Precarious work and methodological challenges to study hard-to-reach populations

OBJECTIVE

To describe the methodological challenges and strategies of a web survey on the working conditions and health among delivery workers.

METHODS

The study population consisted of Brazilian delivery workers operating in the national territory. Procedures include building solid and ongoing collaboration with worker representatives and conducting a four-month data collection from February to May 2022, sharing the link to the online questionnaire on social media such as social networks (Facebook, Instagram) and messaging apps (WhatsApp, Telegram).

RESULTS

The recruitment of 41 leaders or influencers of delivery workers increased the dissemination of the study, some of whom participated in the consensual validation of the questionnaire; the production of content for social media for the dissemination of the questionnaire link on social networks and applications, and the in-person dissemination of the study at the delivery workers' meeting points during the workday played a fundamental role, totaling around 132 hours in 45 shifts. The strategies adopted for data collection with a hybrid approach to dissemination made it possible to carry out the web survey. After four months of the web survey, 564 delivery workers, 543 men and 18 women, responded to the online questionnaire.

CONCLUSION

The web survey presented methodological strategies to overcome the challenge of reaching workers, including hybrid work, to increase the participation of workers, on whom epidemiological research is still scarce.

Work-related musculoskeletal disorders in dockworkers. Systematic review and meta-analysis

BACKGROUND

Dockworkers are exposed to physical overloads that can contribute to the development of musculoskeletal disorders, leading to functional disability and absenteeism.

OBJECTIVE

to map, critically appraise, and synthesize the available evidence on the prevalence of musculoskeletal diseases associated with port occupational activities.

METHODS

A comprehensive search was conducted in structured and unstructured databases in August 2023, with no date or language restriction, to identify observational studies evaluating the prevalence of musculoskeletal disorders in dockworkers' occupational activity. The risk of bias was assessed using validated tools based on the included study designs. Data from studies were pooled in meta-analyses. The certainty of the evidence was assessed using the GRADE approach.

RESULTS

We identified 12 analytical cross-sectional studies involving 7821 participants in ports of five countries. Most studies (75%) had a moderate methodological quality according to the Joanna Briggs Institute tool. Considering the overall worker categories and any musculoskeletal disorders, the meta-analysis showed a prevalence of 58% (95% Confidence Interval [95% CI] 37% to 78%), with degenerative spinal diseases 42% (95% CI -0.6% to 91%) and low back pain 36% (95% CI 21% to 50%) being the most prevalent conditions. Symptoms were predominantly in foremen and stevedores. The certainty of the evidence was very low.

CONCLUSIONS

Musculoskeletal disorders seem prevalent among dockworkers, mainly degenerative spinal diseases and low back pain. Studies with greater methodological consistency are still needed to validate these hypotheses and assist in decision-making for implementing preventive and informational policies in maritime port management organizations. PROSPERO registry CRD42021257677.

Differences in Beliefs About Suicide by Occupation in a Representative Sample of Adults in the United States, General Social Survey 2002-2021

OBJECTIVE

Beliefs about suicide are important aspects of suicide prevention gatekeeper trainings. This study sought to determine if workers in finance- and legal/judicial-related industries have significantly different levels of suicide acceptability compared to the general US population.

METHOD

Cross-sectional data are from the 2002 to 2021 General Social Survey (GSS). Suicide acceptability was measured with four dichotomous items to which respondents indicated yes/no if they thought someone has the right to end their life in four negative life scenarios. Occupational categories were coded based on U.S. Census Bureau occupation and industry codes. Covariates for multiple logistic regression analyses included age, educational attainment, sex, race, ethnicity, survey year, and religiosity.

RESULTS

Among the 15,166 respondents, 651 people worked in finance-related occupations and 319 people worked in legal/judicial-related occupations. In adjusted models, people in finance-related occupations had greater odds of endorsing suicide as acceptable if one has an incurable disease (aOR = 1.25, 95%CI = 1.03-1.52) and marginally greater odds of endorsing suicide as acceptable if one dishonors their family (aOR = 1.31, 95%CI = 0.99-1.74) than the general adult population. People in legal/judicial-related occupations were more likely to endorse 3 of the 4 suicide acceptability items compared to the general adult population, however these differences were not statistically significant after accounting for demographic factors.

CONCLUSION

Workers in non-clinical industries that frequently see clients during negative life events are prime audiences for gatekeeper trainings but may have entrenched beliefs about suicide acceptability. Research is needed to determine how these beliefs may impact gatekeeper training.

Effects of short-term upper extremity exercise training in office workers during COVID-19 restrictions: A randomized controlled trial

BACKGROUND

During COVID-19 pandemic, physical inactivity and inactivity-related health problems have deepened in many individuals, including office workers. It is not yet known whether there are exercise programs through telerehabilitation that will provide rapid relief in a short time in office workers who apply part or full-time teleworking system.

OBJECTIVE

To comparatively investigate influences of short-term upper extremity exercise trainings (UEET) on pain, musculoskeletal discomforts (MSD), physical activity (PA), mood, and quality of life (QOL) in office workers during COVID-19 restrictions.

METHODS

Thirty office workers were divided into exercise (EG) (UEET and walking advice) and control (CG) (walking advice) groups. The UEET was applied for at least 20-40 minutes/day, 5-7 days/week for a one week between February 2022 and June 2022. Office workers' pain, MSD, PA level, mood and QOL were measured.

RESULTS

Baseline characteristics of groups (EG: 37.8±7.04 years, CG: 41.6±7.97 years) were similar (p >  0.05). Following UEET, scores of office workers in EG on total step count, vigorous PA, moderate-intensity PA, walking, total PA, physical functioning, and body pain subscales of QOL significantly increased compared to scores of office workers in CG, while scores on neck, back and hip discomforts and anxiety and depression significantly decreased (p <  0.05).

CONCLUSIONS

One-week UEET and walking advice can improve office workers' daily step counts, MSD, PA levels, mood, and QOL. Office workers who have a busy work schedule may do these UEET and walking exercises in break times to relieve perception of discomfort.

Morbimortality profile by COVID-19 in telework and on-site work in an oil and gas company in Brazil

BACKGROUND

As a reflection of the health emergency caused by COVID-19, many countries adopted guidelines, which included activity restrictions. As a result, some companies maintained their activities with on-site work and telework.

OBJECTIVE

Analyzing the morbidity and mortality profile due to COVID-19 of workers in telework and on-site work in an oil and gas company.

METHODS

Cross-sectional, quantitative, and analytical study that included 8,394 workers diagnosed with COVID-19 at an oil and gas company in Brazil, from June 2020 to June 2021. The company's Surveillance Program database was used as an information source.

RESULTS

The total prevalence of cases was 21.7% . For teleworking and face-to-face workers, they were 20.7% and 23.3%, respectively. There was a predominance of women (19.7%), white ethnicity/colour (64.7%), higher level position (52.6%), age group over 40 years (36.7%), married (53, 8%), working at the company for a period that ranges from 7 to 10 years (17%), administrative activity (68.5%), and a higher number of symptomatic workers and deaths in telework compared to on-site work.

CONCLUSIONS

The results suggest that testing is important to refrain the virus spread in the company's work environments, as it allowed asymptomatic workers to be diagnosed with COVID-19. The study suggested that on-site work was not a transmission facilitator in the occupational environment, which points out the importance of preventive measures in the workplace and the adoption of remote work for the largest possible number of workers to improve the safety of employees, workers who remained in the on-site work modality.

Revisiting the physical activity paradox: the role of cardiorespiratory fitness in workers with high aerobic demands

In contrast to leisure time physical activity, occupational physical activity may have adverse health effects-a phenomenon known as the "Physical activity paradox". Characteristics such as long duration, low intensity, static and restricted movement, body position and insufficient recovery are possible explanations as to why physical activity in the occupational context may "wear one out" rather than provide health benefits. We emphasise the role of low cardiorespiratory fitness as a potential contributor to the physical activity paradox, and present data suggesting that only 25% to 50% of Swedish workers in occupations with higher aerobic demands may have "sufficient" cardiorespiratory fitness to maintain good health during their employment. More research is needed to fully understand the complexity of the role of other confounding factors when examining the relationship between cardiorespiratory fitness and occupational workload. However, we believe that there is an increasing need for general awareness amongst Swedish authorities, employees and employers of the potential health consequences of low levels of cardiorespiratory fitness, especially among workers with high occupational workloads. Importantly, when developing interventions targeting the working situation and/or cardiorespiratory fitness levels among workers, researchers should actively involve the relevant population in the design of the study in order to maximize the effect of the interventions on health outcomes.

Attitudes to and perceptions of workplace health promotion amongst employees from ethnic minorities in the UK: A scoping review

BACKGROUND

Ethnic minorities make up approximately 14% of the UK workforce. Despite the disproportionate burden of ill-health amongst ethnic minorities, and the increased interest in Diversity, Equity & Inclusion (DE&I) in the workplace, workplace health and wellbeing interventions are still most often designed for the ethnic majority.

