, The Netherlands. .,Body@Work, Research Center on Work, Health and Technology, TNO/VUmc, Amsterdam, The Netherlands. .,Amsterdam Public Health, Societal Participation & Health, Amsterdam, The Netherlands.
| | - Karen M. Oude Hengel
- Netherlands Organisation for Applied Scientific Research TNO, Unit Healthy Living, Leiden, The Netherlands ,Body@Work, Research Center on Work, Health and Technology, TNO/VUmc, Amsterdam, The Netherlands
| | - Roosmarijn M. C. Schelvis
- Body@Work, Research Center on Work, Health and Technology, TNO/VUmc, Amsterdam, The Netherlands ,Amsterdam UMC, location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, The Netherlands ,Amsterdam Public Health, Societal Participation & Health, Amsterdam, The Netherlands
| | - Paulien M. Bongers
- Netherlands Organisation for Applied Scientific Research TNO, Unit Healthy Living, Leiden, The Netherlands ,Amsterdam UMC location Vrije Universiteit Amsterdam, Public and Occupational Health, Boelelaan 1117, Amsterdam, The Netherlands ,Body@Work, Research Center on Work, Health and Technology, TNO/VUmc, Amsterdam, The Netherlands
| | - Johannes C. F. Ket
- Medical Library, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Allard J. van der Beek
- Amsterdam UMC location Vrije Universiteit Amsterdam, Public and Occupational Health, Boelelaan 1117, Amsterdam, The Netherlands ,Body@Work, Research Center on Work, Health and Technology, TNO/VUmc, Amsterdam, The Netherlands ,Amsterdam Public Health, Societal Participation & Health, Amsterdam, The Netherlands
| | - Cécile R. L. Boot
- Amsterdam UMC location Vrije Universiteit Amsterdam, Public and Occupational Health, Boelelaan 1117, Amsterdam, The Netherlands ,Body@Work, Research Center on Work, Health and Technology, TNO/VUmc, Amsterdam, The Netherlands ,Amsterdam Public Health, Societal Participation & Health, Amsterdam, The Netherlands
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van Zon SKR, Ots P, Robroek SJW, Burdorf A, Oude Hengel KM, Brouwer S. Do chronic diseases moderate the association between psychosocial working conditions and work exit? Longitudinal results from 55 950 Dutch workers. J Epidemiol Community Health 2022; 76:jech-2021-218432. [PMID: 35798538 DOI: 10.1136/jech-2021-218432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 06/30/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND This study aims to examine whether the presence of chronic diseases or multimorbidity moderates the associations between psychosocial working conditions and work exit through unemployment, work disability or early retirement. METHODS Data from Lifelines (n=55 950), a prospective population-based cohort study, were enriched with monthly information on employment status from Statistics Netherlands. Working conditions were measured with the Copenhagen Psychosocial Questionnaire. Work exit was defined as unemployment, work disability and early retirement. Participants were classified as having no chronic disease, one chronic disease or multimorbidity. Cause-specific Cox proportional hazard regression models, adjusted for age, gender, education and partnership status, were used to analyse associations between working conditions and work exit. Interaction terms were used to examine moderation by chronic disease status. RESULTS Higher social support decreased the risk for unemployment, work disability and early retirement. Higher meaning of work decreased the risk of unemployment, and more possibilities for development decreased the risk for work disability. Chronic disease status did generally not moderate associations between working conditions and work exit. Only among workers without a chronic disease, more possibilities for development was associated with a lower risk for unemployment (HR: 0.89; 95% CI: 0.85 to 0.94). CONCLUSION While efforts to retain workers with chronic diseases in the labour market should continue, favourable psychosocial working conditions are important for all workers.
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Affiliation(s)
- Sander K R van Zon
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Patricia Ots
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Suzan J W Robroek
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Alex Burdorf
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Karen M Oude Hengel
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Work, Health & Technology, Netherlands Organization for Applied Scientific Research, TNO, Leiden, The Netherlands
| | - Sandra Brouwer
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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12
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Schram JLD, Schuring M, Oude Hengel KM, Burdorf A, Robroek SJW. The influence of chronic diseases and poor working conditions in working life expectancy across educational levels among older employees in the Netherlands. Scand J Work Environ Health 2022; 48:391-398. [PMID: 35471244 PMCID: PMC9527781 DOI: 10.5271/sjweh.4028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Objectives This study aims to estimate the influence of chronic diseases and poor working conditions – across educational levels – on working life expectancy (WLE) and working years lost (WYL) in the Dutch workforce after age 50. Methods Information on demographics, chronic diseases, and working conditions from 11 800 Dutch workers aged 50–66 years participating in the Study on Transitions in Employment, Ability and Motivation (STREAM) from 2010/2015 was enriched with monthly information on employment status from Statistics Netherlands up to 2018. In a multistate model, transitions were calculated between paid employment and involuntary exit (disability benefits, unemployment) and voluntary exit (economic inactivity, early retirement) to estimate the impact of education, chronic diseases, and working conditions on WLE and WYL between age 50 and 66. Results Workers with a chronic disease (up to 1.01 years) or unfavorable working conditions (up to 0.63 years) had more WYL due to involuntary pathways than workers with no chronic disease or favorable working conditions. The differences in WYL between workers with and without a chronic disease were slightly higher among workers with a lower education level (male: 0.85, female: 1.01 years) compared to workers with a high educational level (male: 0.72, female: 0.82 years). Given the higher prevalence of chronic diseases and unfavorable working conditions, WYL among lower educated workers were higher than among higher educated workers. Conclusions The presence of a chronic disease or unfavorable working conditions, more prevalent among lower educated workers, contribute substantially to WYL among older workers. This will increase educational inequalities in working careers.
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Affiliation(s)
- Jolinda L D Schram
- Erasmus University Medical Center, Department of Public Health, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
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13
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Ots P, Oude Hengel KM, Burdorf A, Robroek SJW, Nieboer D, Schram JLD, van Zon SKR, Brouwer S. Development and validation of a prediction model for unemployment and work disability among 55 950 Dutch workers. Eur J Public Health 2022; 32:578-585. [PMID: 35613006 PMCID: PMC9341844 DOI: 10.1093/eurpub/ckac045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background This study developed prediction models for involuntary exit from paid employment through unemployment and disability benefits and examined if predictors and discriminative ability of these models differ between five common chronic diseases. Methods Data from workers in the Lifelines Cohort Study (n = 55 950) were enriched with monthly information on employment status from Statistics Netherlands. Potential predictors included sociodemographic factors, chronic diseases, unhealthy behaviours and working conditions. Data were analyzed using cause-specific Cox regression analyses. Models were evaluated with the C-index and the positive and negative predictive values (PPV and NPV, respectively). The developed models were externally validated using data from the Study on Transitions in Employment, Ability and Motivation. Results Being female, low education, depression, smoking, obesity, low development possibilities and low social support were predictors of unemployment and disability. Low meaning of work and low physical activity increased the risk for unemployment, while all chronic diseases increased the risk of disability benefits. The discriminative ability of the models of the development and validation cohort were low for unemployment (c = 0.62; c = 0.60) and disability benefits (c = 0.68; c = 0.75). After stratification for specific chronic diseases, the discriminative ability of models predicting disability benefits improved for cardiovascular disease (c = 0.81), chronic obstructive pulmonary disease (c = 0.74) and diabetes mellitus type 2 (c = 0.74). The PPV was low while the NPV was high for all models. Conclusion Taking workers’ particular disease into account may contribute to an improved prediction of disability benefits, yet risk factors are better examined at the population level rather than at the individual level.
