Objectives The aim of this study was to investigate the effect of ill health and socioeconomic status on labor force exit due to unemployment, early retirement, disability pension, or becoming ...economically inactive. A secondary objective was to investigate the effect of ill health and socioeconomic status on return to work. Methods A representative sample of the Dutch working population (N=15152) was selected for a prospective study with ten years follow-up (93917 person-years). Perceived health and individual and household characteristics were measured at baseline with the Permanent Quality of Life Survey (POLS) during 1999—2002. Statistics Netherlands ascertained employment status monthly from January 1999 to December 2008. Cox proportional hazards analyses were used to determine the factors that predicted labor force exit and return to work. Results Ill health increased the likelihood of labor force exit into unemployment hazard ratio (HR) 1.89, disability pension (HR 6.39), and early retirement (HR 1.20), but was not a determinant of becoming economically inactive (HR 1.07). Workers with low socioeconomic status were, even after adjusting for ill health, more likely to leave the labor force due to unemployment, disability pension, and economic inactivity. Workers with ill health at baseline were less likely to return to work after unemployment (HR 0.75) or disability pension (HR 0.62). Socioeconomic status did not influence re-employment. Conclusions Ill health is an important determinant for entering and maintaining paid employment. Workers with lower education were at increased risk for health-based selection out of paid employment. Policies to improve labor force participation, especially among low socioeconomic level workers, should protect workers with health problems against exclusion from the labor force.
Previous reviews have suggested that infrastructural interventions can be effective in promoting cycling. Given inherent methodological complexities in the evaluation of such changes, it is important ...to understand whether study results obtained depend on the study design and methods used, and to describe the implications of the methods used for causality. The aims of this systematic review were to summarize the effects obtained in studies that used a wide range of study designs to assess the effects of infrastructural interventions on cycling and physical activity, and whether the effects varied by study design, data collection methods, or statistical approaches.
Six databases were searched for studies that evaluated infrastructural interventions to promote cycling in adult populations, such as the opening of cycling lanes, or the expansion of a city-wide cycling network. Controlled and uncontrolled studies that presented data before and after the intervention were included. No language or date restrictions were applied. Data was extracted for any outcome presented (e.g. bikes counted on the new infrastructure, making a bike trip, cycling frequency, cycling duration), and for any purpose of cycling (e.g. total cycling, recreational cycling, cycling for commuting). Data for physical activity outcomes and equity effects was extracted, and quality assessment was conducted following previous methodologies and the UK Medical Research Council guidance on natural experiments. The PROGRESS-Plus framework was used to describe the impact on subgroups of the population. Studies were categorized by outcome, i.e. changes in cycling behavior, or usage of the cycling infrastructure. The relative change was calculated to derive a common outcome across various metrics and cycling purposes. The median relative change was presented to evaluate whether effects differed by methodological aspects.
The review included 31 studies and all were conducted within urban areas in high-income countries. Most of the evaluations found changes in favor of the intervention, showing that the number of cyclists using the facilities increased (median relative change compared to baseline: 62%; range: 4 to 438%), and to a lesser extent that cycling behavior increased (median relative change compared to baseline: 22%; range: - 21 to 262%). Studies that tested for statistical significance and studies that used subjective measurement methods (such as surveys and direct observations of cyclists) found larger changes than those that did not perform statistical tests, and those that used objective measurement methods (such as GPS and accelerometers, and automatic counting stations). Seven studies provided information on changes of physical activity behaviors, and findings were mixed. Three studies tested for equity effects following the opening of cycling infrastructure.
Study findings of natural experiments evaluating infrastructural interventions to promote cycling depended on the methods used and the approach to analysis. Studies measuring cycling behavior were more likely to assess actual behavioral change that is most relevant for population health, as compared to studies that measured the use of cycling infrastructure. Triangulation of methods is warranted to overcome potential issues that one may encounter when evaluating environmental changes within the built environment.
The protocol of this study was registered at PROSPERO (CRD42018091079).