OBJECTIVE

The purpose of this scoping review was to explore the depth and breadth of evidence on the attitudes to and perceptions of health and wellbeing interventions in the workplace within ethnic minority groups in the UK, and to identify gaps in evidence that would provide direction for future research needs.

METHODS

A scoping review with quality appraisal was undertaken, supplemented by a review of grey literature and a narrative review exploring related evidence from the knowledge bases related to community and cultural adaptation.

RESULTS

Only three peer-reviewed studies met inclusion criteria, preventing broad conclusions. 14 papers from the community and cultural adaptation literature provided additional information about how health promotion may be approached effectively in the workplace, including the importance of culturally sensitive, people-centred design, and the use of established adaptation frameworks.

CONCLUSION

The literature suggests a need for improvements in four key areas: (1) reporting of ethnic minorities in data relating to workplace health and wellbeing research, (2) more thorough review of perceptions and attitudes of ethnic minority workers in the UK, (3) design of culturally appropriate interventions that are tested for impact, and (4) testing of the effectiveness of culturally adapted interventions.

Work-related injury or work-related pain? A qualitative investigation of work-related pain and injury management among rehabilitation professionals1

BACKGROUND

Patient mobility tasks place rehabilitation professionals (Physical and Occupational Therapists) working in hospitals at high risk for work-related musculoskeletal disorders (WMSDs). However, when investigating engagement with a Safe Patient Handling and Mobility program (SPHM), administrative records at a level one trauma hospital showed that rehabilitation professionals reported zero work-related injuries over an eight-year period.

OBJECTIVE

As part of a qualitative study conducted to discover their unique work experiences, we explored some of the reasons that rehabilitation professionals might not report work-related injuries to their employers.

METHODS

Using a collective case study design, six focus groups were conducted with 25 members of the rehabilitation team within a level-one trauma hospital. Focus groups were recorded; transcripts were analyzed for emergent themes using first and second cycle coding procedures.

RESULTS

Participants in this study denied experiencing work-related injuries but frequently described working in pain, often attributed to patient mobility tasks. These experiences were not reported to employers. Self-management of their pain through co-worker treatment, over-the-counter medications, or informal alteration in job tasks were reported as common.

CONCLUSION

Administrative injury records may underrepresent injuries among rehabilitation professionals. This may be due to their perception of work-related pain as something different than work-related injuries, or that many of these rehabilitation professionals treat their own work-related pain and symptoms rather than report them. To get a more accurate assessment of injury frequency among rehabilitation professionals, researchers should gather information directly from the participants, and should inquire about work-related pain in addition to injury.

[Candida species at the workplace: microbiota component, opportunistic pathogen and zoonotic agent]

Candida spp. isolated from both humans and animals have a similar genotype. Properties of Candida spp. specific for different host species have not been isolated, followed by studies indicating that animals can be a reservoir of these fungi for humans. Occupational exposure concerns workers who have direct contact with farm animals, i.e., farmers, breeders, veterinarians, farm technicians. Hand dermatitis and fungal infection may be caused by prolonged exposure to water and occlusive gloves. The risk of fungal infection is estimated to be high for seafood workers, florists, hairdressers, bakers and cooks, gastronomy workers and healthcare workers. Even though Candida spp. are effective as saprophytic, in the event of a weakening of the function or disturbance of homeostasis, the risk of developing an additional form of candidiasis is increasing due to the intensification of animal production, environmental changes and the excessive use of antibiotics to treat infections in humans and animals. Employers and workers should adopt appropriate strategies to reduce factors conductive to Candida spp. infection at professional work. Med Pr Work Health Saf. 2023;74(5):425-33.

The role of occupation in SARS-CoV-2 infection within a Brazilian municipality: A test-negative case-control study

OBJECTIVE

To investigate the association between occupation and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections within a Brazilian municipality.

METHODS

In this test-negative study, cases and controls were randomly selected among individuals aged 18-65 years that were registered in a primary health care program in São Caetano do Sul, Brazil. Those who had collected samples for RT-PCR testing between April 2020 and May 2021 were randomly selected to compose the case (positive for SARS-CoV-2) and control (negative for SARS-CoV-2) groups, frequency-matched by sex, age group, and month of sample collection. Complementary data were collected through phone interviews. We estimated the residual effect of occupation on SARS-CoV-2 infection using multiple conditional logistic regression models incrementally adjusted for confounding variables.

RESULTS

1724 cases and 1741 controls who reported being at work at the time of RT-PCR collection were included. Cases were mainly females (52.9%), Whites/Asians (73.3%), and unvaccinated against COVID-19 (46.6%). Compared to other university-level professionals, the highest odds of having COVID-19 were found for workers in police and protective services (odds ratio [OR] 2.21; 95% confidence interval [CI] 1.27-3.84), healthcare and caregiving (OR 1.90; 95% CI 1.34-2.68), and food retail and production (OR 1.88; 95% CI = 1.14-3.11), after adjustment for age, sex, education, means of transport, household crowding, and COVID-19 vaccination.

CONCLUSION

Occupation played an important role in SARS-CoV-2 infection. Food retail and production, health care and caregiving, and police and protective services showed the highest odds of SARS-CoV-2 infection.

Factors Associated with Adherence to the Brazilian Food Guide in Food Service Workers

The present study aimed to evaluate factors associated with adherence to the Food Guide for the Brazilian Population (GAPB) among food service workers. A cross-sectional study was conducted with 421 employees from 43 food service establishments located in a capital of Brazil. Health and lifestyle data were collected, including the continuous use of medication, smoking, physical activity, and alcohol consumption. An instrument based on the GAPB was utilized, covering the domains of planning, household organization, eating habits, and food choices, according to GAPB recommendations. The findings revealed a direct association between the quality of life scores and the total GAPB adherence score (β = 1.17; p < 0.001), as well as the domains of planning (β = 0.53; p < 0.001), household organization (β = 0.22; p = 0.001), and eating habits (β = 0.38; p < 0.001). Adherence to the GAPB among food service workers was strongly linked to their perception of quality of life, in addition to other factors such as gender, age, education, type of work activity, and variables of lifestyle. Therefore, the eating practices of these employees need to be assessed comprehensively, and enhancing their quality of life can encourage proper and healthy eating.

Longitudinal Association of Working From Home on Work Functioning Impairment in Desk Workers During COVID-19 Pandemic: A Nationwide Cohort Study

OBJECTIVE

This study clarifies the longitudinal association between working from home and work functioning impairment among desk workers.

METHODS

Nationwide surveys were conducted from 2020 to 2022, analyzing 3532 desk workers who never worked from home before the COVID-19 pandemic.

RESULTS

The adjusted hazard ratio (95% confidence intervals) of working from home at least once a month or more with the composite result (incidence of work functioning or reduced work participation) was 1.22 (1.04-1.43). The cause-specific hazard ratios of work functioning impairment and reduced work participation were 1.30 (1.04-1.61) and 1.13 (0.86-1.47).

CONCLUSIONS

Working from home could be longitudinally associated with work functioning impairment, especially for workers who are in higher positions. Workers and policy makers should be aware of the potential risk of working from home regarding presenteeism.

Association of Low Hourly Wages in Middle Age With Faster Memory Decline in Older Age: Evidence From the Health and Retirement Study

Little research has investigated the long-term relationship between low wages and memory decline, despite the growing share of low-wage workers in the US labor market. Here, we examined whether cumulative exposure to low wages over 12 years in midlife is associated with memory decline in later life. Using 1992-2016 data from the Health and Retirement Study, we analyzed data from 2,879 individuals born in 1936-1941 using confounder-adjusted linear mixed-effects models. Low-wage work was defined as an hourly wage lower than two-thirds of the federal median wage for the corresponding year and was categorized into "never," "intermittent," and "sustained" based on wages earned from 1992 to 2004. Memory function was measured at each study visit from 2004 to 2016 via a memory composite score. The confounder-adjusted annual rate of memory decline among "never" low-wage earners was -0.12 standard units (95% confidence interval: -0.13, -0.10). Compared with this, memory decline among workers with sustained earning of low midlife wages was significantly faster (βtime×sustained = -0.014, 95% confidence interval: -0.02, -0.01), corresponding to an annual rate of -0.13 standard units for this group. Sustained low-wage earning in midlife was significantly associated with a downward trajectory of memory performance in older age. Enhancing social policies to protect low-wage workers may be especially beneficial for their cognitive health.

Protective and Vulnerability Factors of Municipal Workers' Mental Health: A Cross-Sectional Study

Work is fundamental to an individual's mental health; however, an unfavourable work environment can lead to mental health problems. Despite existing studies addressing workers' mental health, it is essential to understand the reality of specific contexts to design effective tailored interventions. Thus, this study aimed to examine the influence of potential protective and vulnerability factors on municipal workers' depressive symptoms, anxiety and stress levels, and burnout. A cross-sectional study was conducted with data collection performed between July and December 2021 using online self-report measures. The sample comprised 115 municipal workers. The findings revealed that psychological vulnerability is a significant vulnerability factor for the presence of mental health symptoms. In addition, job satisfaction was found to be a significant protective factor for depressive symptoms, anxiety, and burnout of the municipal workers. The results of this study enhance the understanding of factors that influence worker mental health, which may facilitate the proper planning of specific interventions to promote mental health in the workplace.

