Abstract
Within a school grade, children who are young for grade are at increased risk of psychiatric diagnoses, but the long-term implications remain understudied, and associations with students who ...delay or accelerate entry underexplored. We used Norwegian birth cohort records (birth years: 1967–1976, n = 626,928) linked to records in midlife. On-time school entry was socially patterned; among those born in December, 23.0% of children in the lowest socioeconomic position (SEP) delayed school entry, compared with 12.2% among the highest SEP. Among those who started school on time, there was no evidence for long-term associations between birth month and psychiatric/behavioral disorders or mortality. Controlling for SEP and other confounders, delayed school entry was associated with increased risk of psychiatric disorders and mortality. Children with delayed school entry were 1.31 times more likely to die by suicide (95% confidence interval: 1.07, 1.61) by midlife, and 1.96 times more likely to die from drug-related death (95% confidence interval: 1.59, 2.40) by midlife than those born late in the year who started school on time. Associations with delayed school entry are likely due to selection, and results thus underscore that long-term health risks can be tracked early in life, including through school entry timing, and are highly socially patterned.
Mounting evidence indicates increased risk of COVID-19 among healthcare personnel, but the evidence on risks in other occupations is limited. In this study, we quantify the occupational risk of ...COVID-19-related hospital admission in Denmark during 2020-2021.
The source population included 2.4 million employees age 20-69 years. All information was retrieved from public registers. The risk of COVID-19 related hospital admission was examined in 155 occupations with at least 2000 employees (at-risk, N=1 620 231) referenced to a group of mainly office workers defined by a COVID-19 job exposure matrix (N=369 341). Incidence rate ratios (IRR) were computed by Poisson regression.
During 186 million person-weeks of follow-up, we observed 2944 COVID-19 related hospital admissions in at-risk occupations and 559 in referents. Adjusted risk of such admission was elevated in several occupations within healthcare (including health care assistants, nurses, medical practitioners and laboratory technicians but not physiotherapists or midwives), social care (daycare assistants for children aged 4-7, and nursing aides in institutions and private homes, but not family daycare workers) and transportation (bus drivers, but not lorry drivers). Most IRR in these at-risk occupations were in the range of 1.5-3. Employees in education, retail sales and various service occupations seemed not to be at risk.
Employees in several occupations within and outside healthcare are at substantially increased risk of COVID-19. There is a need to revisit safety measures and precautions to mitigate viral transmission in the workplace during the current and forthcoming pandemics.
Changes in incidence of occupational asthma, contact dermatitis, noise-induced hearing loss, carpal tunnel syndrome and upper limb musculoskeletal disorders were compared for the first time across ...diverse surveillance systems in 10 European countries.3 StanDerm (2012–2016) sought to create standards for the prevention and clinical management of occupational skin diseases.4 The Environmental Health Risks in European Birth Cohorts (ENRIECO)5 and Developing a Child Cohort Research Strategy for Europe (CHICOS) (www.chicosproject.eu) projects, and related birth cohort inventory (www.birthcohorts.net), also led to substantial advancements in child health research. More specifically, we seek to inventory numerous cohorts with occupational information in Europe (an initial evaluation indicates at least 63 major individual prospective and retrospective cohorts as well as several large record linkage studies with occupational information on over 30 million workers), implement an online interactive tool with detailed information on existing cohorts, facilitate work on harmonisation of existing occupational exposure and health outcome information and create and pilot-test new protocols for data collection, and connect scientific communities and relevant stakeholders. Trends in incidence of occupational asthma, contact dermatitis, noise-induced hearing loss, carpal tunnel syndrome and upper limb musculoskeletal disorders in European countries from 2000 to 2012.
Objective A consensual definition of occupational burnout is currently lacking. We aimed to harmonize the definition of occupational burnout as a health outcome in medical research and reach a ...consensus on this definition within the Network on the Coordination and Harmonisation of European Occupational Cohorts (OMEGA-NET). Methods First, we performed a systematic review in MEDLINE, PsycINFO and Embase (January 1990 to August 2018) and a semantic analysis of the available definitions. We used the definitions of burnout and burnout-related concepts from the Systematized Nomenclature of Medicine Clinical Terms (SNOMED-CT) to formulate a consistent harmonized definition of the concept. Second, we sought to obtain the Delphi consensus on the proposed definition. Results We identified 88 unique definitions of burnout and assigned each of them to 1 of the 11 original definitions. The semantic analysis yielded a first proposal, further reformulated according to SNOMED-CT and the panelists` comments as follows: "In a worker, occupational burnout or occupational physical AND emotional exhaustion state is an exhaustion due to prolonged exposure to work-related problems". A panel of 50 experts (researchers and healthcare professionals with an interest for occupational burnout) reached consensus on this proposal at the second round of the Delphi, with 82% of experts agreeing on it. Conclusion This study resulted in a harmonized definition of occupational burnout approved by experts from 29 countries within OMEGA-NET. Future research should address the reproducibility of the Delphi consensus in a larger panel of experts, representing more countries, and examine the practicability of the definition.