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Affiliation(s)
- Patricia Ots
- Department of Health Sciences, Community & Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Karen M Oude Hengel
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Work Health Technology, Netherlands Organization for Applied Scientific Research, TNO, Leiden, The Netherlands
| | - Alex Burdorf
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Suzan J W Robroek
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Daan Nieboer
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jolinda L D Schram
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Sander K R van Zon
- Department of Health Sciences, Community & Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sandra Brouwer
- Department of Health Sciences, Community & Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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14
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van der Feltz S, Peters S, Pronk A, Schlünssen V, Stokholm ZA, Kolstad HA, van Veldhoven K, Basinas I, van Tongeren M, Burdorf A, Oude Hengel KM. Validation of a COVID-19 Job Exposure Matrix (COVID-19-JEM) for Occupational Risk of a SARS-CoV-2 Infection at Work: Using Data of Dutch Workers. Ann Work Expo Health 2022; 67:9-20. [PMID: 35583140 PMCID: PMC9129190 DOI: 10.1093/annweh/wxac032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 04/11/2022] [Accepted: 04/19/2022] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES A COVID-19 Job Exposure Matrix (COVID-19-JEM) has been developed, consisting of four dimensions on transmission, two on mitigation measures, and two on precarious work. This study aims to validate the COVID-19-JEM by (i) comparing risk scores assigned by the COVID-19-JEM with self-reported data, and (ii) estimating the associations between the COVID-19-JEM risk scores and self-reported COVID-19. METHODS Data from measurements 2 (July 2020, n = 7690) and 4 (March 2021, n = 6794) of the Netherlands Working Conditions Survey-COVID-19 (NWCS-COVID-19) cohort study were used. Responses to questions related to the transmission risks and mitigation measures of Measurement 2 were used to calculate self-reported risk scores. These scores were compared with the COVID-19-JEM attributed risk scores, by assessing the percentage agreement and weighted kappa (κ). Based on Measurement 4, logistic regression analyses were conducted to estimate the associations between all COVID-19-JEM risk scores and self-reported COVID-19 (infection in general and infected at work). RESULTS The agreement between the COVID-19-JEM and questionnaire-based risk scores was good (κ ≥ 0.70) for most dimensions, except work location (κ = 0.56), and face covering (κ = 0.41). Apart from the precarious work dimensions, higher COVID-19-JEM assigned risk scores had higher odds ratios (ORs; ranging between 1.28 and 1.80) on having had COVID-19. Associations were stronger when the infection were thought to have happened at work (ORs between 2.33 and 11.62). CONCLUSIONS Generally, the COVID-19-JEM showed a good agreement with self-reported infection risks and infection rates at work. The next step is to validate the COVID-19-JEM with objective data in the Netherlands and beyond.
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Affiliation(s)
- Sophie van der Feltz
- Netherlands Organisation for Applied Scientific Research TNO, Department of Work Health Technology, Unit Healthy Living, Schipholweg 79-86, 2316 ZL Leiden, The Netherlands
| | - Susan Peters
- Department Population Health Sciences, Institute for Risk Assessment Sciences, Utrecht University, Yalelaan 2, 3584 CM Utrecht, The Netherlands
| | - Anjoeka Pronk
- Netherlands Organisation for Applied Scientific Research TNO, Department of Work Health Technology, Unit Healthy Living, Schipholweg 79-86, 2316 ZL Leiden, The Netherlands,Netherlands Organisation for Applied Scientific Research TNO, Department pf Risk Analysis for Products in Development, Princetonlaan 6 3584 CB Utrecht, The Netherlands
| | - Vivi Schlünssen
- Department of Public Health, Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark,National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen Ø, Denmark
| | - Zara A Stokholm
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark
| | - Henrik A Kolstad
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark
| | - Karin van Veldhoven
- London School of Hygiene & Tropical Medicine, Faculty of Epidemiology and Public Health, Department of Non-Communicable Disease Epidemiology, Keppel Street, London WC1E 7HT, UK
| | - Ioannis Basinas
- Centre for Occupational and Environmental Health, Centre for Epidemiology, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Martie van Tongeren
- Centre for Occupational and Environmental Health, Centre for Epidemiology, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Alex Burdorf
- Erasmus Medical Center Rotterdam, Department of Public Health, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands
| | - Karen M Oude Hengel
- Author to whom correspondence should be addressed. Tel: +31-6-468-47-269; e-mail:
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15
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van de Ven D, Robroek SJ, Oude Hengel KM, Burdorf A, Schuring M. Changes in health among 45-64-year-old Dutch persons before, during and after becoming unemployed or employed: a seven year follow-up study. Scand J Work Environ Health 2022; 48:283-292. [PMID: 35260909 PMCID: PMC9524163 DOI: 10.5271/sjweh.4016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Objectives This study aimed to evaluate the extent to which physical and mental health and body mass index (BMI) changed before, during and after becoming unemployed or employed, and whether these associations differ across psychosocial and physical working conditions. Methods Participants from seven waves (2010–2017) of the Dutch longitudinal Study on Transitions in Employment, Ability, and Motivation (STREAM) aged 45–64 years were included. STREAM provides information on physical and mental health, BMI and working conditions, and was enriched with monthly information on income components from Statistics Netherlands to define employment status during 2010–2017. Annual changes in physical and mental health (0–100 scales), and BMI (kg/m2) before, during and after becoming unemployed (N=13 279) and employed (N=1902) were estimated with generalized linear mixed-effect models. Results Before employed persons became unemployed they had poorer health than continuously employed persons, which worsened in the period before becoming unemployed. During the year of becoming unemployed, physical [b=1.45, 95% confidence interval (CI) 0.89–2.01] and mental health (b=1.46, 95% CI 0.85–2.07) improved, in particular among persons with unfavorable working conditions. After becoming unemployed physical health deteriorated (b=-0.52, 95% CI -0.80– -0.24) and BMI (b=0.11, 95% CI 0.03–0.19) increased, but mental health improved (b=0.33, 95% CI 0.02–0.63). Unemployed persons had better health before entering employment than continuously unemployed persons. The health of persons who entered employment did not statistically significantly change before or during the year of the transition. After entering employment, physical health deteriorated and BMI increased. Conclusions Maintaining a healthy workforce and limiting unfavorable working conditions may contribute to the prevention of unemployment and the promotion of re-integration.
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Affiliation(s)
- David van de Ven
- Erasmus University Medical Center, Department of Public Health, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
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16
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van de Ven D, Robroek SJ, Oude Hengel KM, van Zon SK, Brouwer S, Ots P, Burdorf A, Schuring M. Associations of within-individual changes in working conditions, health behaviour and BMI with work ability and self-rated health: a fixed effects analysis among Dutch workers. BMJ Open 2022; 12:e058574. [PMID: 35487715 PMCID: PMC9058761 DOI: 10.1136/bmjopen-2021-058574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES This study assessed the associations of (1) within-individual improvements and (2) within-individual deteriorations in working conditions, health behaviour and body mass index (BMI) with changes in work ability and self-rated health among workers. DESIGN Prospective cohort study. SETTING The Netherlands. PARTICIPANTS Persons in paid employment, aged 45-64 years, who participated in the Dutch Study on Transitions in Employment, Ability and Motivation (STREAM) between 2010 and 2017, and improved or deteriorated at least once with respect to working conditions (psychological and emotional job demands, autonomy, social support, physical workload), health behaviour (moderate and vigorous physical activity, smoking status), or BMI between any of two consecutive measurements during the 7-year follow-up. PRIMARY AND SECONDARY OUTCOME MEASURES Changes in self-reported work ability on a scale from 0 to 10 (1st item of the work ability index) and self-rated health on a scale from 1 to 5 (SF-12). RESULTS Of the 21 856 STREAM participants, ultimately 14 159 workers were included in the fixed effects analyses on improvements (N=14 045) and deteriorations (N=14 066). Workers with deteriorated working conditions decreased in work ability (β's: -0.21 (95% CI: -0.25 to -0.18) to -0.28 (95% CI: -0.33 to -0.24)) and health (β's: -0.07 (95% CI: -0.09 to -0.06) to -0.10 (95% CI: -0.12 to -0.08)), whereas improvements were to a lesser extent associated with increased work ability (β's: 0.06 (95% CI: 0.02 to 0.09) to 0.11 (95% CI: 0.06 to 0.16)) and health (β's: 0.02 (95% CI: 0.00 to 0.03) to 0.04 (95% CI: 0.02 to 0.06)). Workers with increased BMI or decreased physical activity reduced in work ability and health. Likewise, decreased BMI or increased vigorous physical activity was associated with improved health. An increase in moderate or vigorous physical activity was modestly associated with a reduced work ability. Quitting smoking was associated with reduced work ability and health. CONCLUSIONS Compared with improvements, preventing deteriorations in working conditions, health behaviour and BMI, might be more beneficial for work ability and workers' health.
