Associations of job strain and working overtime with adverse health behaviors and obesity: evidence from the Whitehall II Study, Helsinki Health Study, and the Japanese Civil Servants Study

Job stressors and smoking cessation among Malaysian male employees

BACKGROUND

Job stressors may reduce the likelihood of quitting smoking.

AIMS

To assess the association between job strain, smoking behaviour and smoking cessation among Malaysian male employees involved in a smoking cessation programme.

METHODS

The study was conducted among employees in two major public universities in Malaysia. All staff from both universities received an invitation to participate in this study. At the start of treatment, participants completed a questionnaire on sociodemographic variables, smoking habits and the Malay version of the Job Content Questionnaire (JCQ). The JCQ consists of scales of job control, job demand, supervisor support, co-worker support, job insecurity, job decision latitude and job skill discretion. Behaviour therapy with free nicotine replacement therapy (NRT) was given as treatment for two months. Participants were contacted at 1 week, 3 months and 6 months to determine their smoking status.

RESULTS

One hundred and eighty five staff from both universities responded and voluntarily showed interest in quitting. At three months (OR = 8.96; 95% CI: 1.14-70.76) and six months (OR = 8.9; 95% CI: 1.15-68.65), men with higher co-workers' support demonstrated a higher likelihood of quitting. Smokers in a 'passive job' also demonstrated higher likelihood of quitting compared with those working in the 'low strain' category at six months (OR = 9.92; 95% CI: 1.20-82.68). No meaningful associations were found between other psychosocial job variables and smoking cessation.

CONCLUSIONS

A positive relationship with and support from co-workers are important factors for workplace smoking cessation.

Job stress and work schedules in relation to nurse obesity

OBJECTIVES

This study aimed to examine the relationship between job stress/work schedules (JS/WS) and obesity among nurses.

BACKGROUND

Job stress and shift work are known risk factors for obesity, yet comprehensive measures of JS/WS in relation to nurse obesity have been little investigated.

METHODS

Secondary data analysis used survey data from 2,103 female nurses. Obesity was measured using body mass index estimates. Binomial logistic regression models incorporated independent components of JS/WS and adjusted for demographics, nursing position, mental/emotional distress, health behaviors, and family-related covariates.

RESULTS

Approximately 55% of the sample was overweight/obese (OW/OB). When compared with underweight/normal weight nurses, OW/OB nurses reported that their jobs had less physical exertion (odds ratio [OR] = 0.82, 95% confidence interval [CI] = 0.72-0.95, P = .01) and more limited movement (OR = 1.14, 95% CI = 1.02-1.28, P = .03). Long work hours (OR = 1.23, 95% CI = 1.08-1.40, P < .01) were significantly associated with being OW/OB as compared with underweight/normal.

CONCLUSIONS

Findings suggest interventions to limit adverse work schedules. Access to healthy food and optimal meal breaks should be investigated.

Sex inequalities in physical and mental functioning of British, Finnish, and Japanese civil servants: role of job demand, control and work hours

In general, women report more physical and mental symptoms than men. International comparisons of countries with different welfare state regimes may provide further understanding of the social determinants of sex inequalities in health. This study aims to evaluate (1) whether there are sex inequalities in health functioning as measured by the Short Form 36 (SF-36), and (2) whether work characteristics contribute to the sex inequalities in health among employees from Britain, Finland, and Japan, representing liberal, social democratic, and conservative welfare state regimes, respectively. The participants were 7340 (5122 men and 2218 women) British employees, 2297 (1638 men and 659 women) Japanese employees, and 8164 (1649 men and 6515 women) Finnish employees. All the participants were civil servants aged 40-60 years. We found that more women than men tended to have disadvantaged work characteristics (i.e. low employment grade, low job control, high job demands, and long work hours) but such sex differences were relatively smaller among employees from Finland, where more gender equal policies exist than Britain and Japan. The age-adjusted odds ratio (OR) of women for poor physical functioning was the largest for British women (OR = 2.08), followed by for Japanese women (OR = 1.72), and then for Finnish women (OR = 1.51). The age-adjusted OR of women for poor mental functioning was the largest for Japanese women (OR = 1.91), followed by for British women (OR = 1.45), and then for Finnish women (OR = 1.07). Thus, sex differences in physical and mental health was the smallest in the Finnish population. The larger the sex differences in work characteristics, the larger the sex differences in health and the reduction in the sex differences in health after adjustment for work characteristics. These results suggest that egalitarian and gender equal policies may contribute to smaller sex differences in health, through smaller differences in disadvantaged work characteristics between men and women.