Health practitioners and decision makers in the medical and insurance systems need knowledge on the work-relatedness of burnout. To gather the most reliable information regarding burnout diagnosis ...and recognition in Europe, we used an 8-item standard questionnaire sent by e-mail to occupational health specialists identified via the Network on the Coordination and Harmonization of European Occupational Cohorts (OMEGA-NET) within the European Cooperation in Science and Technology (COST) Action. Participation rate was 100%, and the questionnaire was completed for 37 countries. In 14 (38%) countries burnout syndrome can be acknowledged as an occupational disease. However, only one country included burnout on the list of occupational diseases. The results showed a high variability in burnout diagnosis, in assessment of its work-relatedness, and in conditions allowing compensation of patients. These results reflect a lack of graded evidence on burnout and its determinants. The ongoing research on burnout conducted in the frame of the OMEGA-NET COST Action should be helpful through facilitating standardization of both existing and new data on burnout, a priority outcome requiring harmonization.
Mechanical and psychosocial work exposures Hanvold, Therese Nordberg; Sterud, Tom; Kristensen, Petter ...
Scandinavian journal of work, environment & health,
05/2019, Letnik:
45, Številka:
3
Journal Article
Recenzirano
Odprti dostop
Objectives The aim of this study was to (i) construct and evaluate a gender-specific job exposure matrix (JEM) for mechanical and psychosocial work exposures and (ii) test its predictive validity for ...low-back pain. Methods We utilized data from the Norwegian nationwide Survey of Living Conditions on work environment in 2006 and 2009. We classified occupations on a 4-digit level based on the Norwegian version of the International Standard Classification of Occupations (ISCO-88). The mechanical and psychosocial exposure information was collected by personal telephone interviews and included exposures that were known risk factors for low-back pain. We evaluated the agreement between the individual- and JEM-based exposure estimates, with kappa, sensitivity and specificity measures. We assessed the JEM`s predictive validity by testing the associations between low-back pain and the individual- and JEM-based exposure. Results The results showed an overall fair-to-moderate agreement between the constructed JEM and individual work exposures. The JEM performed considerably better for mechanical work exposures compared with psychosocial work exposures. The predictive validity of the mechanical and psychosocial JEM showed a consistently lower but predominantly reproducible association with low-back pain for both genders. Conclusions The mechanical estimates and psychosocial stressors, such as psychological demands, monotonous work and decision latitude in the constructed JEM, may be useful in large epidemiological register studies. The predictive validity of the matrix was evaluated as being overall acceptable, it can thus be an effective and versatile approach to estimate the relationship between work exposures and low-back pain.
IntroductionThe working environment may contribute strongly to the development and manifestation of health problems leading to reduced work participation. To maintain high workforce participation, it ...is important to target workplace interventions to occupational groups at high risk of sickness absence (SA).ObjectivesTo identify occupational groups with excessive SA and develop occupation-specific knowledge about the contribution of work-related factors to SA and the potential for prevention.MethodsWe performed a register-based study on employees aged 25–59 in 2013 (N=1,331,547) and calculated gender- and occupation-specific (4-digit ISCO codes) one-year incidence of all-cause and cause-specific SA. We selected the following job exposures: heavy physical work, high job demands and low job control, assessed by a Job Exposure Matrix and compared the gender-specific risk of SA among exposed workers to non-exposed workers. Lastly, we compared the gender-specific risk of SA in ten occupational groups to professionals (reference), controlling for (i) age and (ii) age and job exposures. We used Cox proportional hazards model for all analyses.ResultsWorkers exposed to heavy physical work or low job control had higher risk of SA (RR=3.65; 95% CI 3.54–3.78 and RR=1.41; 95% CI 1.39–1.42, respectively). The ten selected occupational groups all had higher risk of SA, relative to professionals. The relative risk was particularly high among male drivers and mobile plant operators (RR=2.57; 95% CI 2.49–2.64) and female personal care workers (RR=1.43; 95% CI 1.41–1.45). Adjusting for job exposures resulted in attenuation of the RR estimates, most for male building and related trade workers (37% attenuation) and female personal care workers (84%).ConclusionWe identified occupational groups with high risk of SA and the selected job exposures. Excess risk of SA in ten selected occupational groups, as compared to professionals, could partly be attributed to the job exposures.