Abstract Objective In Europe, the demand for informal care is high and will increase because of the ageing population. Although caregiving is intended to contribute to the care recipient's health, ...its effects on the health of older European caregivers are not yet clear. This study explores the association between providing informal personal care and the caregivers' health. Method Data were used from the longitudinal cohort (2004/2005–2010/2011) of the Survey of Health, Ageing and Retirement in Europe (SHARE) (n = 7858). Generalized estimating equations were used to explore the longitudinal association of informal care and the caregiver's health using poor self-rated health (less than good), poor mental health (EURO-D score for depression ≥ 4), and poor physical health (≥ 2 health complaints). Results Providing informal personal care was significantly associated with poor mental health (OR = 1.23, 95% CI = 1.04–1.47) and poor physical health (OR = 1.18, 95% CI = 1.01–1.38), after adjusting for various socio-demographic and health-related factors. No statistical significant association was found for self-rated health in the adjusted models. Conclusion Providing informal personal care may negatively influence the caregiver's mental and physical health. More awareness of the beneficial and detrimental effects of caregiving among policy makers is needed to make well-informed decisions concerning the growth of care demands in the ageing population.
Prenatal exposure to bisphenol A (BPA) has been associated with adverse birth outcomes, but findings of previous studies have been inconsistent.
We investigated the relation of prenatal BPA exposure ...with intrauterine growth and evaluated the effect of the number of measurements per subject on observed associations.
This study was embedded in a Dutch population-based prospective cohort study, with urine samples collected during early, mid-, and late pregnancy. The study comprised 219 women, of whom 99 had one measurement, 40 had two measurements, and 80 had three measurements of urinary BPA. Fetal growth characteristics were repeatedly measured by ultrasound during pregnancy and combined with measurements at birth. Linear regression models for repeated measurements of both BPA and fetal growth were used to estimate associations between urinary concentrations of creatinine-based BPA (BPACB) and intrauterine growth.
The relationship between BPACB and fetal growth was sensitive to the number of BPA measurements per woman. Among 80 women with three BPA measurements, women with BPACB > 4.22 μg/g crea (creatinine) had lower growth rates for fetal weight and head circumference than did women with BPACB < 1.54 μg/g crea, with estimated differences in mean values at birth of -683 g (20.3% of mean) and -3.9 cm (11.5% of mean), respectively. When fewer measurements were available per woman, the exposure-response relationship became progressively attenuated and statistically nonsignificant.
Our findings suggest that maternal urinary BPA may impair fetal growth. Because previous studies have shown contradictory findings, further evidence is needed to corroborate these findings in the general population.
Celotno besedilo
Dostopno za:
CEKLJ, DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Objectives: The aims of this study were to (i) investigate the impact of paid employment on self-rated health, self-esteem, mastery, and happiness among previously unemployed persons with common ...mental health problems, and (ii) determine whether there are educational inequalities in these effects. Methods: A quasi-experimental study was performed with a two-year follow-up period among unemployed persons with mental health problems. Eligible participants were identified at the social services departments of five cities in The Netherlands when being diagnosed with a common mental disorder, primarily depression and anxiety disorders, in the past 12 months by a physician (N=749). Employment status (defined as paid employment for ≥12 hours/week), mental health Short Form 12 (SF-12), physical health (SF-12), self-esteem, mastery, and happiness were measured at baseline, after 12 months and 24 months. The repeated-measurement longitudinal data were analyzed using a hybrid method, combining fixed and random effects. The regression coefficient was decomposed into between- and within-individual associations, respectively. Results: The between-individuals associations showed that persons working ≥12 hours per week reported better mental health (b=26.7, SE 5.1), mastery (b=2.7, SE 0.6), self-esteem (b=5.7, SE 1.1), physical health (b=14.6, SE 5.6) and happiness (OR 7.7, 95% CI 2.3-26.4). The within-individual associations showed that entering paid employment for ≥12 hours per week resulted in better mental health (b=16.3, SE 3.4), mastery (b=1.7, SE 0.4), self-esteem (b=3.4, SE 0.7), physical health (b=9.8, SE 2.9), and happiness (OR 3.1, 95% CI 1.4-6.9). Among intermediate- and high-educated persons, entering paid employment had significantly larger effect on mental health than among low-educated persons. Conclusions: This study provides evidence that entering paid employment has a positive impact on self-reported health; thus work should be considered as an important part of health promotion programs among unemployed persons.
This study aimed to construct a job exposure matrix (JEM) for risk of becoming infected with the SARS-CoV-2 virus in an occupational setting.
Experts in occupational epidemiology from three European ...countries (Denmark, The Netherlands and the United Kingdom) defined the relevant exposure and workplace characteristics with regard to possible exposure to the SARS-CoV-2 virus. In an iterative process, experts rated the different dimensions of the COVID-19-JEM for each job title within the International Standard Classification of Occupations system 2008 (ISCO-08). Agreement scores, weighted kappas, and variances were estimated.