Applicability of Novel Urinary Biomarkers for the Assessment of Renal Injury in Selected Occupational Groups in Sri Lanka: A Comparative Study with Conventional Markers

Screening approaches with more robust biomarkers, are of the utmost importance in the characterization of renal injuries, particularly among communities with high burdens of chronic kidney disease of uncertain etiology (CKDu). The present study aimed to assess the utility of two emerging biomarkers: kidney injury molecule (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) in predicting renal injury in different occupational groups in Sri Lanka. A cross-sectional study was conducted with six occupational groups (n = 188): fisherfolk (FF), paddy farmers (PF), sugarcane farmers (SF), factory workers (FW) and plantation workers (PW) to assess the predictive performance of KIM-1 and NGAL against a CKDu patient (PT) group (n = 40). The median KIM-1 levels of the study groups; FF, PF, SF, FW, PW and PT were 0.67, 0.59, 0.49, 1.62, 0.67 and 5.24 ng/mgCr, respectively, while the median NGAL levels were 1.16, 2.52, 1.42, 1.71, 1.06 and 22.41 ng/mgCr respectively. In ROC analysis to predict CKDu susceptibility, the area under the curve for KIM-1 ranged from 0.88 to 0.99 for the study groups, and in overall analysis, the sensitivity and specificity were 100% and 96%, respectively, for a cutoff value of 2.76 ng/mgCr. Similarly, for NGAL the range of AUC was 0.78-0.94, and a cutoff value of 3.12 ng/mgCr produced 88% sensitivity and 82% specificity. Compared with conventional markers, KIM-1 was the best biomarker for the characterization of renal injury in the participants of the occupational groups. With further validations, KIM-1 may be adopted as a prognostic marker to identify early renal injury and CKDu susceptibilities in community screening.

Health Promotion Practice Among Older Persons: A Nordic Multi-Professional Focus Group Study Exploring what It Is and How It Could be Achieved

The growing ageing population in the Nordic region calls for increased focus on health promotion work. To enhance multi-professional understanding and further develop strategies for promoting healthy ageing, it is vital to consider the perspectives of those working with health promotion. The aim of this study was to explore a wide spectrum of practitioners’ experiences of community-level health promotion targeting older adults in Finland and Sweden. Nine focus group interviews (34 informants) were conducted in 2019–2020. “Seeing the person” emerged as the ideal for health promotion targeting older adults, but this ideal was not always realized in current practice. Barriers related to organizational structures and the practitioner role were identified. However, work methods connected to user involvement and technology-based tools were considered key facilitators, enabling tailored health promotion initiatives.

The Effect of the Imacoco Care Psychoeducation Website on Improving Psychological Distress Among Workers During the COVID-19 Pandemic: Randomized Controlled Trial

BACKGROUND

The prolonged COVID-19 pandemic has affected mental health among workers. Psychoeducational intervention via a website could be effective for primary prevention of mental illness among workers in the current COVID-19 pandemic.

OBJECTIVE

The aim of this randomized controlled trial is to examine the effect of a newly developed online psychoeducational website named Imacoco Care on reducing psychological distress and fear about COVID-19 infection among workers.

METHODS

Participants in the study were recruited from registered members of a web survey company in Japan. Participants who fulfilled the eligibility criteria were randomly allocated to the intervention or control group. Participants in the intervention group were invited to access the Imacoco Care program within a month after the baseline survey. The Kessler Psychological Distress Scale (K6) and the Fear of COVID-19 Scale (FCV-19S) scores were obtained at baseline and at 1- and 3-month follow-ups.

RESULTS

A total of 1200 workers were randomly allocated to the intervention and control groups (n=600 [50%] per group). The Imacoco Care intervention group showed a significant favorable effect on K6 scores (P=.03) with a small effect size (ES; Cohen d=-0.14) and an adverse effect on FCV-19S scores (P=.01) with a small ES (Cohen d=0.16) at 3-month follow-up. In the per protocol analysis (including only participants who had read the Imacoco Care content at least 1 time), the Imacoco Care intervention group also showed a significant favorable effect on reducing K6 scores (P=.03), while an adverse effect on FCV-19S scores was not significant (P=.06) in the intervention group at 3-month follow-up.

CONCLUSIONS

A web-based psychoeducation approach may be effective for improving psychological distress among workers; however, it may be important not only to distribute information but also to encourage active engagement with the content of the program to prevent adverse effects of psychoeducational intervention.

TRIAL REGISTRATION

University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) UMIN000042556; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000048548.

Seroprevalence of anti-SARS-CoV-2 antibodies in the Northern Italy population before the COVID-19 second wave

OBJECTIVES

The COVID-19 pandemic is due to SARS-CoV-2 coronavirus infections. It swept across the world in the spring of 2020, and so far it has caused a huge number of hospitalizations and deaths. In the present study, the authors investigated serum anti-SARS-CoV-2 antibody prevalence in the period of June 1-September 25, 2020, in 7561 subjects in Modena, Northern Italy.

MATERIAL AND METHODS

The study population included 5454 workers referred to testing by their companies, and 2107 residents in the Modena area who accessed testing through self-referral.

RESULTS

The authors found the overall seroprevalence to be 4.7% (95% confidence interval [CI] 4.2-5.2%), which was higher in women (5.4%, 95% CI: 4.5-6.2%) than in men (4.3%, 95% CI: 3.7-4.9%), and in the oldest age groups (7.3%, 95% CI: 5.2-9.3% for persons aged 60-69 years, and 11.8%, 95% CI: 8.6-15.1%, for persons aged ≥70 years). Among the occupational categories, the highest seroprevalence was found in healthcare workers (8.8%, 95% CI: 7.0-10.5%), dealers and vehicle repairers (5.2%, 95% CI: 2.9-7.6%), and workers in the sports sector (4.0%, 95% CI: 1.8-6.1%), while there was little or no such evidence for those employed in sectors such as transport and storage, accommodation and restaurant services, and the school system.

CONCLUSIONS

These results have allowed, for the first time, to assess population seroprevalence in this area of Italy severely hit by the epidemic, while at the same time identifying the subgroups at a higher risk of exposure to SARS-CoV-2. Int J Occup Med Environ Health. 2022;35(1):63-74.

Non-skilled occupation as a risk factor of diabetes among working population: A population-based study of community-dwelling adults in Hong Kong

Diabetes among working population brings to society concerns on productivity and social welfare cost, in addition to healthcare burden. While lower socio-economic status has been recognised as a risk factor of diabetes; occupation, compared with other socio-economic status indicators (e.g., education and income), has received less attention. There is some evidence from studies conducted in Europe that occupation is associated with diabetes risk, but less is known in Asia, which has different organisational cultures and management styles from the West. This study examines the association between occupation and diabetes risk in a developed Asian setting, which is experiencing an increasing number of young onset of diabetes and aging working population at the same time. This is a cross-sectional study of working population aged up to 65 with data from a population-based survey collecting demographic, socio-economic, behavioural and metabolic data from Hong Kong residents, through both self-administered questionnaires and clinical health examinations (1,429 participants). Non-skilled occupation was found to be an independent risk factor for diabetes, with an odds ratio (OR) of 3.38 (p < 0.001) and adjusted OR of 2.59 (p = 0.022) after adjusting for demographic, behavioural and metabolic risk factors. Older age (adjusted OR = 1.08, p < 0.001), higher body mass index (adjusted OR = 1.23, p < 0.001) and having hypertriglyceridemia (adjusted OR = 1.93, p = 0.033) were also independently associated with diabetes. Non-skilled workers were disproportionately affected by diabetes with the highest age-standardized prevalence (6.3%) among all occupation groups (4.9%-5.0%). This study provides evidence that non-skilled occupation is an independent diabetes risk factor in a developed Asian setting. Health education on improving lifestyle practices and diabetes screening should prioritise non-skilled workers, in particular through company-based and sector-based diabetes screening programmes. Diabetes health service should respond to the special needs of non-skilled workers, including service at non-office hour and practical health advice in light of their work setting.

Weight Reduction Interventions Using Digital Health for Employees with Obesity: A Systematic Review

PURPOSE

This study aimed to systematically review the literature on randomized controlled trials on weight reduction interventions using digital health for employees with obesity.

METHODS

All relevant articles published until September 2021 were systematically identified from six electronic databases: MEDLINE, EMBASE, CINAHL, PsycINFO, RISS, and KISS. Data selection and extraction were independently performed by three researchers. Methodological quality was assessed using the JBI Critical Appraisal Checklist for Randomized Controlled Trials. The results were narratively synthesized.