Psychosocial working conditions and active leisure-time physical activity in middle-aged us workers

OBJECTIVES

This study was to examine whether psychosocial work characteristics such as job control, psychological job demands, and their combinations are associated with leisure-time physical activity (LTPA) in US workers.

MATERIALS AND METHODS

2019 workers (age range: 32 to 69) from the National Survey of Midlife Development in the United States (MIDUS) II study (2004-2006) were chosen for this cross-sectional study. Job control and job demands were measured by standard questionnaire items. Active LTPA was defined as "moderate or vigorous" level of physical activity.

RESULTS

After controlling for covariates (e.g., age, race, education, income, physical effort at work, obesity, and alcohol consumption), high job control was associated with active LTPA. Active jobs (high control and low demands) and low-strain jobs (high control and high demands), compared to passive jobs (low control and low demands), increased the odds for active LTPA. The associations varied by sex and education level. Job demands alone were not associated with active LTPA.

CONCLUSIONS

Having on-the-job learning opportunities and decision authority on their tasks may be conducive to active LTPA in middle-aged US workers.

Tabagismo, situação no mercado de trabalho e gênero: análise da PNAD 2008

O presente estudo teve como objetivo verificar se o tabagismo atual está associado à inserção no mercado de trabalho, após ajuste por escolaridade, renda e saúde em homens e mulheres; objetivou, também, discutir hipóteses explicativas. Foram estudados indivíduos de 15 a 64 anos, residentes em regiões metropolitanas brasileiras, pertencentes à população economicamente ativa, incluídos na Pesquisa Nacional por Amostra de Domicílios (2008). Razão de prevalência (RP) e intervalo de 95% de confiança (IC95%) foram obtidos pela regressão de Poisson. Após ajustes, o tabagismo foi estatisticamente maior em indivíduos inseridos no trabalho sem proteção social (homens, RP = 1,31, IC95%: 1,24-1,38; mulheres, RP = 1,22, IC95%: 1,12-1,31) e desempregados (homens, RP = 1,31, IC95%: 1,18-1,44; mulheres, RP = 1,16, IC95%: 1,03-1,32). Prevalências mais altas de tabagismo foram observadas nos homens inseridos no trabalho sem proteção social. Nossos resultados confirmam que a situação no mercado de trabalho é uma dimensão independente das desigualdades sociais no tabagismo. O gradiente social observado foi mais acentuado nos homens, mas a associação entre inserção no trabalho e tabagismo está presente nos dois gêneros.

Association between overweight, obesity and self-perceived job insecurity in German employees

BACKGROUND

Recent studies have shown an association between job insecurity and morbidity as well as mortality, however until now, knowledge about a potential association between job insecurity and overweight or obesity has been lacking.

METHODS

In order to identify a possible association between job insecurity and overweight or obesity, we analysed data from the German Socioeconomic Panel (GSOEP) 2004/2005, a longitudinal study of private households in Germany. In this representative cohort of the German adult population, living and working conditions were observed. Data on Body Mass Index (BMI) and self-perceived probability of job loss within the next 2 years were available for 10,747 adults either employed or attending training programs.

RESULTS

We identified 5,216 (49%) individuals as being overweight (BMI > 25 kg/m²) and 1,358(13%) individuals as being obese (BMI > 30 kg/m²). A total of 5,941 (55%) participants reported having concerns regarding job insecurity. In the multivariate analysis--after adjustment for relevant confounders--a statistically significant association between obesity and job insecurity (100% probability for losing the job in the following two years) could be observed with an adjusted odds ratio of 2.55 (95% confidence interval: 1.09-5.96).

CONCLUSIONS

Because of these results, we were able to conclude that overweight and obese persons perceive job insecurity more often than their normal weight counterparts in Germany and that the concurrence of obesity and job insecurity might lead employees into a vicious cycle. Further research with an emphasis on the occupational setting might be necessary in order to establish useful preventive programmes at the workplace.