BackgroundEmployment is an essential component of adult life, and occupation is a major determinant of health. Despite profound changes in working life, there has been little coordinated European ...occupational health research.ObjectivesWe present results from the HERA international project funded by the EU Horizon2020 program, to set priorities for an environment and health research agenda in the EU for 2020–2030.MethodsWe contacted hundreds of researchers in Europe through an online survey. We also identified major policy needs in the health and environment/occupation nexus by contacting national, regional, and European stakeholders representing authorities, intergovernmental organizations, civil society, and the private sector through surveys and regional meetings. We applied a priori defined criteria to examine novelty, public health importance, importance to the environment, impact on policies, and potential for innovation within the sustainable development goals.ResultsMain research gaps identified include(i) Climate change and worker health; (ii) Ageing workers; (iii) New technologies and chemicals; (iv) Working time; (v) Changing employment patterns and precarious employment; (vi) Mixed exposures and biomonitoring; (vii) Work-life-balance; and (viii) Neglected occupational diseases. In addition, priority actions related to occupational health were identified such as commuting to work, tools, and infrastructure such as the development of big data, biobanks, occupational cohorts, and large population cohorts with occupational information, development of exposome type approaches, and approaches examining societal aspects on employment and productivity.ConclusionsWe will discuss challenges in the identification of key areas in occupational health research that will benefit from new scientific evidence and challenges in strategies to ensure the engagement of stakeholders. This large initiative in Europe has systematically evaluated priorities through the engagement of a wide spectrum of stakeholders across the continent. A consultation process will continue over the next year to raise additional research gaps and calibrate recommendations.
ObjectiveWithin the framework of the Exposome Project for Health and Occupational Research (EPHOR), we aimed to provide an overview of knowledge gaps in the associations between occupational ...exposures and their health effects across multiple health outcomes.MethodsWe conducted a narrative umbrella review of occupational risk factors that can be considered established (sufficient evidence) and suspected (with limited, insufficient or inconsistent evidence) for six main non-communicable disease (NCD) groups: non-malignant respiratory diseases; cancer; neurodegenerative diseases; cardiovascular and metabolic diseases; mental diseases; and musculoskeletal disorders. For each NCD-group, a working group was formed where the literature searches were coordinated and findings discussed. Regular meetings between working group leaders were held to align efforts. The narrative review was mainly based on systematic reviews and authoratitive reports supplemented with narrative reviews, reports and original studies as appropriate. The status of knowledge was summarized in tables and heatmaps. We further identified knowledge gaps, e.g., based on missing information on exposure-response relationships, gender differences, critical time windows, multiple exposures, as well as inadequate study quality.ResultsWe identified over 200 occupational exposures with suspected or established associations to common NCDs. Various exposures were identified as possible risk factors for multiple outcomes, including diesel engine exhaust, silica, cadmium and shift work. Potential areas for future research have been identified considering an exposome research context. For suspected associations, conclusive evidence would be needed, while for established risk factors improvements in case definition, as well as quality of exposure assessment and study design could lead to better understanding of the association.ConclusionBy providing an overview of knowledge gaps in the associations between occupational exposures and their health effects, our narrative review helps to set priorities in exposome-based occupational health research.
This study aimed to compare the risk of labor market marginalization among refugees across different host countries of resettlement and examine the moderating role of birth country and length of stay ...on these associations.
Cohorts of refugees and native-born individuals aged 19-60 in Sweden (N=3 605 949, 3.5% refugees) and Norway (N=1 784 861, 1.7% refugees) were followed during 2010-2016. Rates (per 1000 person-years) of long-term unemployment, long-term sickness absence, and disability pension were estimated for refugees and the host populations. Cox regression models estimated crude and adjusted (for sex, age, educational level, and civil status) hazard ratio (HR
) for refugees compared to their respective host population, with 95% confidence intervals (CI). Analyses were also stratified by birth country and length of stay.
Refugees in Norway and Sweden had a higher incidence of labor market marginalization compared to their host population. Refugees in Sweden had a comparatively lower relative risk of long-term unemployment but higher risk of disability pension (HR
3.44, 95% CI, 3.38-3.50 and HR
2.45, 2.35-2.56, respectively) than refugees in Norway (HR
3.70, 3.58-3.82 and HR
1.57, 1.49-1.66, respectively). These relative risks varied when stratifying by birth country. A shorter length of stay was associated with a higher risk of long-term unemployment and a lower risk of disability pension, with a stronger gradient in Sweden than in Norway.
The relative risk of labor market marginalization varied by the refugees' birth country but followed similar trends in Sweden and Norway. Although speculative, these findings may hint at non-structural factors related to the refugee experience playing a more important role than host country structural factors for the risk of labor market marginalization among refugees. Future research, including host countries with more variability in structural factors, is required to further investigate these associations. The higher risk of long-term unemployment among refugees with shorter length of stay indicates a need for more efficient labor market integration policies for newly-arrived refugees.
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