RESULTS

Eleven studies were included in the systematic review. All studies had a low risk of bias. The settings and sample sizes of the included studies were different. The contents of the interventions included nutrition, physical activity, behavioral change, incentives, and motivation. Four studies were based on social cognitive theory. A total of ten studies delivered web-based intervention, while the other used tele-monitoring device. A wide range of intervention strategies was used including providing online resources, tele-counseling, and patient-tailored advice. As a result of the intervention, a total of seven studies showed a significant weight reduction in both the intervention and comparison groups, with significant differences between groups.

CONCLUSION

Until now, use of digital health in weight reduction interventions for employees with obesity has been conducted on a web-based. Various contents such as nutrition, physical activity and theories were explored. Further study is required using more diverse delivery methods such as mobile application, use of wearable devices.

Work ability in aging office workers with musculoskeletal disorders and non-communicable diseases and its associated factors: a cross-sectional study

Objectives. The prevalence of musculoskeletal disorders (MSDs) and non-communicable diseases (NCDs) increases with age. This study examined the impact of MSDs and NCDs on work ability, using the work ability index (WAI), among aging office workers (between 45 and 60 years old) and determined factors associated with WAI scores. Methods. A cross-sectional study was conducted in office workers from 27 government offices in Bangkok and nearby provinces using an online questionnaire. Analyses were conducted using the Mann-Whitney U test and a multivariable logistic regression model. Results. Of 689 workers (452 females and 237 males), 34, 13, 12 and 41% reported MSDs, NCDs, MSDs + NCDs and no MSDs/NCDs, respectively, in the past year. Median scores (interquartile range) of WAI were 37.0 (6) for MSDs, 37.0 (4) for NCDs, 34.5 (6) for MSDs + NCDs and 40.0 (4) for no MSDs/NCDs. Significant difference in WAI scores was found between the MSDs and MSDs + NCDs groups (p = 0.005); and between the NCDs and MSDs + NCDs groups (p < 0.001). Female, high work experience and low job control were significantly associated with reduced WAI scores (WAI ≤ 36). Conclusion. The presence of MSDs or NCDs reduced work ability among aging office workers compared to their healthy counterparts. Having MSDs + NCDs further reduced work ability.

I Am a Nurse, Not a Martyr: Qualitative Investigation of Nurses' Experiences During Onset of the Coronavirus Pandemic

Nurses have always played an essential role during epidemics, risking their lives caring for sick and dying patients. However, the unprecedented nature of the novel coronavirus disease 2019 (COVID-19) has left organizations and healthcare professionals ill-prepared and under-equipped to manage the severity, manifestations, and acute and long-term implications. While COVID-19 has presented profound physical and mental health implications for nurses, we know little about nurses' professional experiences within their organizational context. Thus, this qualitative descriptive study fills that gap through in-depth exploration of nurses' shared professional experiences working in hospitals during the first surge of COVID-19 in the United States. Twenty-two nurses were interviewed via telephone during April and May 2020. Through thematic analysis four main themes emerged: (1) fear, (2) collective resilience through shared trauma, (3) uncharted territory, and (4) perceived disposability. Nurses felt ill-praepared for the rapid changes wrought by COVID-19; yet they also felt proud with a renewed sense of meaning in their work. While unit colleagues were a great source of strength, nurses still reported disappointment, even feeling abandoned by their organizations. Our study indicates that nurses relied on one another to cope and find meaning. These findings are invaluable for policy development and the establishment of preventive and early intervention strategies. Done right, such efforts could better support nurses by encouraging team building, protection, and rewards to maintain nurses' wellbeing during such outbreaks and in their aftermath. Organizations also ought to make nurses' health and wellbeing a priority by streamlining communication, transparency, and leadership visibility.

Airborne Fumigants and Residual Chemicals in Shipping Containers Arriving in New Zealand

Background

Airborne fumigants and other hazardous chemicals inside unopened shipping containers may pose a risk to workers handling containers.

Methods

Grab air samples from 490 sealed containers arriving in New Zealand were analysed for fumigants and other hazardous chemicals. We also collected grab air samples of 46 containers immediately upon opening and measured the total concentration of volatile organic compounds in real-time during ventilation. Additive Mixture Values (AMV) were calculated using the New Zealand Workplace Exposure standard (WES) and ACGIH Threshold Limit Values (TLV) of the 8-h, time-weighted average (TWA) exposure limit. Regression analyses assessed associations with container characteristics.

Results

Fumigants were detectable in 11.4% of sealed containers, with ethylene oxide detected most frequently (4.7%), followed by methyl bromide (3.5%). Other chemicals, mainly formaldehyde, were detected more frequently (84.7%). Fumigants and other chemicals exceeded the WES/TLV in 6.7%/7.8%, and 7.8%/20.0% of all containers, respectively. Correspondingly, they more frequently exceeded ‘1’ for the AMV-TLV compared to the AMV-WES (25.7% versus 7.8%). In samples taken upon opening of doors, fumigants were detected in both fumigated and non-fumigated containers, but detection frequencies and exceedances of the WES, TLV, and AMVs were generally higher in fumigated containers. Detection frequencies for other chemicals were similar in fumigated and non-fumigated containers, and only formaldehyde exceeded both the WES and TLV in both container groups. Volatile compounds in container air reduced rapidly during ventilation. Some cargo types (tyres; personal hygiene, beauty and medical products; stone and ceramics; metal and glass; and pet food) and countries of origin (China) were associated with elevated airborne chemical and fumigant concentrations.

Conclusion

Airborne chemicals in sealed containers frequently exceed exposure limits, both in fumigated and non-fumigated containers, and may contribute to short-term peak exposures of workers unloading or inspecting containers.

Exposure to Hand-Arm Vibration in the Australian Workforce

OBJECTIVE

To estimate the prevalence of hand-arm vibration (HAV) in Australian workplaces.

METHODS

The Australian Workplace Exposure Survey (AWES)-Hearing was a cross-sectional telephone survey of Australian workers conducted in 2016-2017. Respondents were asked about the time spent using tools or performing tasks known to be associated with HAV during their most recent working day. We created a library of HAV magnitude levels for each tool/task and estimated each worker's daily HAV exposure level using standard formulae. We categorized each worker as to whether they exceeded the daily occupational limits of 2.5 and 5.0 m/s2. Results were extrapolated to the Australian working population using a raked weighting method.

RESULTS

In our sample of 4991 workers, 5.4% of men and 0.7% of women exceeded the HAV action limit of 2.5 m/s2 on their most recent working day. We estimate that 3.8% of the Australian workforce exceeds the HAV limit of 2.5 m/s2 and 0.8% exceeds the 5 m/s2 limit. Men were more likely to exceed the HAV limits than women, as were those with trade qualifications, and those who worked in remote locations. Workers in the construction, farming, and automobile industries had the highest prevalence of HAV exposure. Tool groups that contributed to higher exposure levels included: compactors, rollers, and tampers; power hammers and jackhammers; and underground mining equipment.

CONCLUSIONS

HAV is common in the Australian working population. Given the health risks associated with this exposure, reduction strategies and interventions should be developed, with engineering controls as the starting point for exposure reduction strategies.

Cardiorespiratory Fitness in Occupational Groups-Trends over 20 Years and Future Forecasts

BACKGROUND

Reports have indicated a negative trend in cardiorespiratory fitness (CRF) in the general population. However, trends in relation to different occupational groups are missing. Therefore, the aim of our study was to examine the trends in CRF during the last 20 years, and to provide a prognosis of future trends in CRF, in different occupational groups of Swedish workers.

METHODS

Data from 516,122 health profile assessments performed between 2001 to 2020 were included. CRF was assessed as maximal oxygen consumption and was estimated from a submaximal cycling test. Analyses include CRF as a weighted average, standardized proportions with low CRF (<32 mL/min/kg), adjusted annual change in CRF, and forecasting of future trends in CRF.

RESULTS

There was a decrease in CRF over the study period, with the largest decrease in both absolute and relative CRF seen for individuals working in administrative and customer service (-10.1% and -9.4%) and mechanical manufacturing (-6.5% and -7.8%) occupations. The greatest annual decrease was seen in transport occupations (-1.62 mL/min/kg, 95% CI -0.190 to -0.134). Men and younger individuals had in generally a more pronounced decrease in CRF. The proportion with a low CRF increased, with the greatest increase noted for blue-collar and low-skilled occupations (range: +19% to +27% relative change). The forecast analyses predicted a continuing downward trend of CRF.

CONCLUSION

CRF has declined in most occupational groups in Sweden over the last two decades, with a more pronounced decline in blue-collar and low-skilled occupational groups.

Molybdenum Occupational Study in a French Cohort of Workers

OBJECTIVES

Occupational exposure to molybdenum has been poorly documented to date. Here, we present a retrospective study evaluating urinary molybdenum concentration before and after shift over a period of 2 years in exposed workers.

METHODS

This retrospective study was conducted across eight industrial sites in France and included all workers undergoing medical follow-up for occupational molybdenum exposure. A mean of six sequential samples (before and after shift) was performed for each worker. The urinary molybdenum concentration was determined using a validated method of inductively coupled plasma-mass spectrometry. A mixed linear model was built and linear regression was used to verify the extent to which the urinary molybdenum concentration depends on the age of the workers and the sampling period. Additionally, an analysis based on individual trajectory was also performed.