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Affiliation(s)
- David van de Ven
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Suzan Jw Robroek
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Karen M Oude Hengel
- Department of Work Health Technology, Netherlands Organisation for Applied Scientific Research (TNO), Leiden, The Netherlands
| | - Sander Kr van Zon
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Sandra Brouwer
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Patricia Ots
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Alex Burdorf
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Merel Schuring
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
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17
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van Elk F, Robroek SJW, Smits-de Boer S, Kouwenhoven-Pasmooij TA, Burdorf A, Oude Hengel KM. Study design of PerfectFit@Night, a workplace health promotion program to improve sleep, fatigue, and recovery of night shift workers in the healthcare sector. BMC Public Health 2022; 22:779. [PMID: 35436871 PMCID: PMC9014783 DOI: 10.1186/s12889-022-13206-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 04/08/2022] [Indexed: 11/10/2022] Open
Abstract
Background Healthcare workers need to be at work 24 h a day to ensure continuity of care in hospitals. However, shift work - particularly night shifts - can have negative acute and long-term effects on health and productivity due to disturbances in the circadian rhythm. Shift work is also associated with unhealthy lifestyle behaviors such as poor sleep hygiene and diet. The PerfectFit@Night intervention aims to improve sleep and recovery, and reduce fatigue, and therewith contribute to sustainable employability of healthcare workers. The current study describes the intervention and the evaluation and implementation. Methods The study population will consist of healthcare workers, nurses and physicians, with night shifts in a large Dutch academic hospital. The intervention consists of individual and environmental intervention elements: i) an e-learning for healthcare workers to increase knowledge and awareness on a healthy lifestyle during night shifts, ii) a powernap bed to take powernaps during night shifts, iii) the availability of healthy food at the department during night shifts, iv) a workshop on healthy rostering at the level of the department, and v) individual sleep coaching among the high risk group. In a longitudinal prospective study, data will be collected 1 month before the start of the intervention, in the week before the start of the intervention, and three and 6 months after the start of the intervention. The primary outcomes are sleep, fatigue, and need for recovery. The implementation process will be evaluated using the framework of Steckler and Linnan. Cost-benefit analyses from the employers perspective will be conducted to understand the possible financial consequences or benefits of the implementation of PerfectFit@Night. Discussion The feasibility and effectiveness of this workplace health promotion program will be investigated by means of an effect, process and economic evaluation. If proven effective, PerfectFit@Night can be implemented on a larger scale within the healthcare sector. Trial registration Netherlands Trial Register trial number NL9224. Registered 17 January 2021.
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Affiliation(s)
- Fleur van Elk
- Department of Public Health, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
| | - Suzan J W Robroek
- Department of Public Health, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Sonja Smits-de Boer
- Occupational Health Service, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - Alex Burdorf
- Department of Public Health, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Karen M Oude Hengel
- Department of Public Health, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Work Health Technology, Netherlands Organisation for Applied Scientific Research TNO, Leiden, The Netherlands
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18
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Kranenburg LW, de Veer MR, Oude Hengel KM, Kouwenhoven-Pasmooij TA, de Pagter AP, Hoogendijk WJ, Busschbach JJ, van Mol MM. Need for support among healthcare professionals during the COVID-19 pandemic: a qualitative study at an academic hospital in the Netherlands. BMJ Open 2022; 12:e059124. [PMID: 35210349 PMCID: PMC8882635 DOI: 10.1136/bmjopen-2021-059124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES The aim of the current study is to gain insight into the factors that benefit vitality and resilience of healthcare workers during the COVID-19 pandemic, to develop and direct specific support strategies. DESIGN, SETTING AND PARTICIPANTS This study applies a qualitative design, consisting of six focus groups and five interviews among 38 frontline healthcare workers in a large Dutch academic hospital. Included were professionals of the intensive care unit, COVID-19 departments, infection prevention units and facility management services. The study was conducted in October and November 2020, during the second wave of the COVID-19 pandemic. DATA ANALYSIS Thematic analysis was applied to focus group and interview data to gain insight into the factors that contribute to maintaining vitality and resilience, and to assess specific support needs. RESULTS Data analysis of the focus groups and individual interviews resulted in a thematic map of the factors that contribute to maintaining resilience and vitality. The map stretches over two axes: one ranging from a healthy basis to adequate professional functioning and the other from individual to organisation, resulting in four quadrants: recharge and recover (healthy basis, individual), safety and connectedness at work (healthy basis, organisational), collaboration (professional functioning, organisational) and professional identity (professional functioning, individual). CONCLUSION Areas for organisational support strategies to increase vitality and resilience among healthcare professionals are: consistent communication, realistic job performance expectations, monitor and improve mental resilience, showing appreciation and act upon practical support requests.
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Affiliation(s)
- Leonieke W Kranenburg
- Department of Psychiatry, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
| | - Mathijs R de Veer
- Department of Psychiatry, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
| | - Karen M Oude Hengel
- Department of Public Health, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
- Department of Work, Health and Technology, Netherlands Organization for Applied Scientific Research TNO, Leiden, The Netherlands
| | | | - Anne Pj de Pagter
- Challenge and Support Programme, Erasmus MC Sophia Children Hospital, Rotterdam, Zuid-Holland, The Netherlands
| | - Witte Jg Hoogendijk
- Department of Psychiatry, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
| | - Jan Jv Busschbach
- Department of Psychiatry, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
| | - Margo Mc van Mol
- Department of Intensive Care Adults, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
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19
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Ots P, Oude Hengel KM, Burdorf A, Robroek SJ, Nieboer D, Schram JL, van Zon SK, Brouwer S. Development and Validation of a Prediction Model for Unemployment and Disability Benefits: Results from the Longitudinal Population-Based Lifelines Cohort Study and Biobank. Saf Health Work 2022. [DOI: 10.1016/j.shaw.2021.12.1645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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20
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Oude Hengel KM, Burdorf A, Pronk A, Schlünssen V, Stokholm ZA, Kolstad HA, van Veldhoven K, Basinas I, van Tongeren M, Peters S. Exposure to a SARS-CoV-2 infection at work: development of an international job exposure matrix (COVID-19-JEM). Scand J Work Environ Health 2021; 48:61-70. [PMID: 34788471 PMCID: PMC8729167 DOI: 10.5271/sjweh.3998] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective This study aimed to construct a job exposure matrix (JEM) for risk of becoming infected with the SARS-CoV-2 virus in an occupational setting. Methods Experts in occupational epidemiology from three European countries (Denmark, The Netherlands and the United Kingdom) defined the relevant exposure and workplace characteristics with regard to possible exposure to the SARS-CoV-2 virus. In an iterative process, experts rated the different dimensions of the COVID-19-JEM for each job title within the International Standard Classification of Occupations system 2008 (ISCO-08). Agreement scores, weighted kappas, and variances were estimated. Results The COVID-19-JEM contains four determinants of transmission risk [number of people, nature of contacts, contaminated workspaces and location (indoors or outdoors)], two mitigation measures (social distancing and face covering), and two factors for precarious work (income insecurity and proportion of migrants). Agreement scores ranged from 0.27 [95% confidence interval (CI) 0.25–0.29] for ‘migrants’ to 0.76 (95% CI 0.74–0.78) for ‘nature of contacts’. Weighted kappas indicated moderate-to-good agreement for all dimensions [ranging from 0.60 (95% CI 0.60–0.60) for ‘face covering’ to 0.80 (95% CI 0.80–0.80) for ‘contaminated workspaces’], except for ‘migrants’ (0.14 (95% CI -0.07–0.36). As country differences remained after several consensus exercises, the COVID-19-JEM also has a country-axis. Conclusions The COVID-19-JEM assesses the risk at population level using eight dimensions related to SARS-COV-2 infections at work and will improve our ability to investigate work-related risk factors in epidemiological studies. The dimensions of the COVID-19-JEM could also be valuable for other future communicable diseases in the workplace.
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Affiliation(s)
- Karen M Oude Hengel
- Netherlands Organisation for Applied Scientific Research (TNO), Department of Work Health Technology, Postbus 3005, 2301 DA Leiden, The Netherlands.
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21
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Robroek SJ, Coenen P, Oude Hengel KM. Decades of workplace health promotion research: marginal gains or a bright future ahead. Scand J Work Environ Health 2021; 47:561-564. [PMID: 34655223 PMCID: PMC9058620 DOI: 10.5271/sjweh.3995] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Suzan Jw Robroek
- Suzan Robroek, Department of Public Health, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.
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22
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van de Ven HA, Hulsegge G, Zoomer T, de Korte EM, Burdorf A, Oude Hengel KM. The acute effects of working time patterns on fatigue and sleep quality using daily measurements of 6195 observations among 223 shift workers. Scand J Work Environ Health 2021; 47:446-455. [PMID: 34029370 PMCID: PMC8504543 DOI: 10.5271/sjweh.3964] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES This study aimed to estimate acute effects of roster characteristics on fatigue and sleep quality and investigated whether these effects differed by individual characteristics. METHODS Using an ecological measurement assessment survey, fatigue and sleep quality were daily measured among 223 shift workers for up to eight weeks. A questionnaire assessed baseline characteristics, and roster data were retrieved from the company registers to determine roster parameters. The effects between each shift parameter on fatigue and sleep quality were estimated with random- and fixed-effects models. RESULTS Compared to day shifts, night shifts were related to fatigue [β=0.22; 95% confidence interval (CI) 0.05-0.39] and poorer sleep quality (β=0.64; 95% CI 0.47-0.80), and more successive night shifts with more fatigue (up to β=0.68; 95% CI 0.49-0.87 for ≥2 nights). Fatigue was increased after a quick return (<11 hours) (β=1.94; 95% CI 1.57-2.31) or 11-16 hours (β=0.43; 95% CI 0.26-0.61) compared to >16 hours between shifts. Compared to forward rotation, stable (β=0.22; 95% CI 0.01-0.43) and backward rotation (β=0.49; 95% CI 0.23-0.74) were also associated with more fatigue. Workers with a morning or intermediate chronotype had poorer sleep quality after a night shift, while workers with poor health reported poor sleep quality as well as more fatigue after a night shift. CONCLUSIONS To alleviate acute effects of shift work on fatigue, shift schedules should be optimized by ensuring more time to recover and rotate forwards.
