Objectives The study aimed to (i) determine the influence of poor health on competing exit routes from paid employment among older workers in Europe, (ii) assess whether these risks are different ...among welfare state regimes in Europe, and (iii) evaluate differences in estimates between two different competing risk approaches. Methods The study population consisted of 5273 respondents (6-years follow-up) from the Survey of Health, Ageing, and Retirement in Europe (SHARE). The effect of poor health on exit routes from paid employment was assessed with a cause-specific Cox model and a Fine ＆ Gray (F＆G) model. These two competing risk analyses were used to calculate absolute risks of labor force exit among welfare state regimes in Europe. Results In both models, poor health was a risk factor for disability benefit hazard ratio (HR) 3.36; subdistribution hazard ratio (SHR) 3.22, and unemployment (HR 1.43, SHR 1.32). Both models produced similar absolute risks. In countries with a Bismarckian welfare state regime, low-educated older workers living alone and in poor health had an 11% risk of disability benefit, 7% of unemployment, 46% of early retirement, and 7% of becoming economically inactive. In countries with a Scandinavian welfare state regime, the risks were 10%, 7%, 29%, and 3%, respectively, and in Southern European welfare state regimes 4%, 5%, 35%, and 7%. Conclusions Workers with poor health are more likely to leave the labor force than workers with good health. The absolute risks of early retirement and becoming economically inactive were lowest in countries with a Scandinavian welfare state regime. For disability benefit and unemployment, absolute risks were lowest in Southern European welfare state regimes. The direct estimation of absolute risks of leaving the labor force in the presence of competing exit routes is an appealing feature of the F＆G model.
Objective This study aimed to systematically review the literature on the contribution of work and lifestyle factors to socioeconomic inequalities in self-rated health among workers. Methods A search ...for cross-sectional and longitudinal studies assessing the contribution of work and/or lifestyle factors to socioeconomic inequalities in self-rated health among workers was performed in PubMed, PsycINFO and Web of Science in March 2017. Two independent reviewers performed eligibility and risk of bias assessment. The median change in odds ratio between models without and with adjustment for work or lifestyle factors across studies was calculated to quantify the contribution of work and lifestyle factors to health inequalities. A best-evidence synthesis was performed. Results Of those reviewed, 3 high-quality longitudinal and 17 cross-sectional studies consistently reported work factors to explain part (about one-third) of the socioeconomic health inequalities among workers (grade: strong evidence). Most studies separately investigated physical and psychosocial work factors. In contrast with the 12 cross-sectional studies, 2 longitudinal studies reported no separate contribution of physical workload and physical work environment to health inequalities. Regarding psychosocial work factors, lack of job resources (eg, less autonomy) seemed to contribute to health inequalities, whereas job demands (eg, job overload) might not. Furthermore, 2 longitudinal and 4 cross-sectional studies showed that lifestyle factors explain part (about one-fifth) of the health inequalities (grade: strong evidence). Conclusions The large contribution of work factors to socioeconomic health inequalities emphasizes the need for future longitudinal studies to assess which specific work factors contribute to health inequalities.
Abstract
Background
This study aimed to evaluate individual characteristics associated with participation and effectiveness of a worksite health promotion program with motivational interviewing ...targeting health and health behaviour among Dutch workers in low socioeconomic position.
Methods
In a production company and a hospital, 838 workers were invited for a Preventive Medical Examination and subsequent coaching with motivational interviewing up to 7 sessions within 6 months. Follow-up information was collected after 6 months. Characteristics associated with participation in coaching were assessed with logistic regression models. The effectiveness of coaching on body mass index (BMI), bodyweight, self-rated health, vigorous physical activity, smoking, alcohol intake, fruit- and vegetable consumption, work ability, and sickness absence was evaluated with linear regression models and on participation in health promotion activities with logistic regression analysis. The analyses on effectiveness were performed without and with propensity score adjustment.