Occupational factors associated with 4-year weight gain in Australian adults

OBJECTIVE

This article examined whether occupational factors predicted 4-year change in body mass index (BMI) in a sample of full-time Australian employees.

METHODS

Data from 1670 full-time Australian employees were collected through the Longitudinal Study of Australian Children. Multinomial logistic regression was used to examine whether several occupational factors at baseline predicted changes in BMI at 4-year follow up; several health and demographic covariates were controlled.

RESULTS

Inflexible working hours (odds ratio = 1.54, 95% confidence interval [1.14 to 2.09]) and weekend work (odds ratio = 1.33, 95% confidence interval [1.04 to 1.68]) significantly predicted increased BMI.

CONCLUSIONS

This article demonstrates that certain occupational factors (ie, inflexible work hours and weekend work) significantly predicted increased BMI. Targeting these factors may play a role in combating obesity and related health problems among employees.

Work hours, weight status, and weight-related behaviors: a study of metro transit workers

BACKGROUND

Associations between hours worked per week and Body Mass Index (BMI), food intake, physical activity, and perceptions of eating healthy at work were examined in a sample of transit workers.

METHODS

Survey data were collected from 1086 transit workers. Participants reported hours worked per week, food choices, leisure-time physical activity and perceptions of the work environment with regard to healthy eating. Height and weight were measured for each participant. Multivariate linear and logistic regressions were conducted to examine associations between work hours and behavioral variables. Associations were examined in the full sample and stratified by gender.

RESULTS

Transit workers working in the highest work hour categories had higher BMI and poorer dietary habits, with results differing by gender. Working 50 or more hours per week was associated with higher BMI among men but not women. Additionally, working 50 or more hours per week was significantly associated with higher frequency of accessing cold beverage, cold food, and snack vending machines among men. Working 40 or more hours per week was associated with higher frequency of accessing cold food vending machines among women. Reported frequency of fruit and vegetable intake was highest among women working 50 or more hours per week. Intake of sweets, sugar sweetened beverages, and fast food did not vary with work hours in men or women. Physical activity and perception of ease of eating healthy at work were not associated with work hours in men or women.

CONCLUSIONS

Long work hours were associated with more frequent use of garage vending machines and higher BMI in transit workers, with associations found primarily among men. Long work hours may increase dependence upon food availability at the worksite, which highlights the importance of availability of healthy food choices.

Health of people with spinal cord injury in Singapore: implications for rehabilitation planning and implementation

PURPOSE

This study aimed to provide a broad overview of the health of people with spinal cord injury (SCI) in Singapore, so as to highlight areas of potential need. These areas could then guide future research and rehabilitation programme development.

METHODS

Demographic data, injury information and information about SCI-related secondary impairments, chronic conditions and their associated risk factors, medical and hospital utilisation, participation (Craig Handicap Assessment and Reporting Technique) and life satisfaction (Satisfaction with Life Scale) were collected via interviews from people living with traumatic SCI.

RESULTS

On average, participants (50 men and 5 women) were aged 48.3 ± 16.54 years and had had their SCIs for 5 years. -75% with tetraplegia. The most prevalent SCI-related secondary impairments were pain, spasms, bladder problems, bowel problems and oedema. Chronic conditions and their associated risk factors were prevalent. Participation and life satisfaction scores were lower than those reported for similar populations cross-culturally.

CONCLUSION

The study revealed several health areas that may be affecting the overall health of people with SCI in Singapore. By focusing on community reintegration and health promotion, physiotherapists and other rehabilitation professionals may augment health outcomes and improve the quality of life of this population in Singapore.