RESULTS

Seventy-seven workers were included in the present study. Post-shift urinary molybdenum concentrations were significantly higher than pre-shift values [median (95th percentile) 37.9 (91.1), versus 60.6 (190.0) µg g-1 creatinine, respectively, P < 0.009]. No accumulation of molybdenum over time was observed. The urinary molybdenum concentrations were not influenced by age. Four workers presented high post-shift values as a result of not adhering to protection measures (maxima of 529.8, 359.7, 386.3, and 1459.7 µg g-1 creatinine, respectively).

CONCLUSIONS

To our knowledge, this is the first study of occupational molybdenum exposure in France to include an individual trajectory analysis. No accumulation of molybdenum was seen but high post-shift molybdenum urinary concentrations were observed for some workers. The study emphasizes the importance of molybdenum monitoring in exposed workers.

Changes in Alcohol Habits Among Workers During the Confinement of COVID-19: Results of a Canadian Cross-Sectional Survey

Background

The restrictions implemented around the world to contain the spread of the coronavirus disease 2019 (COVID-19) impact workers. Emotional distress and maladaptive behaviors such as alcohol misuse are expected, particularly in vulnerable groups such as front-line health workers. In the present study, we examined if alcohol consumption behaviors in Quebec workers changed during confinement of the COVID-19 pandemic, and whether healthcare workers reported specific patterns of changes.

Methods

Data were obtained from an anonymous online survey conducted among adult workers aged ⩾18 years in the province of Quebec, Canada, between May 25, 2020 and June 26, 2020. Participants provided self-reported data regarding sociodemographic including field of work, as well as mental health disorders, alcohol use, alcohol craving, and type of alcohol consumed. Changes in alcohol behaviors were assessed using Wilcoxon signed rank test for categorial variables and paired-t tests for continuous variables.

Results

The survey was completed by 847 participants (77.8% women), with 42.5% healthcare workers. Participants reported increased daily alcohol use (Z = -10.60; P < .001, r = -.372) and alcohol craving (P < .001, d = 0.485) during the confinement. Only the type of alcohol consumed during the confinement differed between health care workers and other workers (OR = 0.45, P = .003). Health care workers used less high alcohol products during the confinement.

Conclusion

Our results show a significant increase in daily alcohol consumption and in alcohol craving during the confinement in the Quebec working population.

Factors related to psychological well-being in unskilled manual workers

OBJECTIVES

The authors characterized the demographic, socioeconomic, and psychosocial work factors associated with performance of unskilled manual work, and then identified the modifiable psychosocial work factors that affected the psychological well-being of these workers.

MATERIAL AND METHODS

This study analyzed data from the fifth Korean Working Condition Survey conducted in 2017. The study subjects were 37 081 Korean employees. The occupational classes investigated were: managers, professionals, and clerks; service and sales workers; and skilled or unskilled manual workers.

RESULTS

Unskilled manual workers were more likely to be elderly and less educated, to have low income, to work fewer hours weekly, to have a shorter work duration, to perform temporary or daily jobs, and to report poor subjective health and well-being. Unskilled manual workers were also more likely to experience psychosocial hazards, such adverse social behaviors, a lack of job satisfaction, a lack of support from managers, and a poor social climate. However, with statistical adjustment for demographic, socioeconomic, and psychosocial work factors, unskilled manual work was no longer associated with poor psychological well-being, but psychosocial work factors were associated with poor psychological well-being.

CONCLUSIONS

The poor psychological well-being of unskilled manual workers cannot be explained by the intrinsic nature of this type of work. Instead, the poor psychological well-being of these workers is associated with unfavorable psychosocial work factors, such as a poor employment status, a lack of job satisfaction, a lack of support from managers, and a bad social climate. These results thus suggest that the modification of psychosocial work factors may improve the psychological well-being of unskilled manual workers.

Mental Health Status of Canadian Funeral Service Workers at the Beginning of the COVID-19 Pandemic

OBJECTIVE

To describe the mental health situation and job stress levels of Funeral Service Workers (FSW) during the first months of the pandemic.

METHODS

We conducted a cross-sectional study in Canada between May and July 2020. Funeral service professional organizations were asked to spread a questionnaire to their members including job description, assessment of anxiety (GAD-7), depression (PHQ-8), and job stress (effort-reward imbalance questionnaire).

RESULTS

Fifty-eight FSW completed a questionnaire, 32% reported anxiety symptoms (GAD-7 > 10), 29% reported depressive symptoms (PHQ-8 > 10), 31% reported job stress. Women were more likely to report overcommitment (66.7% vs. 31.8%, P = 0.015).

CONCLUSIONS

Levels of anxiety and depression identified in Canadian FSW were higher than those identified in other occupational groups during the first few months of the pandemic.

Specifying who delivers behaviour change interventions: development of an Intervention Source Ontology

Background:  Identifying how behaviour change interventions are delivered, including by whom, is key to understanding intervention effectiveness. However, information about who delivers interventions is reported inconsistently in intervention evaluations, limiting communication and knowledge accumulation. This paper reports a method for consistent reporting: The Intervention Source Ontology. This forms one part of the Behaviour Change Intervention Ontology, which aims to cover all aspects of behaviour change interventions . Methods: The Intervention Source Ontology was developed following methods for ontology development and maintenance used in the Human Behaviour-Change Project, with seven key steps: 1) define the scope of the ontology, 2) identify key entities and develop their preliminary definitions by reviewing existing classification systems (top-down) and reviewing 100 behaviour change intervention reports (bottom-up), 3) refine the ontology by piloting the preliminary ontology on 100 reports, 4) stakeholder review by 34 behavioural science and public health experts, 5) inter-rater reliability testing of annotating intervention reports using the ontology, 6) specify ontological relationships between entities and 7) disseminate and maintain the Intervention Source Ontology. Results: The Intervention Source Ontology consists of 140 entities. Key areas of the ontology include Occupational Role of Source, Relatedness between Person Source and the Target Population, Sociodemographic attributes and Expertise. Inter-rater reliability was found to be 0.60 for those familiar with the ontology and 0.59 for those unfamiliar with it, levels of agreement considered 'acceptable'. Conclusions: Information about who delivers behaviour change interventions can be reliably specified using the Intervention Source Ontology. For human-delivered interventions, the ontology can be used to classify source characteristics in existing behaviour change reports and enable clearer specification of intervention sources in reporting.

Occupational Exposure to Second-Hand Tobacco Smoke: Development of a Job Exposure Matrix

Exposure to second-hand tobacco smoke (SHS) in the workplace has been largely controlled in most workplaces in many countries that have adopted smoke-free laws and regulations. Workers in offices, bars, restaurants, and many other settings have experienced substantial reductions in the frequency and intensity of their exposure to SHS. While current exposure to SHS of most non-smoking adults arises from living with a smoker there are likely to be some jobs where non-negligible exposure to SHS continues to occur. This study describes the development of a simple job exposure matrix (JEM) for SHS exposure for the UK working population in 2020 and identifies that at least 1.04 million workers are likely to be exposed to SHS while performing their job. Occupations with the highest frequency and intensity of exposure include those where workers carry out work tasks in private, domestic settings: including care workers and home carers. This SHS-JEM provides a novel method for assessing occupational exposure to SHS in other countries, and can act as a tool to identify priorities for policies to protect those workers who continue to be at risk from SHS.

Applicability of time-restricted eating for the prevention of lifestyle-dependent diseases in a working population: results of a pilot study in a pre-post design

Background: The ongoing epidemic of lifestyle-dependent diseases in industrialized countries threatens to overtax the health and social systems of these nations. New approaches beyond the usual therapeutic and preventive measures which have been applied so far must be tested. A paradigm shift with regard to nutrition and associated illness is overdue. Time-restricted eating (TRE) offers a low-threshold and easy-to-implement lifestyle change which may have what it takes for broad, population-wide applicability and a widely diversified range of possible effects. In this pilot study, we examine the feasibility and adherence of TRE in healthy adult employees. Methods: Pre-post design study with healthy volunteers from the staff of Ulm University and Ulm University Hospital. Participants were asked to reduce their daily eating time to 8-9 hours for three months. Surrounding the eating time, they were allowed drinks other than water for 12 hours, and water for the rest of the day. Anthropometric measurements were taken by trained staff, and blood samples were taken at baseline and follow-up. Pre- and post-data on lifestyle, health and health-related quality of life (HRQoL, recorded with the Visual Analog Scale (VAS) of the EuroQol 5-Dimension (EQ-5D)), and attitudes towards TRE were collected in questionnaires. During the course of the study, timing of the first and the last meal, as well as sleep duration and quality, were assessed in diaries. Primary outcome was the percentage of days with achievement of the fasting goal out of the total number of days recorded per participant. Results: Sixty-three participants (aged 47.8±10.5 years, 86% female) were recruited and started the intervention immediately after the baseline assessment. Two persons dropped out while all others finished the study. Ratings of compatibility of TRE with professional activities were good in 78% of participants, neither good nor difficult in 3%, and 18% reported to have encountered some difficulties. On average, the fasting target was reached on 72.2±18.9% of the recorded days. After three months of TRE, participants showed moderate reductions in weight (-1.3±2.3 kg, p≤0.001) and waist circumference (-1.7±3.2 cm, p≤0.001). HRQoL increased significantly by 5.8±12.4 (p=0.008) points between baseline and follow-up. Conclusion: TRE is feasible and well accepted, even in regularly employed persons, and may improve HRQoL. TRE may help to reduce obesity and abdominal obesity in adult working people, thereby preventing lifestyle-dependent diseases; however, volunteers need more guidance to increase effects.