Results
Of the 838 invited workers, 313 workers participated in the Preventive Medical Examination and follow-up data were available for 176 workers, of whom 100 workers with increased cardiovascular risk attended coaching. The majority of workers with obesity (73%), overweight (60%), and unhealthy behaviours (58%-69%) at baseline participated in motivational interviewing. Males, workers with overweight or obesity, workers at the production company, workers with insufficient vigorous physical activity, and workers with a low educational level were most likely to participate in coaching. Coaching with motivational interviewing after the Preventive Medical Examination was associated with a 4.74 times higher likelihood 95% confidence interval (CI): 1.99;11.32 to participate in health promotion activities and 10.9% (95%CI: 0.6;21.3) more persons who quit smoking compared to workers without coaching. No statistically significant effects were observed on BMI, bodyweight, health, health behaviour, work ability and sickness absence.
Conclusions
The program combining a Preventive Medical Examination with follow-up coaching reached – as intended – workers with obesity or overweight, those with a low education and with unhealthy behaviours. Adding coaching with motivational interviewing to a Preventive Medical Examination contributed to higher participation in health promotion activities and an increase in smoking cessation after 6 months among workers with a lower socioeconomic position, but was not effective on other outcomes.
Trial registration
The study was registered retrospectively in the Netherlands Trial Register as
NL8178
on 22/11/2019.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
This review is an update of a previous systematic review and assesses the evidence for the association of work-related physical and psychosocial risk factors and specific disorders of the shoulders. ...Medline, Embase, Web of Science Core Collection, Cochrane Central and PsycINFO were searched and study eligibility and risk of bias assessment was performed by two independent reviewers. A total of 14 new articles were added with the majority focusing on rotator cuff syndrome (RCS) with seven studies. Nine articles reported psychosocial exposures in addition to physical exposures. The strongest evidence was found for the association between elevation, repetition, force and vibration and the occurrence of SIS and tendinosis/tendonitis. Evidence also suggests that psychosocial exposures are associated with the occurrence of RCS and tendinosis/tendonitis. Other findings were inconsistent which prevents drawing strong conclusions.
To study the performance of a developed job exposure matrix (JEM) for the assessment of psychosocial factors at work in terms of accuracy, possible misclassification bias and predictive ability to ...detect known associations with depression and low back pain (LBP).
We utilized two large population surveys (the Health 2000 Study and the Finnish Work and Health Surveys), one to construct the JEM and another to test matrix performance. In the first study, information on job demands, job control, monotonous work and social support at work was collected via face-to-face interviews. Job strain was operationalized based on job demands and job control using quadrant approach. In the second study, the sensitivity and specificity were estimated applying a Bayesian approach. The magnitude of misclassification error was examined by calculating the biased odds ratios as a function of the sensitivity and specificity of the JEM and fixed true prevalence and odds ratios. Finally, we adjusted for misclassification error the observed associations between JEM measures and selected health outcomes.
The matrix showed a good accuracy for job control and job strain, while its performance for other exposures was relatively low. Without correction for exposure misclassification, the JEM was able to detect the association between job strain and depression in men and between monotonous work and LBP in both genders.
Our results suggest that JEM more accurately identifies occupations with low control and high strain than those with high demands or low social support. Overall, the present JEM is a useful source of job-level psychosocial exposures in epidemiological studies lacking individual-level exposure information. Furthermore, we showed the applicability of a Bayesian approach in the evaluation of the performance of the JEM in a situation where, in practice, no gold standard of exposure assessment exists.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background The rapid increase of frail older people worldwide will have a substantial impact on healthcare systems. The frailty process may be delayed or even reversed, which makes it attractive for ...early interventions. However, little is known about the determinants of frailty state changes. The aim of this study is to compare socio-demographic determinants of worsening in frailty state in 11 European countries. Methods Data of 14 424 community-dwelling persons aged ≥55 years, enrolled in 2004 in the Survey of Health, Ageing and Retirement in Europe, were analysed. Three frailty states were identified (non-frail, pre-frail and frail) using Fried's criteria, and frailty state changes over a 2-year period were determined. Multinomial regression analyses adjusted for baseline frailty state were conducted to investigate whether sex, age, marital status and level of education determined a worsening in frailty state in the total and country-specific European population. Results Of all individuals, 22.1% worsened, 61.8% showed no change and 16.1% improved in frailty state. Women, those aged ≥65 years, and lower educated persons showed an increased risk of worsening in frailty state. In Southern European countries, there was an earlier and larger increase in risk of worsening in frailty state in life, which was more pronounced in women compared with men. Conclusions In Europe, persons aged ≥65 years, women and lower educated persons are at increased risk of worsening in frailty state. Differences between countries indicate that interventions aimed at delaying the frailty process in Southern European countries should start earlier with more attention towards women.