Sex differences in physical and mental functioning of Japanese civil servants: explanations from work and family characteristics

Poor physical and mental functioning are more common among women than men and those with disadvantaged work and family characteristics. This study aims to clarify whether sex differences in health functioning can be explained by sex differences in work and family characteristics. The subjects were 3787 civil servants (2525 men and 1262 women), aged 20-65, working in a local government on the west coast of Japan. A questionnaire survey was conducted in January 2003. Low employment grade, high demands, long work hours, shift work, being unmarried, having no young children, high family-to-work conflict and high work-to-family conflict were more common among women than men and were independently associated with poor physical and mental functioning. The age-adjusted odds ratios (ORs) of women for poor health functioning were 1.80 for poor physical functioning and 1.77 for poor mental functioning. When adjusted for employment grade and work characteristics (control, demand, support, work hours, and shift work), the sex differences in health functioning attenuated. When adjusted for family characteristics (family structure and work-family conflicts), the sex differences in health functioning further attenuated and were no longer statistically significant. Sex differences in family characteristics contributed more to sex difference in mental functioning than sex differences in work characteristics. Japan belongs to conservative welfare regimes. In such countries, men are able to concentrate on their work with relative freedom from their family tasks and responsibilities, whereas women feel difficulties in maintaining their work-life balances. Such sex differences in work- and family-related stresses may contribute to sex difference in health. Longitudinal research is necessary to clarify the causal nature of these associations.

Work-related stress, inability to relax after work and risk of adult asthma: a population-based cohort study

BACKGROUND

There is an extensive literature linking stressful work conditions to adverse health outcomes. Notwithstanding, the relationship with asthma has not been examined, although various other measures of psychological stress have been associated with asthma. Therefore, we aimed to investigate the relation between work stress and asthma prevalence and incidence.

METHODS

We used data from a population-based cohort study (n = 5114 at baseline in 1992-1995 and n = 4010 at follow-up in 2002/2003). Asthma was measured by self-reports. Two scales that assessed psychologically adverse work conditions were extracted from a list of work-condition items by factor analysis (these scales were termed 'work stress' and 'inability to relax after work'). For each scale, the derived score was employed both as continuous z-score and as categorized variable in analyses. Associations with asthma were estimated by prevalence ratios (PRs) and risk ratios (RRs) using Poisson regression with a log-link function adjusting for demographics, health-related lifestyles, body mass index and family history of asthma. Analyses were restricted to those in employment (n = 3341).

RESULTS

Work stress and inability to relax z-scores were positively associated with asthma prevalence (PR = 1.15, 95%CI = 0.97, 1.36 and PR = 1.43, 95%CI = 1.12, 1.83, respectively). Prospective analyses using z-scores showed that for each 1 standard deviation increase in work stress and inability to relax, the risk of asthma increased by approximately 40% (RR for work stress = 1.46, 95%CI = 1.06, 2.00; RR for inability to relax = 1.39, 95%CI = 1.01, 1.91). Similar patterns of associations were observed in analyses of categorized exposures.

CONCLUSIONS

This is the first study to show a cross-sectional and longitudinal association of work stress with asthma.

Healthy Eating Strategies in the Workplace

PURPOSE

There is a clear link between dietary behavior and a range of chronic diseases, and overweight and obesity constitute an indirect risk in relation to these diseases. The worksite is a central venue for influencing dietary behavior. The purpose of this paper is to provide an overview of workplace influences on worker dietary patterns.

DESIGN/METHODOLOGY/APPROACH

The paper reviews the evidence of the effectiveness of dietary health promotion, and provides a brief overview of appropriate theoretical frameworks to guide intervention design and evaluation. The findings are illustrated through research examples.

FINDINGS

Through case studies and published research, it is found that workplace dietary interventions are generally effective, especially fruit and vegetable interventions. There is less consistent evidence on the long term effectiveness of workplace weight management interventions, underscoring the need for further research in this area. This paper also reports evidence that changes in the work environment, including through health and safety programs, may contribute to enhancing the effectiveness of workplace health promotion, including dietary interventions. Organizational factors such as work schedule may also influence dietary patterns. The social ecological model, the social contextual model and political process approach are presented as exemplar conceptual models that may be useful when designing or assessing the effects of workplace health promotion.

ORIGINALITY/VALUE

Using the worksite as setting for influencing health by influencing dietary patterns holds considerable promise and may be instrumental in reducing workers' risk of chronic diseases.