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Affiliation(s)
- Hardy A van de Ven
- Netherlands Organisation for Applied Scientific Research TNO, Department of Sustainable Productivity and Employability, Schipholweg 77, 2316 ZL, Leiden, The Netherlands.
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23
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Oude Hengel KM, Riumallo-Herl C, Schram JL, Nieboer D, van der Beek AJ, Burdorf A. Effects of changes in early retirement policies on labor force participation: the differential effects for vulnerable groups. Scand J Work Environ Health 2021; 47:224-232. [PMID: 33399213 PMCID: PMC8126444 DOI: 10.5271/sjweh.3946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objectives: This study investigated the effects of a national early retirement reform, which was implemented in 2006 and penalized early retirement, on paid employment and different exit pathways and examined whether these effects differ by gender, income level and health status. Methods: This study included all Dutch individuals in paid employment born six months before (control group) and six months after (intervention group) the cut-off date of the reform (1 January 1950) that fiscally penalized early retirement. A regression discontinuity design combined with restricted mean survival time analysis was applied to evaluate the effect of penalizing early retirement on labor force participation from age 60 until workers reached the retirement age of 65 years, while accounting for secular trends around the threshold. Results: The intervention group postponed early retirement by 7.41 months [95% confidence interval (CI) 6.11–8.72], and partly replaced this by remaining 4.87 months (95% CI 3.60–6.24) longer in paid employment. Workers born after the threshold, annually earning €25 000–40 000, spent 1.24 months (95% CI 0.31–2.18) more in economic inactivity than those born before. The working months lost to unemployment increased by 1.50 months (95% CI 0.30–2.71) for female workers and 1.99 months (95% CI 0.06–3.92) for workers reporting multiple chronic diseases. Conclusions: The national reform successfully prolonged working lives of older workers. However, workers with a middle income, female workers, and workers with chronic diseases were more vulnerable to premature exit from the labor market through unemployment or being without any income or benefit.
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Affiliation(s)
- Karen M Oude Hengel
- Erasmus University Medical Center, Department of Public Health, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
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24
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Robroek SJW, Oude Hengel KM, van der Beek AJ, Boot CRL, van Lenthe FJ, Burdorf A, Coenen P. Socio-economic inequalities in the effectiveness of workplace health promotion programmes on body mass index: An individual participant data meta-analysis. Obes Rev 2020; 21:e13101. [PMID: 32696580 PMCID: PMC7583467 DOI: 10.1111/obr.13101] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 06/04/2020] [Accepted: 06/26/2020] [Indexed: 12/30/2022]
Abstract
This individual participant data meta-analysis assessed the effectiveness of workplace health promotion programmes on body mass index (BMI) across socio-economic groups and whether study and intervention characteristics explained inequalities in effectiveness. Studies were eligible if they assessed the effect of a workplace health promotion programme on BMI in the Netherlands, included workers of at least two different socio-economic positions (SEPs) and had a study design with premeasurement and postmeasurement and control condition. Data of 13 studies presenting 16 interventions (5183 participants) were harmonized. In a two-stage meta-analysis, the interaction between intervention and SEP on BMI was tested with linear mixed models for each study. Subsequently, the interaction terms were pooled. The influence of study and intervention characteristics on the effectiveness of workplace health promotion programmes was evaluated using meta-regression analyses. Compared with control conditions, workplace health promotion programmes overall showed a statistically non-significant 0.12 kg/m2 (95% CI: -0.01, 0.25) decrease in BMI, which did not differ across SEP. Interventions evaluated within randomized controlled trials, agentic interventions, those that focused on high-risk groups, included a counselling component, consisted of more than five sessions, or were offered at the individual level did statistically significantly reduce BMI. No evidence was found for intervention-generated SEP inequalities.
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Affiliation(s)
- Suzan J W Robroek
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Karen M Oude Hengel
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Work Health Technology, Netherlands Organisation for Applied Scientific Research TNO, Leiden, The Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Cécile R L Boot
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Frank J van Lenthe
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Alex Burdorf
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Pieter Coenen
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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25
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Ots P, van Zon SKR, Schram JLD, Burdorf A, Robroek SJW, Oude Hengel KM, Brouwer S. The influence of unhealthy behaviours on early exit from paid employment among workers with a chronic disease: A prospective study using the Lifelines cohort. Prev Med 2020; 139:106228. [PMID: 32758508 DOI: 10.1016/j.ypmed.2020.106228] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 07/27/2020] [Accepted: 08/02/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This study examined the risk of unhealthy behaviours and the additive effects of multiple unhealthy behaviours on exit from paid employment among workers with a chronic disease and investigated effect modification by gender and educational level. METHODS Data from the Lifelines cohort, collected between 2006 and 2013, were enriched with registry data from Statistics Netherlands with up to 11 years follow-up. Workers with a chronic disease were selected (n = 11,467). The influence of unhealthy behaviours (physical inactivity, smoking, unhealthy diet, high alcohol intake, and obesity) on exit from paid employment (unemployment, disability benefits, early retirement, and economic inactivity) was examined using competing risk models. To examine effect modification by gender and educational level, interaction terms were added. RESULTS Smoking and low fruit intake increased the risk to exit paid employment through unemployment and disability benefits. Low vegetable intake increased the risk of unemployment, obesity the risk of receiving disability benefits, and high alcohol intake the risk of early retirement. Physical inactivity was not associated with any exit from paid employment. Having multiple unhealthy behaviours increased the risk of both unemployment and of receiving disability. No consistent effect modification for gender or educational level was found. CONCLUSIONS Unhealthy behaviours increased the risk to exit paid employment through unemployment and disability benefits among workers with a chronic disease, and this risk increased when having multiple unhealthy behaviours. Health promotion to support workers with chronic diseases to make healthier choices may help to extend their working life.
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Affiliation(s)
- Patricia Ots
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community & Occupational Medicine, Groningen, the Netherlands.
| | - Sander K R van Zon
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community & Occupational Medicine, Groningen, the Netherlands.
| | - Jolinda L D Schram
- Erasmus Medical Center Rotterdam, Department of Public Health, Rotterdam, the Netherlands.
| | - Alex Burdorf
- Erasmus Medical Center Rotterdam, Department of Public Health, Rotterdam, the Netherlands.
| | - Suzan J W Robroek
- Erasmus Medical Center Rotterdam, Department of Public Health, Rotterdam, the Netherlands.
| | - Karen M Oude Hengel
- Erasmus Medical Center Rotterdam, Department of Public Health, Rotterdam, the Netherlands; Work, Health & Technology, Netherlands Organization for Applied Scientific Research, TNO, Leiden, the Netherlands.
| | - Sandra Brouwer
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community & Occupational Medicine, Groningen, the Netherlands.
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26
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Coenen P, Robroek SJW, van der Beek AJ, Boot CRL, van Lenthe FJ, Burdorf A, Oude Hengel KM. Socioeconomic inequalities in effectiveness of and compliance to workplace health promotion programs: an individual participant data (IPD) meta-analysis. Int J Behav Nutr Phys Act 2020; 17:112. [PMID: 32887617 PMCID: PMC7650284 DOI: 10.1186/s12966-020-01002-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 07/22/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND This individual patient data (IPD) meta-analysis aimed to investigate socioeconomic inequalities in effectiveness on healthy behavior of, and compliance to, workplace health promotion programs. METHODS Dutch (randomized) controlled trials were identified and original IPD were retrieved and harmonized. A two-stage meta-analysis was conducted where linear mixed models were performed per study (stage 1), after which individual study effects were pooled (stage 2). All models were adjusted for baseline values of the outcomes, age and gender. Intervention effects were assessed on physical activity, diet, alcohol use, and smoking. Also, we assessed whether effects differed between participants with low and high program compliance and. All analyses were stratified by socioeconomic position. RESULTS Data from 15 studies (n = 8709) were harmonized. Except for fruit intake (beta: 0·12 [95% CI 0·08 0·15]), no effects were found on health behaviors, nor did these effects differ across socioeconomic groups. Only participants with high compliance showed significant improvements in vigorous and moderate-to-vigorous physical activity, and in more fruit and less snack intake. There were no differences in compliance across socioeconomic groups. CONCLUSIONS Workplace health promotion programs were in general not effective. Neither effectiveness nor compliance differed across socioeconomic groups (operationalized by educational level). Even though stronger effects on health behavior were found for participations with high compliance, effects remained small. The results of the current study emphasize the need for new directions in health promotion programs to improve healthy behavior among workers, in particular for those in lower socioeconomic position.