Risk factors for problematic alcohol use among male waste pickers and caddies in Johannesburg, South Africa: a cross-sectional study

Informal workers may be prone to problematic substance use due to many factors, including adverse working conditions and low income. The aim of this secondary analysis was to investigate problematic alcohol use risk factors among male informal workers in Johannesburg, South Africa. Alcohol use among the two groups of informal workers in the analysis y golf caddies and waste pickers was measured using the World Health Organization (WHO) Alcohol Use Disorder Identification Test (AUDIT) tool. The WHO self-reporting questionnaire (SRQ) for common mental health disorders (CMD) was used to assess mental health. A multivariate logistic regression model was used to explore the predictors of problematic drinking in informal workers. The study consisted of 514 participants, of which 48.4% were golf caddies and 51.6%, waste pickers. Most participants were younger than 40 years (50.9%). Over half of the participants (54.7%) were alcohol consumers and 74.1% were smokers. Over 60% of the participants who were alcohol consumers had a probable drinking problem. Unstratified regression results showed that common mental distress (aOR = 1.06; 95%CI: 1.01-1.09), age: 30-40 years (aOR = 2.17; 95%CI: 1.18-3.97), smoking (aOR = 2.25; 95%CI: 1.34-3.79), and other water sources (aOR = 0.2; 95%CI: 0.04-0.99) were associated with a probable alcohol problem. Waste pickers (aOR = 0.33; 95%CI: 0.20-0.70) were less likely to be problematic drinkers compared to golf caddies. Problematic drinking in this study was common in both caddies and waste pickers along with smoking. Problematic alcohol use was associated with caddying, mental distress, age, and smoking. Measures such as providing counseling services to informal workers and improvement of working conditions may help change the behaviors of these vulnerable groups.

Wearable Devices Suitable for Monitoring Twenty Four Hour Heart Rate Variability in Military Populations

Heart rate variability (HRV) measurements provide information on the autonomic nervous system and the balance between parasympathetic and sympathetic activity. A high HRV can be advantageous, reflecting the ability of the autonomic nervous system to adapt, whereas a low HRV can be indicative of fatigue, overtraining or health issues. There has been a surge in wearable devices that claim to measure HRV. Some of these include spot measurements, whilst others only record during periods of rest and/or sleep. Few are capable of continuously measuring HRV (≥24 h). We undertook a narrative review of the literature with the aim to determine which currently available wearable devices are capable of measuring continuous, precise HRV measures. The review also aims to evaluate which devices would be suitable in a field setting specific to military populations. The Polar H10 appears to be the most accurate wearable device when compared to criterion measures and even appears to supersede traditional methods during exercise. However, currently, the H10 must be paired with a watch to enable the raw data to be extracted for HRV analysis if users need to avoid using an app (for security or data ownership reasons) which incurs additional cost.

Impact of the COVID-19 Pandemic on Physicians Working in the Head and Neck Field

Background  With the COVID-19 pandemic, the clinical practice of physicians who work in the head and neck field in Brazil dropped dramatically. The sustained impact of the pandemic is not known.

Methods  An anonymous online survey was distributed to Brazilian otolaryngologists, head and neck surgeons, medical and radiation oncologists, asking about their clinical practice in the third to fourth months of the pandemic.

Results  The survey was completed by 446 specialists. About 40% reported reduction of more than 75% in outpatient care. A reduction of 90% to 100% in airway endoscopies was reported by 50% of the responders, and the same rate of reduction regarding surgeries (pediatric or nasosinusal) was reported by 80% of them. Family income decreased by 50%, and the psychological burden on physicians was considerable. The availability of personal protective equipment and safety precautions were limited, especially in the public sector.

Conclusion  COVID-19 is still impacting the head and neck field, and safety concerns may hinder the prompt resumption of elective care.

Association between perceived stress and health-risk behaviours in workers

Individuals who experience stress can engage in health-risk behaviours that may decrease work performance. The aim of this study was to determine perceived stress levels in Brazilian workers and verify whether perceived stress was associated with health-risk behaviours. Stress levels of 1,270 workers (1,019 men, 251 women) were assessed using the Perceived Stress Scale. The health-risk behaviours investigated were low intake of vegetables and fruits, daily smoking, high-risk alcohol consumption, physical inactivity, and the presence of obesity. The Student's t-test or one-way analysis of variance was used to assess differences in stress levels. Ordinal regression was used to determine the association between the degrees of stress and health-risk behaviours. Women had higher perceived stress levels than men. In addition, perceived stress levels were higher in those who had low socioeconomic status, were unmarried, had a negative perception of their health, were smokers, or had obesity. Smoking and the presence of two or more health-risk behaviours were associated with 1.84 (95% CI: 1.24-2.73) times and 1.49 (95% CI: 1.18-1.89) times higher odds of experiencing higher degrees of stress, respectively. In women, such an association was observed with the presence of obesity (odds ratio: 2.0; 95% CI: 1.01-3.98).

The Meaning of Work and Self-Management Experiences among Elderly Workers with Multiple Chronic Diseases: A Qualitative Study

With population aging, increasingly many elderly individuals are expected to participate in economic activities. Elderly workers have a higher prevalence of multiple chronic diseases, making it necessary to examine elderly workers' experiences of health-related self-management in work environments. This qualitative study investigated the meaning of work and health-related self-management experiences among elderly workers with multiple chronic diseases. The study participants were elderly workers residing in South Korea (65 years old or older) with at least two chronic diseases. Twelve participated in individual interviews, which were audio-recorded and transcribed. Qualitative content analysis was conducted with the transcribed data. Six themes, 21 sub-themes, and 40 codes were derived. The themes were "benefit of work on health and life", "adaptation to a new work environment", "endurance", "continuous efforts to maintain health", "difficulties in self-management", and "requirements for health promotion". The participants experienced difficulties in health-related self-management due to time constraints, poor work environment, and financial burdens. However, participants expressed their desire to invest effort into managing their physical and psychological health and to work as long as possible. Programs that consider the aging and health-related characteristics of elderly workers and their work environments should be developed and implemented.

THE DEVELOPMENT OF HYPERTENSION DISEASE AND ISCHEMIC HEART DISEASE IN EMERGENCY WORKERS OF THE CHORNOBYL ACCIDENT AND INFLUENCE ON IT CONDITIONS OF BEING UNDER RADIATION

The objective of this investigation is to determine features of hypertensive heart disease (HHD) and coronary heart disease (CHD) development in emergency workers (EW) of Chornobyl Nuclear Power Plant (ChNPP) in dependence on gender, occupation, duration of stay under radiation and the nature of performed job.

MATERIALS AND METHODS

During the period from 2012 to 2018, 483 male EW (EW-m) and 134 female EW (EW-f), who worked in the accident zone over 1986-1987, were examined. All EW of both gender at the time of emergency works had no signs of cardiac pathology. The diagnosis of cardiovascular disease was established in accordance with the diagnostic standards adopted in Ukraine [2964], on the basis of clinical and laboratory examination.

RESULTS

EW could be divided into the following categories according to their occupational membership and nature of performed job: (1) ChNPP staff, (2) persons engaged in construction works (builders), (3) drivers, (4) engineers and technicians, (5) Soviet Army (SA) personnel, policemen and firemen served in Ministry of Internal Affairs (MIA), officers of Interior Troops (IT), (6) low skilled laborers (LSL), (7) medical staff (doctors, nurses, paramedics) and (8) service staff. Among all examined men and women who took part in emergency work, the overwhelming majority stood in the accident area from the end of April to the end of December 1986: 440 men and 111 women. Others were involved to work during 1987. Most men and women worked on liquidation of the accident from April 26, 1986 to the end of May (349 and 71 persons respectively), with the proportion of men was significantly higher. In the rest months of 1986 and the beginning of 1987, on the contrary, the relative number of women involved in the accident exceeded the proportion of men.The EW-m of all occupations were in the risk zone of the cardiovascular diseases, and the HHD development truly correlated with service in MIA, SA and IT, CHD development with profession of engi- neer and technician, and builder as well, and MI development with driver job. The risk of HHD development during the first 10 years after the accident was 4.6 times higher among officers of MIA, SA and IT who had non-shift work in Prypiat and/or at the ChNPP comparing with persons of other occupations and working conditions. The risk of CHD development during the first 15 years was 8.2 times higher in the engineers and technicians who worked in the 30-km zone, compared with other EW and risk of MI throughout the observation period was 6.4 times higher in the drivers, who had shift work in a 30-km zone. In EW-f the risk of HHD developing during the first 10 years after the accident was 2.1 times lower than those who worked in the service sector (kitchen, trade, economists and account- ants, communications, etc.) compared with the representatives of any other profession, and the risk of CHD devel- oping during the first 15 years after the accident was higher in medical staff and EW of other occupational cate- gories that had shift work. Women who worked with shifts had a 4.8-fold higher risk of MI developing than those who had limited terms of work with the subsequent withdrawal from the accident area.