OBJECTIVE:To investigate whether work engagement influences self-perceived health, work ability, and sickness absence beyond health behaviors and work-related characteristics.
METHODS:Employees of ...two organizations participated in a 6-month longitudinal study (n = 733). Using questionnaires, information was collected on health behaviors, work-related characteristics, and work engagement at baseline, and self-perceived health, work ability, and sickness absence at 6-month follow-up. Associations between baseline and follow-up variables were studied using multivariate and multinomial logistic regression analyses and changes in R were calculated.
RESULTS:Low work engagement was related with low work ability (odds ratio3.68; 95% confidence interval2.15 to 6.30) and long-term sickness absence (odds ratio1.84; 95% confidence interval1.04 to 3.27). Work engagement increased the explained variance in work ability and sickness absence with 4.1% and 0.5%, respectively.
CONCLUSIONS:Work engagement contributes to work ability beyond known health behaviors and work-related characteristics.
Some authors have reported that high psychosocial work demands is an independent risk factor of LBP (2), whereas others have noted that psychosocial factors, such as job strain, are more important in ...aggravation and slower recovery of LBP (5). ...authors have also focused on job strain as a promoting factor of sickness absence among those with musculoskeletal complaints (6). The two main candidates for explaining differences between a FE model and statistical methods that include both within- and between-person variation (ordinary least squares, random effects regression) are bias and associations of short-term versus sustained exposure. Psychosocial job quality and mental health among young workers: a fixed-effects regression analysis using 13 waves of annual data.
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.
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.
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.
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.eers.
ObjectivesThe main purpose of the current study was to investigate the psychometric properties of the Italian version of the University Stress Scale (USS) among Italian medical students.Design, ...setting and participantsA cross-sectional observational study based on data from an online cross-sectional survey from 11 to 23 December 2018. A total of 1858 Italian medical students participated in the study.Outcome measuresWe measured perceived stress among medical students using the USS, the Effort-Reward Imbalance Student Questionnaire (ERI-SQ) and the Kessler-10 (K10).ResultsResults showed that a bifactor-Exploratory Structural Equation Modeling solution provided excellent levels of fit to the data. Our results suggest that the modified version of 19 items of the Italian version of the USS does not have a simple unidimensional structure. Overall, an inspection of ancillary indices (omega indices, ECV and percentage of uncontaminated correlations) revealed that these were too low to suggest the use of the USS as a composite measure of university stress. We tested an alternative unidimensional short form (eight items; USS-S) that assessed all the five sources of stress. This version provided a good fit to the data. Evidence of convergent validity of the USS-S was observed by analysing the correlations between the USS and ERI-SQ (ranging from −0.34 to 0.37, all p<0.01). Finally, based on the clinical cut-off recommended on the K10, results from receiver operating characteristic showed that considering the clinical cut-off of the USS is 7.5 and that 59.70% of medical students reported stress levels in the clinical range.ConclusionFinally, our results showed a lack of support for using the USS to measure a general university stress factor, as the general USS factor accounted for little variance in our sample. In this sense, stress scores among Italian students can be better assessed by the use of the USS-S.
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