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Affiliation(s)
- Pieter Coenen
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081, BT, Amsterdam, The Netherlands.
| | - Suzan J W Robroek
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081, BT, Amsterdam, The Netherlands
| | - Cécile R L Boot
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081, BT, Amsterdam, The Netherlands
| | - Frank J van Lenthe
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Alex Burdorf
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Karen M Oude Hengel
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands.,Department of Work, Health and Technology, Netherlands Organisation for Applied Scientific Research TNO, Schipholweg 79-86, 2316, Leiden, The Netherlands
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27
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Schuring M, Robroek SJW, Carrino L, O'Prinsen AC, Oude Hengel KM, Avendano M, Burdorf A. Does reduced employment protection increase the employment disadvantage of workers with low education and poorer health? J Epidemiol Community Health 2020; 74:851-857. [PMID: 32611691 PMCID: PMC7577106 DOI: 10.1136/jech-2020-213772] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 04/01/2020] [Accepted: 06/02/2020] [Indexed: 11/03/2022]
Abstract
BACKGROUND Declines in employment protection may have disproportionate effects on employment opportunities of workers with low education and poorer health. This study investigates the impact of changes in employment protection levels on employment rates according to education and health in 23 European countries. METHODS Data were taken from the 4-year rotating panel European Union Statistics on Income and Living Conditions study. Employed participants aged 29-59 years (n = 334 999) were followed for 1 year over an 11-year period, from 2003 up to 2014. A logistic regression model with country and period fixed effects was used to estimate the association between changes in the Organisation for Economic Co-operation and Development (OECD) employment protection index and labour market outcomes, incorporating interaction terms with education and health. RESULTS 15 of the 23 countries saw their level of employment protection decline between 2003 and 2014. Reduced employment protection of temporary workers increased odds of early retirement (OR 6.29, 95% CI 3.17 to 12.48) and unemployment (OR 1.37, 95% CI 1.07 to 1.76). Reduced employment protection of permanent workers increased odds of early retirement more among workers in poor health (OR 4.46, 95% CI 2.26 to 8.78) than among workers in good health (OR 2.58, 95% CI 1.30 to 5.10). The impact of reduced employment protection of temporary workers on unemployment was stronger among lower-educated workers (OR 1.47, 95% CI 1.13 to 1.90) than among higher-educated workers (OR 1.21, 95% CI 0.95 to 1.54). CONCLUSION Reduced employment protection increased the odds of early exit from paid employment, especially among workers with lower education and poorer health. Employment protection laws may help reduce the employment disadvantage of workers with low education and poorer health.
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Affiliation(s)
- Merel Schuring
- Department of Public Health, Erasmus Medical Center, Rotterdam, Netherlands
| | - Suzan J W Robroek
- Department of Public Health, Erasmus Medical Center, Rotterdam, Netherlands
| | - Ludovico Carrino
- Global Health & Social Medicine, King's College London, London, UK
| | - Anouk C O'Prinsen
- Department of Public Health, Erasmus Medical Center, Rotterdam, Netherlands
| | - Karen M Oude Hengel
- Department of Public Health, Erasmus Medical Center, Rotterdam, Netherlands.,Netherlands Organization for Applied Scientific Research TNO, Leiden, Netherlands
| | - Mauricio Avendano
- Department of Global Health and Social Medicine, King's College London School of Social Science and Public Policy, London, UK.,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Cambridge, Massachusetts, USA
| | - Alex Burdorf
- Department of Public Health, Erasmus Medical Center, Rotterdam, Netherlands
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28
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Schram JLD, Robroek SJW, Ots P, Brouwer S, Burdorf A, van Zon SKR, Oude Hengel KM. Influence of changing working conditions on exit from paid employment among workers with a chronic disease. Occup Environ Med 2020; 77:628-633. [PMID: 32439828 PMCID: PMC7476309 DOI: 10.1136/oemed-2019-106383] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 03/20/2020] [Accepted: 04/21/2020] [Indexed: 11/24/2022]
Abstract
Objectives To investigate the relation between changes in working conditions and exit from paid employment among workers with a chronic disease. Methods Six waves from the longitudinal Study on Transitions in Employment, Ability and Motivation (2010–2016), enriched with tax-based employment information from Statistics Netherlands (2011–2017), were available for 4820 chronically ill workers aged 45–63 years (mean 55.3 years, SD 5.1). A change in working conditions (physical workload, psychological job demands, job autonomy, emotional job demands and social support) was defined as an increase or decrease between two consecutive waves of at least one SD. Discrete-time survival models with repeated measurements were used to estimate the relative risk (RR) of a change in working conditions on exiting paid employment in the following year compared with no change and consecutive favourable working conditions. Results A favourable change in physical workload lowered the risk to exit paid employment (RR 0.46, 95% CI 0.22 to 0.94). An adverse change in psychosocial working conditions, especially a decrease in social support (RR 2.07, 95% CI 1.52 to 2.81), increased the likelihood to exit paid employment. In contrast, a favourable change in psychological job demands increased the risk to exit paid employment (RR 1.57, 95% CI 1.09 to 2.24). Multiple adverse changes increased the risk to exit paid employment up to six times (RR 6.06, 95% CI 2.83 to 12.98). Conclusions Changes in working conditions among workers with chronic diseases influence exit from paid employment. Ensuring that working conditions can be adapted to the needs of workers with a chronic disease may help to extend working life.
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Affiliation(s)
- Jolinda L D Schram
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Suzan J W Robroek
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Patricia Ots
- Department of Health Sciences, Community & Occupational Medicine, University Medical Center Groningen, Groningen, The Netherlands
| | - Sandra Brouwer
- Department of Health Sciences, Community & Occupational Medicine, University Medical Center Groningen, Groningen, The Netherlands
| | - Alex Burdorf
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Sander K R van Zon
- Department of Health Sciences, Community & Occupational Medicine, University Medical Center Groningen, Groningen, The Netherlands
| | - Karen M Oude Hengel
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands .,Work, Health & Technology, Netherlands Organization for Applied Scientific Research TNO, Leiden, The Netherlands
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29
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Abstract
OBJECTIVE The study investigates the trends in health-related inequalities in paid employment among men and women in different educational groups in 26 countries in 5 European regions. DESIGN Individual-level analysis of repeated cross-sectional annual data (2005-2014) from the EU Statistics on Income and Living Conditions. SETTING 26 European countries in 5 European regions. PARTICIPANTS 1 844 915 individuals aged 30-59 years were selected with information on work status, chronic illness, educational background, age and gender. OUTCOME MEASURES Absolute differences were expressed by absolute differences in proportion in paid employment between participants with and without a chronic illness, using linear regression. Relative differences were expressed by prevalence ratios in paid employment, using a Cox proportional hazard model. Linear regression was used to examine the trends of inequalities. RESULTS Participants with a chronic illness had consistently lower labour force participation than those without illnesses. Educational inequalities were substantial with absolute differences larger within lower educated (men 21%-35%, women 10%-31%) than within higher educated (men 5%-13%, women 6%-16%). Relative differences showed that low-educated men with a chronic illness were 1.4-1.9 times (women 1.3-1.8 times) more likely to be out of paid employment than low-educated persons without a chronic illness, whereas this was 1.1-1.2 among high-educated men and women. In the Nordic, Anglo-Saxon and Eastern regions, these health-related educational inequalities in paid employment were more pronounced than in the Continental and Southern region. For most regions, absolute health-related educational inequalities in paid employment were generally constant, whereas relative inequalities increased, especially among low-educated persons. CONCLUSIONS Men and women with a chronic illness have considerable less access to the labour market than their healthy colleagues, especially among lower educated persons. This exclusion from paid employment will increase health inequalities.