CONCLUSIONS

For more accurately assess the radiation effects on the cardiovascular system of persons who took part in the emergency works at the ChNPP, it should not be limited by comparing the effects of unexposed populations, but to take into account the EW professional affiliation, the terms of stay in the accident area and the nature of performed work.

Barriers and Willingness to Accept Re-Employment among Unemployed Senior Workers: The SeniorWorkingLife Study

Labor market participation has a positive impact on social inclusion and is linked to financial security. This study identifies barriers and willingness to accept re-employment among unemployed seniors that could highlight opportunities for societal action. From the first wave of SeniorWorkingLife in 2018 combined with the Danish version of the International Standard Classification of Occupations register (ISCO), +50-year-old unemployed senior workers (n = 1682) were stratified into mainly seated work (ISCO 1–4) and mainly physical work (ISCO 5–9), respectively, in their latest employment. We used SurveyFreq and SurveyLogistics of SAS combined with model-assisted weights based on national registers to estimate representative frequencies and odds ratios (OR) for barriers and willingness to accept re-employment. Higher age was perceived as a general barrier for re-employment in both groups. Health was a more pronounced barrier for seniors with mainly physical work compared to seniors with mainly seated work (OR 2.35; CI95 1.31–4.21). Overall, seniors showed a large degree of flexibility and willingness to re-enter the labor market. Different barriers and willingness to accept re-employment exist among currently unemployed seniors. These results highlight the need for different approaches across occupational groups to help unemployed seniors back into the labor market.

The Prevalence of Cardiovascular Risk Factors in Different Occupational Groups in New Zealand

OBJECTIVES

Although cardiovascular disease (CVD) risk has been shown to differ between occupations, few studies have specifically evaluated the distribution of known CVD risk factors across occupational groups. This study assessed CVD risk factors in a range of occupational groups in New Zealand, stratified by sex and ethnicity.

METHODS

Two probability-based sample surveys of the general New Zealand adult population (2004-2006; n = 3003) and of the indigenous people of New Zealand (Māori; 2009-2010; n = 2107), for which occupational histories and lifestyle factors were collected, were linked with routinely collected health data. Smoking, body mass index, deprivation, diabetes, high blood pressure, and high cholesterol were dichotomized and compared between occupational groups using age-adjusted logistic regression.

RESULTS

The prevalence of all known CVD risk factors was greater in the Māori survey than the general population survey, and in males compared with females. In general for men and women in both surveys 'Plant and machine operators and assemblers' and 'Elementary workers' were more likely to experience traditional CVD risk factors, while 'Professionals' were less likely to experience these risk factors. 'Clerks' were more likely to have high blood pressure and male 'Agricultural and fishery workers' in the general survey were less likely to have high cholesterol, but this was not observed in the Māori survey. Male Māori 'Trades workers' were less likely to have high cholesterol and were less obese, while for the general population survey, this was not observed.

CONCLUSIONS

This study showed differences in the distribution of known CVD risk factors across occupational groups, as well as between ethnic groups and males and females.

Risk of problem gambling among occupational groups: A population and registry study

Aims:

To identify which occupational groups have elevated levels of regular gambling participation and at-risk and problem gambling, and to explore job-specific factors associated with elevated levels.

Methods:

Statistical analyses were performed on data from the 2015 Swedish population study on gambling and health. The principal registry variable was occupation, classified according to the Swedish version of the International Standard Classification of Occupations (ISCO-08). Two gambling variables were studied: regular gambling participation and at-risk and problem gambling, as measured by the Problem Gambling Severity Index (PGSI). For statistical regression analyses, socio-demographic data were used such as gender, income, and country of origin.

Results:

We found significant differences between occupational groups with regard to the two gambling variables. In general, manual jobs with predominantly male workers scored high, especially when there was no fixed workplace. Several significant differences remained when we controlled for gender. We also found support for three types of workers having elevated levels on the gambling variables: (1) building, construction and service, mobile, (2) vehicle drivers, and (3) monotonous manual indoor work. These results were confirmed by comparisons with propensity score matched controls.

Conclusion:

A policy implication of this study is that some occupational groups should be prioritised in the prevention of problem gambling. Theoretically, the study shows that occupational categories represent real-life cultures and contexts of gambling and non-gambling as distinct from the abstract socio-demographic factors that are usually considered in relation to gambling participation and problem gambling.

Effect of the COVID-19 Pandemic on the Activity of Physicians Working in the Areas of Head and Neck Surgery and Otorhinolaryngology

Introduction  Coronavirus disease 2019 (COVID-19) is an acute infection caused by the new coronavirus (SARS-CoV-2) and it is highly transmissible, especially through respiratory droplets. To prepare the health system for the care of these patients also led to a restriction in the activity of several medical specialties. Physicians who work with patients affected by diseases of the head and neck region constitute one of the populations most vulnerable to COVID-19 and also most affected by the interruption of their professional activities.

Objective  The aim of the present study was to assess the impact of the COVID-19 pandemic on the practice of head and neck surgeons and otorhinolaryngologists in Brazil.

Methods  An anonymous online survey of voluntary participation was applied, containing 30 questions regarding demographic aspects, availability of personal protective equipment (PPE), and impact on the routine of head and neck surgeons and otorhinolaryngologists, as well as clinical oncologists and radiation oncologists who work with head and neck diseases.

Results  Seven hundred and twenty-nine answers were received in a period of 4 days, ∼ 40 days after the 1 ^st confirmed case in Brazil. With professionals working in public and private services, there was a high level of concerns with the disease and its consequences, limited availability of PPE and a significant decrease in the volume of specialized medical care.

Conclusion  The study demonstrated a direct impact of the COVID-19 pandemic on the clinical practice of specialties related to the treatment of patients with diseases of the head and neck region already in the beginning of the illness management in Brazil.

Respirable coal mine dust at surface mines, United States, 1982-2017

BACKGROUND

Exposure to respirable coal mine dust can cause pneumoconiosis, an irreversible lung disease that can be debilitating. The mass concentration and quartz mass percent of respirable coal mine dust samples (annually, by occupation, by geographic region) from surface coal mines and surface facilities at U.S. underground mines during 1982-2017 were summarized.

METHODS

Mine Safety and Health Administration (MSHA) collected and analyzed data for respirable dust and a subset of the samples were analyzed for quartz content. We calculated the respirable dust and quartz concentration geometric mean, arithmetic mean, and percent of samples exceeding the respirable dust permissible exposure limit (PEL) of 2.0 mg/m3, and the average percent of quartz content in samples.

RESULTS

The geometric mean for 288 705 respirable dust samples was 0.17 mg/m³ with 1.6% of the samples exceeding the 2.0 mg/m³ PEL. Occupation-specific geometric means for respirable dust in active mining areas were highest among drillers. The geometric mean for respirable dust was higher in central Appalachia compared to the rest of the U.S. The geometric mean for respirable quartz including 54 040 samples was 0.02 mg/m³ with 15.3% of these samples exceeding the applicable standard (PEL or reduced PEL). Occupation-specific geometric means for respirable quartz were highest among drillers.

CONCLUSION

Higher concentrations of respirable dust or quartz in specific coal mining occupations, notably drilling occupations, and in certain U.S. regions, underscores the need for continued surveillance to identify workers at higher risk for pneumoconiosis.

Respirable coal mine dust in underground mines, United States, 1982-2017

BACKGROUND

This study summarized the mass concentration and quartz mass percent of respirable coal mine dust samples (annually, by district, and by occupation) from underground coal mines during 1982-2017.

METHODS

Respirable dust and quartz data collected and analyzed by Mine Safety and Health Administration (MSHA) were summarized by year, coal mining occupation, and geographical area. The older (before August 2016) 2.0 mg/m ³ respirable dust MSHA permissible exposure limit (PEL) was used across all years for comparative purposes. For respirable dust and quartz, geometric mean and percent of samples exceeding the respirable dust PEL (2.0 mg/m ³ or a reduced standard for samples with >5% quartz content) were calculated. For quartz samples, the average percent quartz content was also calculated.

RESULTS

The overall geometric mean concentration for 681 497 respirable dust samples was 0.55 mg/m ³ and 5.5% of the samples exceeded the 2.0 mg/m ³ PEL. The overall respirable quartz geometric mean concentration for 210 944 samples was 0.038 mg/m ³ and 18.7% of these samples exceeded the applicable standard. There was a decline over time in the percent of respirable dust samples exceeding 2.0 mg/m ³ . The respirable dust geometric mean concentration was lower in central Appalachia compared to the rest of the United States. However, the respirable quartz geometric mean concentration and the mean percent quartz content were higher in central Appalachia.