The COVID-19-JEM contains four determinants of transmission risk number of people, nature of contacts, contaminated workspaces and location (indoors or outdoors), two mitigation measures (social distancing and face covering), and two factors for precarious work (income insecurity and proportion of migrants). Agreement scores ranged from 0.27 95% confidence interval (CI) 0.25-0.29 for 'migrants' to 0.76 (95% CI 0.74-0.78) for 'nature of contacts'. Weighted kappas indicated moderate-to-good agreement for all dimensions ranging from 0.60 (95% CI 0.60-0.60) for 'face covering' to 0.80 (95% CI 0.80-0.80) for 'contaminated workspaces', except for 'migrants' (0.14 (95% CI -0.07-0.36). As country differences remained after several consensus exercises, the COVID-19-JEM also has a country-axis.
The COVID-19-JEM assesses the risk at population level using eight dimensions related to SARS-COV-2 infections at work and will improve our ability to investigate work-related risk factors in epidemiological studies. The dimensions of the COVID-19-JEM could also be valuable for other future communicable diseases in the workplace.
Objectives The objective of this study was to investigate the occurrence of disability pensions over time among workers with physically demanding jobs. Methods The occurrence of disability pension ...was prospectively studied between 1980-2008 among 325 549 Swedish construction workers. The risks for disability pension and years lost of working life were compared among 22 occupational groups, adjusting for age, body mass index, height, and smoking habits. Results The risk varied considerably among blue-collar workers. For example, rock workers had double the risk of disability pension relative risk (RR) 2.16, 95% confidence interval (95% CI) 1.96-2.39 compared to electricians. Most working years lost due to disability pensions (about 75%) were found among men >50 years, mainly as a result of musculoskeletal and cardiovascular diseases. The years of working life lost due to disability pension varied from 0.7 (salaried employees) to 3.2 years (rock workers) among occupational groups. Conclusion Work environment is an important predictor for disability pension among construction workers with those in physically heavy jobs having the highest burden of disability. If the purpose is to increase labor force participation for workers with heavy jobs, strategies to reduce physical demands at work among elderly workers are important.
In the upcoming decades, hospitals and clinics around the world face a steep rise in demand from patients seeking knee replacement surgery. An absolute increase in knee replacement surgery of 297%-to ...57,893 procedures-is forecasted in The Netherlands between 2005 and 2030. The situation is similar in many countries: Sweden, 163% to 21,700 (2013-2030); Italy, 45% to about 100,000 (2017-2050), the UK, 916% to about 1.2 million (2015-2035); Australia, 276% to 65,569 (2013-2030); and the USA, 673% to 3.48 million (2005-2030). No projections are available for Asia, however, similar growth percentages have already been seen in Japan of 373% (2007-2014) and Korea (407%, 2001-2010). Here, Kuijer and Burdorf discuss how work might play a significant role in reducing the steep rise in replacement surgery for knee osteoarthritis across the world.
Purpose
This study investigates whether common diseases, i.e., musculoskeletal diseases (MSD), cardiovascular diseases (CVD), mental disorders (MD), and respiratory diseases (RD), influence work ...ability and sick leave and whether lifestyle-related factors, and psychosocial and physical work-related factors are associated with low work ability and sick leave.
Methods
In a cross-sectional study among 8364 Dutch health care employees, self-reported information was acquired concerning common diseases, lifestyle-related factors, psychosocial and physical work-related factors, work ability, and sick leave. Logistic regression analyses were performed to describe the associations between common diseases with low work ability and sick leave, and to evaluate differences in associations between lifestyle-related and work-related factors with low work ability and sick leave among healthy employees and employees with common diseases.
Results
Employees with MD (OR 6.35), CVD (OR 2.63), MSD (OR 2.62), and RD (OR 2.11) had a higher risk of low work ability compared to healthy employees. Workers with common diseases also reported more often sick leave (ORs > 1.60), in particular long-term sick leave (>25 days). Multimorbidity increased both the occurrence of low work ability and sick leave. Unfavourable psychosocial work-related factors were associated with low work ability and sick leave regardless of health status. Physical work-related factors and lifestyle factors were less consistently associated with low work ability and sick leave.
Conclusions
Common diseases, and foremost mental disorders, were related to both low work ability and sick leave. To maintain or improve work ability and prevent sick leave, interventions that promote a healthy psychosocial work environment are needed.
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