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Affiliation(s)
- Jolinda L D Schram
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Merel Schuring
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Karen M Oude Hengel
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
- Netherlands Organization for Applied Scientific Research TNO, Leiden, The Netherlands
| | - Alex Burdorf
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
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30
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Oude Hengel KM, Coenen P, Robroek SJW, Boot CRL, van der Beek AJ, Van Lenthe FJ, Burdorf A. Socioeconomic inequalities in reach, compliance and effectiveness of lifestyle interventions among workers: protocol for an individual participant data meta-analysis and equity-specific reanalysis. BMJ Open 2019; 9:e025463. [PMID: 30765409 PMCID: PMC6398771 DOI: 10.1136/bmjopen-2018-025463] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Obesity and unhealthy behaviour are more prevalent among workers with a low compared with a high socioeconomic position (SEP), and thus contribute to socioeconomic health inequalities. The occupational setting is considered an important setting to address unhealthy behaviours due to the possibility to efficiently reach a large group of adults through worksite health promotion. This paper describes the rationale and design for an individual participant data (IPD) meta-analysis and a socioeconomic equity-specific reanalysis aiming to: (1) investigate socioeconomic differences in the effectiveness of interventions aimed at promoting healthy behaviour and preventing obesity, (2) examine socioeconomic differences in reach and compliance and (3) to investigate underlying factors affecting possible socioeconomic differences. METHODS AND ANALYSIS A systematic search was conducted in electronic databases including Embase, Medline Ovid, Web of Science, Cochrane Central and Google Scholar as well as in grey literature and trial registries. Two researchers have independently selected a total of 34 relevant studies (from 88 articles). Responsible researchers of these eligible studies were asked to provide their study data and an assessment of the methodological criteria was done. The data of the intervention studies will be pooled for the IPD meta-analysis, whereas the socioeconomic equity-specific reanalysis will focus on each study separately, stratified for SEP. Both methods will be conducted to investigate socioeconomic differences in effectiveness, reach and compliance (research aims 1 and 2). For research aim 3, different factors, such as population characteristics, organisational work environment and intervention characteristics, will be investigated as possible moderators in the associations between SEP and effectiveness, reach and compliance. ETHICS AND DISSEMINATION The Medical Ethical Committee of Erasmus MC declared that the Medical Research Involving Human Subjects Act does not apply to the meta-analyses. The findings will be disseminated through peer-reviewed publications and (inter)national conference presentations. TRIAL REGISTRATION NUMBER CRD42018099878.
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Affiliation(s)
- Karen M Oude Hengel
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Work Health Technology, Netherlands Organization for Applied Scrientific Research TNO, Leiden, The Netherlands
| | - Pieter Coenen
- Department of Public and Occupational Health, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Suzan J W Robroek
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Cecile R L Boot
- Department of Public and Occupational Health, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Frank J Van Lenthe
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Human Geography and Spatial Planning, Utrecht University, Utrecht, The Netherlands
| | - Alex Burdorf
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
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31
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Schelvis RMC, Wiezer NM, van der Beek AJ, Twisk JWR, Bohlmeijer ET, Oude Hengel KM. The effect of an organizational level participatory intervention in secondary vocational education on work-related health outcomes: results of a controlled trial. BMC Public Health 2017; 17:141. [PMID: 28143547 PMCID: PMC5282626 DOI: 10.1186/s12889-017-4057-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 01/21/2017] [Indexed: 11/16/2022] Open
Abstract
Background Work-related stress is highly prevalent in the educational sector. The aim of the current study was to evaluate the effectiveness of an organizational level, participatory intervention on need for recovery and vitality in educational workers. It was hypothesized that the intervention would decrease need for recovery and increase vitality. Methods A quasi-experiment was conducted at two secondary Vocational Education and Training schools (N = 356) with 12- and 24-months follow-up measurements. The intervention consisted of 1) a needs assessment phase, wherein staff and teachers developed actions for happy and healthy working under supervision of a facilitator, and 2) an implementation phase, wherein these actions were implemented by the management teams. Mixed model analysis was applied in order to assess the differences between the intervention and control group on average over time. All analyses were corrected for baseline values and several covariates. Results No effects of the intervention were found on need for recovery, vitality and most of the secondary outcomes. Two small, statistically significant effects were in unfavorable direction: the intervention group scored on average over time significantly lower on absorption (i.e. a subscale of work engagement) and organizational efficacy than the control group. Conclusions Since no beneficial effects of this intervention were found on the primary and most of the secondary outcomes, further implementation of the intervention in its current form is not eligible. We recommend that future organizational level interventions for occupational health 1) incorporate an elaborate implementation strategy, 2) are more specific in relating actions to stressors in the context, and 3) are integrated with secondary preventive, individual focused stress management interventions. Trial registration Netherlands Trial Register NTR3284 (date registered: February 14 2012).
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Affiliation(s)
- Roosmarijn M C Schelvis
- Netherlands Organization for Applied Scientific Research TNO, Work, Health and Technology, P.O. Box 3005, NL-2301 DA, Leiden, The Netherlands. .,Body@Work, Research Center on Physical Activity, Work and Health, TNO-VUmc, P.O. Box 3005, NL-2301 DA, Leiden, The Netherlands. .,Department of Public and Occupational Health, the EMGO+ Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, NL-1007 MB, Amsterdam, The Netherlands.
| | - Noortje M Wiezer
- Netherlands Organization for Applied Scientific Research TNO, Work, Health and Technology, P.O. Box 3005, NL-2301 DA, Leiden, The Netherlands. .,Body@Work, Research Center on Physical Activity, Work and Health, TNO-VUmc, P.O. Box 3005, NL-2301 DA, Leiden, The Netherlands.
| | - Allard J van der Beek
- Body@Work, Research Center on Physical Activity, Work and Health, TNO-VUmc, P.O. Box 3005, NL-2301 DA, Leiden, The Netherlands.,Department of Public and Occupational Health, the EMGO+ Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, NL-1007 MB, Amsterdam, The Netherlands
| | - Jos W R Twisk
- Department of Epidemiology and Biostatistics, VU University Medical Center, De Boelelaan 1089a, Amsterdam, NL-1081 HV, The Netherlands.,Department of Health Sciences, VU University, Amsterdam, The Netherlands
| | - Ernst T Bohlmeijer
- Department of Psychology, Health and Technology, University of Twente, P. O. Box 217, NL-7500 AE, Enschede, The Netherlands
| | - Karen M Oude Hengel
- Netherlands Organization for Applied Scientific Research TNO, Work, Health and Technology, P.O. Box 3005, NL-2301 DA, Leiden, The Netherlands.,Body@Work, Research Center on Physical Activity, Work and Health, TNO-VUmc, P.O. Box 3005, NL-2301 DA, Leiden, The Netherlands
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Schelvis RMC, Wiezer NM, Blatter BM, van Genabeek JAGM, Oude Hengel KM, Bohlmeijer ET, van der Beek AJ. Evaluating the implementation process of a participatory organizational level occupational health intervention in schools. BMC Public Health 2016; 16:1212. [PMID: 27905904 PMCID: PMC5134077 DOI: 10.1186/s12889-016-3869-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 11/23/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The importance of process evaluations in examining how and why interventions are (un) successful is increasingly recognized. Process evaluations mainly studied the implementation process and the quality of the implementation (fidelity). However, in adopting this approach for participatory organizational level occupational health interventions, important aspects such as context and participants perceptions are missing. Our objective was to systematically describe the implementation process of a participatory organizational level occupational health intervention aimed at reducing work stress and increasing vitality in two schools by applying a framework that covers aspects of the intervention and its implementation as well as the context and participants perceptions. METHODS A program theory was developed, describing the requirements for successful implementation. Each requirement was operationalized by making use of the framework, covering: initiation, communication, participation, fidelity, reach, communication, satisfaction, management support, targeting, delivery, exposure, culture, conditions, readiness for change and perceptions. The requirements were assessed by quantitative and qualitative data, collected at 12 and 24 months after baseline in both schools (questionnaire and interviews) or continuously (logbooks). RESULTS The intervention consisted of a needs assessment phase and a phase of implementing intervention activities. The needs assessment phase was implemented successfully in school A, but not in school B where participation and readiness for change were insufficient. In the second phase, several intervention activities were implemented at school A, whereas this was only partly the case in school B (delivery). In both schools, however, participants felt not involved in the choice of intervention activities (targeting, participation, support), resulting in a negative perception of and only partial exposure to the intervention activities. Conditions, culture and events hindered the implementation of intervention activities in both schools. CONCLUSIONS The framework helped us to understand why the implementation process was not successful. It is therefore considered of added value for the evaluation of implementation processes in participatory organizational level interventions, foremost because of the context and mental models dimensions. However, less demanding methods for doing detailed process evaluations need to be developed. This can only be done if we know more about the most important process components and this study contributes to that knowledge base. TRIAL REGISTRATION Netherlands Trial Register NTR3284 .