CONCLUSION

This study summarizes respirable dust and quartz concentrations from coal mine inspector samples and may provide an insight into differences in the prevalence of pneumoconiosis by region and occupation.

Stress and Strain among Seafarers Related to the Occupational Groups

The present study analyses whether the stress and strain experienced by seafarers differ between the various occupational groups on board container ships. In a maritime field study, 323 sailors on 22 container ships were asked to complete a questionnaire and were biometrically surveyed. In addition, a survey of energy expenditure and heart rate (variability) was carried out with the SenseWear^® armband monitor and the Polar RS800 watch, respectively. The activity data objectively collected by the armband monitor showed an average sleep duration of 5.0 h per day, with particularly short sleep episodes amongst nautical officers. This occupational group also significantly more frequently reported sleep deficits (67%). The highest work-related energy expenditure per day was among the deck ratings (801 kcal), followed by the engine room personnel (777 kcal), and finally the nautical officers (568 kcal). The last-mentioned group, who were also the most likely to experience mental stress in the workplace, had the lowest heart rate variability compared to the other occupational groups. The average working time was the only stress parameter that correlated significantly negatively with the heart rate variability (r = −0.387; p = 0.002). Overall, job-related stressors of seafarers on board should be objectified in further studies and occupational group-specific health promotion programmes should be developed.

Association of Attention-deficit Hyperkinetic Disorder with Alcohol Use Disorders in Fishermen

INTRODUCTION

Alcohol use is a widely prevalent problem and poses hazard during work for certain groups such as fishermen. Disorders such as Attention-Deficit/Hyperkinetic Disorder (ADHD) correlate with early onset and greater severity of alcohol use disorders.

AIMS

We planned to study the frequency of ADHD among fishermen in a fishing hamlet of southern India using adult ADHD self-reported scale (ASRS) and correlated with the severity of alcohol use disorder as evidenced by age at initiation of alcohol use, presence of harmful use, or dependence use as defined by Alcohol Use Disorders Identification Test (AUDIT).

SUBJECTS AND METHODS

This was a community-based interview using AUDIT questionnaire for severity of alcohol use and the ASRS to detect ADHD.

RESULTS

The prevalence of adult ADHD among fishermen in this study was 25.7% using the critical items of the ASRS. ADHD was about twice as likely in participants with dependence as those without dependence (odds ratio = 2.10). ADHD was also more likely in participants with onset of use before 30 years of age than others (25.1% vs. 15.4%) (P = 0.27).

DISCUSSION

We found a high frequency of alcohol use among fishermen (79.8%). However, only 9.9% had alcohol dependence which is higher than the general population (2.3%) in the region. Fishermen with alcohol dependence were twice as likely to have ADHD as those without alcohol dependence.

CONCLUSION

In a community-based survey of fishermen, the prevalence of alcohol dependence was about 10%. The presence of alcohol dependence predicted a two times higher likelihood of ADHD among fishermen than those without alcohol dependence.

Occupational variation in incidence of bladder cancer: a comparison of population-representative cohorts from Nordic countries and Canada

OBJECTIVES

The objective of this study was to compare occupational variation of the risk of bladder cancer in the Nordic countries and Canada.

METHODS

In the Nordic Occupational Cancer study (NOCCA), 73 653 bladder cancer cases were observed during follow-up of 141.6 million person-years. In the Canadian Census Health and Environment Cohort (CanCHEC), 8170 cases were observed during the follow-up of 36.7 million person-years. Standardised incidence ratios with 95% CI were estimated for 53 occupations in the NOCCA cohort and HR with 95% CIs were estimated for 42 occupations in the CanCHEC.

RESULTS

Elevated risks of bladder cancer were observed among hairdressers, printers, sales workers, plumbers, painters, miners and laundry workers. Teachers and agricultural workers had reduced risk of bladder cancer in both cohorts. Chimney-sweeps, tobacco workers and waiters had about 1.5-fold risk in the Nordic countries; no risk estimates for these categories were given from the CanCHEC cohort.

CONCLUSION

We observed different occupational patterns in risk of bladder cancer in Nordic countries and Canada. The only occupation with similarly increased risk was observed among sales workers. Differences in smoking across occupational groups may explain some, but not all, of this variation.

Urinary Bisphenol A (BPA) Concentrations among Workers in Industries that Manufacture and Use BPA in the USA

Background

Bisphenol A (BPA) toxicity and exposure risk to humans has been the subject of considerable scientific debate; however, published occupational exposure data for BPA are limited.

Methods

In 2013-2014, 77 workers at six US companies making BPA, BPA-based resins, or BPA-filled wax provided seven urine samples over two consecutive work days (151 worker-days, 525 samples). Participant information included industry, job, tasks, personal protective equipment used, hygiene behaviors, and canned food/beverage consumption. Total (free plus conjugated) BPA, quantified in urine by mass spectrometry, was detected in all samples.

Results

The geometric mean (GM) creatinine-adjusted total BPA (total BPACR) concentration was 88.0 µg g-1 (range 0.78-18900 µg g-1), ~70 times higher than in US adults in 2013-2014 (1.27 µg g-1). GM total BPACR increased during Day 1 (26.6-127 µg g-1), decreased by pre-shift Day 2 (84.4 µg g-1) then increased during Day 2 to 178 µg g-1. By industry, baseline and post-baseline total BPACR was highest in BPA-filled wax manufacturing/reclaim (GM = 111 µg g-1) and lowest in phenolic resin manufacturing (GM = 6.56 µg g-1). By job, total BPACR was highest at baseline in maintenance workers (GM = 157 µg g-1) and post-baseline in those working with molten BPA-filled wax (GM = 441 µg g-1). Workers in the job of flaking a BPA-based resin had the lowest concentrations at baseline (GM = 4.81 µg g-1) and post-baseline (GM = 23.2 µg g-1). In multiple regression models, at baseline, industry significantly predicted increased total BPACR (P = 0.0248); post-baseline, handling BPA containers (P = 0.0035), taking ≥3 process/bulk samples with BPA (P = 0.0002) and wearing a Tyvek® coverall (P = 0.0042) significantly predicted increased total BPACR (after adjusting for total BPACR at baseline, time point, and body mass index).

Conclusion

Several work-related factors, including industry, job, and certain tasks performed, were associated with increased urinary total BPACR concentrations in this group of manufacturing workers. The potential for BPA-related health effects among these workers is unknown.

Levels of Occupational Exposure to Solar Ultraviolet Radiation in Vancouver, Canada

INTRODUCTION

Outdoor workers are at high risk of exposure to solar ultraviolet radiation (UVR), a known human carcinogen. In Canada, no objective measures of UVR exposure are available for occupational settings.

METHODS

The Outdoor Workers Project collected UVR exposure data among outdoor workers in Vancouver, Canada during the summer of 2013. Objective measures of exposure were taken for one week using calibrated electronic UVR dosimeters. Additional data was collected from workers on skin cancer risk factors, family history of skin cancer, and job type; as well as meteorological data for sampling days. Marginal models were constructed to examine the worker, job and meteorological determinants of UVR exposure levels, as measured in standard erythemal dose (SED).

RESULTS

Seventy-eight workers were recruited, of which 73 had at least 1 day of measured UVR exposure for this analysis. Participants were mostly male, young and Caucasian. Mean exposure (corrected for repeated measures) was 1.08 SED. Exposure measures were highly variable even in the same workplace, ranging from 0.01 SED to 19.2 SED. Younger age, working in land-based construction, and sunnier weather forecasts led to higher levels of UVR exposure.

CONCLUSIONS

Exposure levels capable of causing sunburn were common in this study of outdoor workers, in a location not typically associated with high sun exposure.

The prevalence of tularemia in occupational groups that have contact with animals

BACKGROUND/AIM

The aim of the current study was to investigate the presence of antibodies against Francisella tularensis in individuals in different occupations that have contact with animals in the Kars region of northeastern Turkey.

MATERIALS AND METHODS

A total of 201 blood samples specifically including 103 farmers, 45 clinical veterinarians, 42 butchers, and 11 hunters were analyzed. The results of the study were reported in relation to some sociodemographic features (age, sex, occupation, and experience) of the volunteers. The presence of antibodies was determined by a microagglutination (MA) test. In addition, positive sera were confirmed using an ELISA kit.

RESULTS

Fifteen (7.46%) individuals, including fourteen farmers and one clinical veterinarian, were found to be positive for F. tularensis by both MA and ELISA with a titer range of 1/10 to 1/160. The highest seroprevalence rate was observed in farmers (13.59%), followed by clinical veterinarians (2.22%). The occurrence of tularemia was found to increase with age.

CONCLUSION

Though the main route of tularemia outbreaks is water-borne in Turkey, it was determined that people whose occupations bring them into contact with animals are at risk. Similar studies are recommended in order to further clarify the epidemiology of the disease in the northeast of Turkey.