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Affiliation(s)
- Roosmarijn M C Schelvis
- Netherlands Organization for Applied Scientific Research TNO, P.O. Box 3005, NL-2301 DA, Leiden, The Netherlands. .,Body@Work, Research Center on Physical Activity, Work and Health, TNO-VU/VUmc, Amsterdam, The Netherlands. .,Department of Public and Occupational Health, the EMGO+ Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, NL-1007 MB, Amsterdam, The Netherlands.
| | - Noortje M Wiezer
- Netherlands Organization for Applied Scientific Research TNO, P.O. Box 3005, NL-2301 DA, Leiden, The Netherlands.,Body@Work, Research Center on Physical Activity, Work and Health, TNO-VU/VUmc, Amsterdam, The Netherlands
| | - Birgitte M Blatter
- Netherlands Organization for Applied Scientific Research TNO, P.O. Box 3005, NL-2301 DA, Leiden, The Netherlands.,Body@Work, Research Center on Physical Activity, Work and Health, TNO-VU/VUmc, Amsterdam, The Netherlands.,VeiligheidNL, Overschiestraat 65, NL-1062 XD, Amsterdam, The Netherlands
| | - Joost A G M van Genabeek
- Netherlands Organization for Applied Scientific Research TNO, P.O. Box 3005, NL-2301 DA, Leiden, The Netherlands
| | - Karen M Oude Hengel
- Netherlands Organization for Applied Scientific Research TNO, P.O. Box 3005, NL-2301 DA, Leiden, The Netherlands.,Body@Work, Research Center on Physical Activity, Work and Health, TNO-VU/VUmc, Amsterdam, The Netherlands
| | - Ernst T Bohlmeijer
- Department of Psychology, Health and Technology, University of Twente, P. O. Box 217, 7500 AE, Enschede, The Netherlands
| | - Allard J van der Beek
- Body@Work, Research Center on Physical Activity, Work and Health, TNO-VU/VUmc, Amsterdam, The Netherlands.,Department of Public and Occupational Health, the EMGO+ Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, NL-1007 MB, Amsterdam, The Netherlands
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van Deurssen E, Meijster T, Oude Hengel KM, Boessen R, Spaan S, Tielemans E, Heederik D, Pronk A. Effectiveness of a Multidimensional Randomized Control Intervention to Reduce Quartz Exposure Among Construction Workers. ANNHYG 2015; 59:959-71. [DOI: 10.1093/annhyg/mev037] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 04/21/2015] [Indexed: 12/30/2022]
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Schlevis RMC, Oude Hengel KM, Burdorf A, Blatter BM, Strijk JE, van der Beek AJ. Evaluation of occupational health interventions using a randomized controlled trial: challenges and
alternative research designs. Scand J Work Environ Health 2015; 41:491-503. [DOI: 10.5271/sjweh.3505] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Oude Hengel KM, van Deurssen E, Meijster T, Tielemans E, Heederik D, Pronk A. 'Relieved Working' study: systematic development and design of an intervention to decrease occupational quartz exposure at construction worksites. BMC Public Health 2014; 14:760. [PMID: 25069393 PMCID: PMC4133610 DOI: 10.1186/1471-2458-14-760] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 07/14/2014] [Indexed: 11/10/2022] Open
Abstract
Background Occupational quartz exposure continues to be a serious hazard in the construction industry. Until now, evidence-based interventions aimed at reducing quartz exposure are scarce. The aim of this study was to systematically develop an intervention and to describe the study to evaluate its effectiveness. Methods/Design The intervention was developed according to the principles of the Intervention Mapping protocol, meaning that evidence from the literature was combined with information collected from stakeholders (e.g., construction workers, managers and researchers). The intervention aimed to integrate technical, behavioural and organizational factors. The intervention consists of two plenary meetings for all employers within the company, and individual visits at construction worksites, including specific intervention materials. Additionally, a demonstration session regarding control measures was organized for all managers. The effectiveness of the intervention will be evaluated in a cluster randomized controlled trial among eight construction companies, with measurements at baseline and follow-up. Outcome measures are personal respirable dust and quartz exposure by means of exposure assessment, and behavioural and organizational determinants which will be assessed by means of questionnaires. Additionally, a process evaluation will shed light on whether the intervention (does not) works, and, if so, the reasons for this. Discussion Applying Intervention Mapping in the development of an intervention to reduce occupational quartz exposure was useful, as different stakeholders provided input for the intervention as well as the implementation strategy. Therefore, the feasibility of the intervention has been enhanced, as it appeals to construction workers and managers and will not unduly interfere with the ongoing construction work. Trial registration number NTR4586 (May 7th 2014).
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Affiliation(s)
- Karen M Oude Hengel
- Netherlands Organisation for Applied Scientific Research TNO, P,O, Box 718, 2130 AS Hoofddorp, The Netherlands.
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Schelvis RMC, Oude Hengel KM, Wiezer NM, Blatter BM, van Genabeek JAGM, Bohlmeijer ET, van der Beek AJ. Design of the Bottom-up Innovation project--a participatory, primary preventive, organizational level intervention on work-related stress and well-being for workers in Dutch vocational education. BMC Public Health 2013; 13:760. [PMID: 23947538 PMCID: PMC3751794 DOI: 10.1186/1471-2458-13-760] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 08/05/2013] [Indexed: 11/18/2022] Open
Abstract
Background In the educational sector job demands have intensified, while job resources remained the same. A prolonged disbalance between demands and resources contributes to lowered vitality and heightened need for recovery, eventually resulting in burnout, sickness absence and retention problems. Until now stress management interventions in education focused mostly on strengthening the individual capacity to cope with stress, instead of altering the sources of stress at work at the organizational level. These interventions have been only partly effective in influencing burnout and well-being. Therefore, the “Bottom-up Innovation” project tests a two-phased participatory, primary preventive organizational level intervention (i.e. a participatory action approach) that targets and engages all workers in the primary process of schools. It is hypothesized that participating in the project results in increased occupational self-efficacy and organizational efficacy. The central research question: is an organization focused stress management intervention based on participatory action effective in reducing the need for recovery and enhancing vitality in school employees in comparison to business as usual? Methods/Design The study is designed as a controlled trial with mixed methods and three measurement moments: baseline (quantitative measures), six months and 18 months (quantitative and qualitative measures). At first follow-up short term effects of taking part in the needs assessment (phase 1) will be determined. At second follow-up the long term effects of taking part in the needs assessment will be determined as well as the effects of implemented tailored workplace solutions (phase 2). A process evaluation based on quantitative and qualitative data will shed light on whether, how and why the intervention (does not) work(s). Discussion “Bottom-up Innovation” is a combined effort of the educational sector, intervention providers and researchers. Results will provide insight into (1) the relation between participating in the intervention and occupational and organizational self-efficacy, (2) how an improved balance between job demands and job resources might affect need for recovery and vitality, in the short and long term, from an organizational perspective, and (3) success and fail factors for implementation of an organizational intervention. Trial registration number Netherlands Trial Register NTR3284
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Affiliation(s)
- Roosmarijn M C Schelvis
- Netherlands Organization for Applied Scientific Research TNO, P.O. Box 718, 2130 AS Hoofddorp, The Netherlands.
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Viester L, Verhagen EALM, Oude Hengel KM, Koppes LLJ, van der Beek AJ, Bongers PM. The relation between body mass index and musculoskeletal symptoms in the working population. BMC Musculoskelet Disord 2013; 14:238. [PMID: 23937768 PMCID: PMC3751130 DOI: 10.1186/1471-2474-14-238] [Citation(s) in RCA: 93] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2012] [Accepted: 07/30/2013] [Indexed: 12/19/2022] Open
Abstract
Background The primary aim of this study was to investigate the association between BMI and musculoskeletal symptoms in interaction with physical workload. In addition, it was aimed to obtain insight into whether overweight and obesity are associated with an increase in occurrence of symptoms and/or decrease in recovery from symptoms. Methods Based on a large working population sample (n = 44,793), using the data from The Netherlands Working Conditions Survey (NWCS), logistic regression analyses were carried out to investigate the association between BMI and musculoskeletal symptoms, with adjustment for potential confounders. Longitudinal data from the Netherlands Working Conditions Cohort Study (NWCCS) of 7,909 respondents was used for the second research aim (i.e., to investigate the transition in musculoskeletal symptoms). Results For high BMI an increased 12-month prevalence of musculoskeletal symptoms was found (overweight: OR 1.13, 95% CI: 1.08-1.19 and obesity: OR 1.28, 95% CI: 1.19-1.39). The association was modified by physical workload, with a stronger association for employees with low physical workload than for those with high physical workload. Obesity was related to developing musculoskeletal symptoms (OR 1.37, 95% CI: 1.05-1.79) and inversely related to recovery from symptoms (OR 0.76, 95% CI: 0.59-0.97). Conclusion BMI was associated with musculoskeletal symptoms, in particular symptoms of the lower extremity. Furthermore, the association differed for employees with high or low physical workload. Compared to employees with normal weight, obese employees had higher risk for developing symptoms as well as less recovery from symptoms. This study supports the role of biomechanical factors for the relationship between BMI and symptoms in the lower extremity.
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Affiliation(s)
- Laura Viester
- Department of Public and Occupational Health, the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
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Oude Hengel KM, Blatter BM, van der Molen HF, Bongers PM, van der Beek AJ. The effectiveness of a construction worksite prevention program on work ability, health, and sick leave: results from a cluster randomized controlled trial. Scand J Work Environ Health 2013; 39:456-67. [DOI: 10.5271/sjweh.3361] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Oude Hengel KM, Blatter BM, Joling CI, van der Beek AJ, Bongers PM. Effectiveness of an intervention at construction worksites on work engagement, social support, physical workload, and need for recovery: results from a cluster randomized controlled trial. BMC Public Health 2012; 12:1008. [PMID: 23171354 PMCID: PMC3534539 DOI: 10.1186/1471-2458-12-1008] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2012] [Accepted: 11/14/2012] [Indexed: 11/10/2022] Open
Abstract
Background To prolong sustainable healthy working lives of construction workers, a worksite prevention program was developed which aimed to improve the health and work ability of construction workers. The aim of the current study was to investigate the effectiveness of this program on social support at work, work engagement, physical workload and need for recovery. Methods Fifteen departments from six construction companies participated in this cluster randomized controlled trial; 8 departments (n=171 workers) were randomized to an intervention group and 7 departments (n=122 workers) to a control group. The intervention consisted of two individual training sessions of a physical therapist to lower the physical workload, a Rest-Break tool to improve the balance between work and recovery, and two empowerment training sessions to increase the influence of the construction workers at the worksite. Data on work engagement, social support at work, physical workload, and need for recovery were collected at baseline, and at three, six and 12 months after the start of the intervention using questionnaires. Results No differences between the intervention and control group were found for work engagement, social support at work, and need for recovery. At 6 months follow-up, the control group reported a small but statistically significant reduction of physical workload. Conclusion The intervention neither improved social support nor work engagement, nor was it effective in reducing the physical workload and need for recovery among construction workers. Trial registration NTR1278
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Affiliation(s)
- Karen M Oude Hengel
- Netherlands Organisation for Applied Scientific Research TNO, P,O, Box 718, Hoofddorp, AS 2130, The Netherlands.
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Oude Hengel KM, Joling CI, Proper KI, van der Molen HF, Bongers PM. Intervention Mapping as a framework for developing an intervention at the worksite for older construction workers. Am J Health Promot 2012; 26:e1-10. [PMID: 21879927 DOI: 10.4278/ajhp.100326-qual-88] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this study was to apply the Intervention Mapping approach as a framework in the development of a worksite intervention to improve the work ability of construction workers. DESIGN Development of an intervention by using the Intervention Mapping approach. SETTING Construction worksite. PARTICIPANTS Construction workers aged 45 years and older. MEASURES AND ANALYSIS According to the principles of Intervention Mapping, evidence from the literature was combined with data collected from stakeholders (e.g., construction workers, managers, providers). RESULTS The Intervention Mapping approach resulted in an intervention with the following components: (1) two individual visits of a physical therapist to lower the physical workload, (2) a Rest-Break tool to improve the balance between work and recovery, and (3) two empowerment training sessions to increase the range of influence at the worksite. CONCLUSIONS Application of Intervention Mapping in the development of a worksite prevention program was useful in the construction industry to obtain a positive attitude and commitment. Stakeholders could give input regarding the program components as well as provide specific leads for the practical intervention strategy. Moreover, it also gives insight in the current theoretical and empirical knowledge in the field of improving the work ability of older workers in the construction industry.
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Affiliation(s)
- Karen M Oude Hengel
- Body@Work Research Centre on Physical Activity, Work and Health, TNO-VU/VUMC, Hoofddorp, the Netherlands.
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Oude Hengel KM, Blatter BM, Geuskens GA, Koppes LLJ, Bongers PM. Factors associated with the ability and willingness to continue working until the age of 65 in construction workers. Int Arch Occup Environ Health 2011; 85:783-90. [DOI: 10.1007/s00420-011-0719-3] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2011] [Accepted: 10/20/2011] [Indexed: 10/15/2022]
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Oude Hengel KM, Visser B, Sluiter JK. The prevalence and incidence of musculoskeletal symptoms among hospital physicians: a systematic review. Int Arch Occup Environ Health 2010; 84:115-9. [PMID: 20686782 PMCID: PMC3020318 DOI: 10.1007/s00420-010-0565-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2010] [Accepted: 07/21/2010] [Indexed: 11/30/2022]
Abstract
Objective Physicians are exposed to a range of work-related risk factors that may result in occupational diseases. This systematic review aims at shedding light on the prevalence and incidence of musculoskeletal complaints among hospital physicians. Methods A systematic literature search was performed in Pubmed and EMBASE (1990–2010), and methodological quality criteria were applied. A search was done for musculoskeletal complaints. Results Five medium-quality studies and three high-quality studies were included in this review. The definitions and assessment used in the studies for musculoskeletal complaints were different. In short, the frequently reported prevalence for hand and wrist pain was 8–33 and 0%, 17% for shoulder pain, and 9–28% for neck pain. Moreover, the annual prevalence of low back pain was between 33 and 68%. Interpretation The limited number of studies makes it difficult to draw conclusions, and the results should be intepreted with care. In conclusion, musculoskeletal complaints may be work-related complaints in hospital physicians, which need future attention.
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Affiliation(s)
- Karen M Oude Hengel
- Research Institute MOVE, Faculty of Human Movement Sciences, VU University, Amsterdam, The Netherlands
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Houwink A, Oude Hengel KM, Odell D, Dennerlein JT. Providing training enhances the biomechanical improvements of an alternative computer mouse design. Hum Factors 2009; 51:46-55. [PMID: 19634308 DOI: 10.1177/0018720808329843] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE The purpose of this study is to determine if an alternative mouse promotes more neutral postures and decreases forearm muscle activity and if training enhances these biomechanical benefits. BACKGROUND Computer mouse use is a risk factor for developing musculoskeletal disorders; alternative mouse designs can help lower these risks. Ergonomic training combined with alternative input devices could be even more effective than alternative designs alone. METHODS Thirty healthy adults (15 males, 15 females) performed a set of computer mouse tasks with a standard mouse and an alternative mouse while an electromagnetic motion analysis system measured their wrist and forearm postures and surface electromyography measured the muscle activity of three wrist extensor muscles. Fifteen participants received no training on how to hold the alternative mouse, whereas the remaining 15 participants received verbal instructions before and during use of the alternative mouse. RESULTS The alternative mouse was found to promote a more neutral forearm posture compared with the standard mouse (up to 11.5 degrees lower forearm pronation); however, pronation was further reduced when instructions on how to hold the mouse were provided. Wrist extensor muscle activity was reduced for the alternative mouse (up to 1.8% of maximum voluntary contraction lower) compared with the standard mouse, but only after participants received instructions. CONCLUSION The alternative mouse design decreased biomechanical exposures; however, instructions enhanced this potential ergonomic benefit of the design. APPLICATION User knowledge and training are important factors when effectively implementing an alternative ergonomic device.
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Oude Hengel KM, Houwink A, Odell D, van Dieën JH, Dennerlein JT. Smaller external notebook mice have different effects on posture and muscle activity. Clin Biomech (Bristol, Avon) 2008; 23:727-34. [PMID: 18348899 DOI: 10.1016/j.clinbiomech.2008.01.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2007] [Revised: 01/23/2008] [Accepted: 01/28/2008] [Indexed: 02/07/2023]
Abstract
BACKGROUND Extensive computer mouse use is an identified risk factor for computer work-related musculoskeletal disorders; however, notebook computer mouse designs of varying sizes have not been formally evaluated but may affect biomechanical risk factors. METHODS Thirty adults performed a set of mouse tasks with five notebook mice, ranging in length from 75 to 105 mm and in width from 35 to 65 mm, and a reference desktop mouse. An electro-magnetic motion analysis system measured index finger (metacarpophalangeal joint), wrist and forearm postures, and surface electromyography measured muscle activity of three extensor muscles in the forearm and the first dorsal interosseus. FINDINGS The smallest notebook mice were found to promote less neutral postures (up to 3.2 degrees higher metacarpophalangeal joint adduction; 6.5 degrees higher metacarpophalangeal joint flexion, 2.3 degrees higher wrist extension) and higher muscle activity (up to 4.1% of maximum voluntary contraction higher wrist extensor muscle activity). Participants with smaller hands had overall more non-neutral postures than participants with larger hands (up to 5.6 degrees higher wrist extension and 5.9 degrees higher pronation); while participants with larger hands were more influenced by the smallest notebook mice (up to 3.6 degrees higher wrist extension and 5.5% of maximum voluntary contraction higher wrist extensor values). Self-reported ratings showed that while participants preferred smaller mice for portability; larger mice scored higher on comfort and usability. INTERPRETATION The smallest notebook mice increased the intensity of biomechanical exposures. Longer term mouse use could enhance these differences, having a potential impact on the prevention of work-related musculoskeletal disorders.
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Affiliation(s)
- Karen M Oude Hengel
- Faculty of Human Movement Science, VU University Amsterdam, Van der Boechorststraat 9, 1081 BT Amsterdam, The Netherlands
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