Short sleep mediates the association between long work hours and increased body mass index

This study examined whether short sleep duration, physical activity and time spent sitting each day mediated the association between long work hours and body mass index (BMI). Participants included 16,951 middle aged Australian adults who were employed in full time work (i.e. ≥35 h a week). Data on BMI, sleep duration, work hours and other health and demographic variables were obtained through a self-report questionnaire. A multiple mediation model was tested whereby sleep duration, physical activity and amount of time spent sitting were entered as potential mediators between work hours and BMI. The results demonstrated that short sleep partially mediated the association between long work hours and increased BMI in males. In females, long work hours were indirectly related to higher BMI through short sleep. The results provide some support for the hypothesis that long work hours could contribute to obesity via a reduction in sleep duration; this warrants further investigation in prospective studies.

The relative importance of socioeconomic indicators in explaining differences in BMI and waist:hip ratio, and the mediating effect of work control, dietary patterns and physical activity

Socioeconomic differences in overweight are well documented, but most studies have only used one or two indicators of socioeconomic position (SEP). The aim of the present study was to explore the relative importance of indicators of SEP (occupation, education and income) in explaining variation in BMI and waist:hip ratio (WHR), and the mediating effect of work control and lifestyle factors (dietary patterns, smoking and physical activity). The Oslo Health Study, a cross-sectional study, was carried out in 2000-1, Oslo, Norway. Our sample included 9235 adult working Oslo citizens, who attended a health examination and filled in two complementary FFQ with < 20% missing responses to food items. Four dietary patterns were identified through factor analysis, and were named 'modern', 'Western', 'traditional' and 'sweet'. In multivariate models, BMI and WHR were inversely associated with education (P < 0.001/P < 0.001) and occupation (P = 0.002/P < 0.001), whereas there were no significant associations with income or the work control. The 'modern' (P < 0.001) and the 'sweet' (P < 0.001) dietary patterns and physical activity level (P < 0.001) were inversely associated, while the 'Western' dietary pattern (P < 0.001) was positively associated with both BMI and WHR. These lifestyle factors could not fully explain the socioeconomic differences in BMI or WHR. However, together with socioeconomic factors, they explained more of the variation in WHR among men (21%) than among women (7%).

Sleep complaints in middle-aged women and men: the contribution of working conditions and work-family conflicts

This study aimed to examine how physical working conditions, psychosocial working conditions and work-family conflicts are associated with sleep complaints, and whether health behaviours explain these associations. We used pooled postal questionnaire surveys collected in 2001-2002 among 40-60-year-old employees of the City of Helsinki (n = 5819, response rate 66%). Participants were classified as having sleep complaints if they reported sleep complaints at least once a week on average (24% of women and 20% of men). Independent variables included environmental work exposures, physical workload, computer work, Karasek's job strain and work-family conflicts. Age, marital status, occupational class, work arrangements, health behaviours and obesity were adjusted for. Most working conditions were associated strongly with sleep complaints after adjustment for age only. After adjustment for work-family conflicts, the associations somewhat attenuated. Work-family conflicts were also associated strongly with women's [odds ratio (OR) 5.90; confidence interval (CI) 4.16-8.38] and men's sleep (OR 2.56; CI 1.34-4.87). The associations remained robust even after controlling for unhealthy behaviours, obesity, health status, depression and medications. Physically strenuous working conditions, psychosocial job strain and work-family conflicts may increase sleep complaints. Efforts to support employees to cope with psychosocial stress and reach a better balance between paid work and family life might reduce sleep complaints. Sleep complaints need to be taken into account in worksite health promotion and occupational health care in order to reduce the burden of poor sleep.

Job strain among Malaysian office workers of a multinational company

BACKGROUND

Information on job strain exposure among Malaysian workers in multinational companies is limited.

AIMS

To investigate the prevalence and factors associated with high job strain among office workers of a multinational company in Malaysia.

METHODS

A cross-sectional study was conducted in November 2007 among 470 eligible workers. Respondents self-administered the Job Content Questionnaire downloaded from the company's intranet. A median-split procedure was applied to create four groups according to the Job Demand-Control Model: active, passive, high and low job strain. Logistic regression models were used to investigate the associations between socio-demographic, occupational and psychosocial factors and high job strain.

RESULTS

A total of 356 questionnaires were received (response rate 76%). Twenty-one per cent of respondents were in the high job strain group, 35% were in the passive group, whereas 26% and 17% of workers were in the low strain and active groups, respectively. After controlling for confounders, three factors were found to be associated with high job strain: male workers (adjusted OR 1.94, 95% CI 1.04-3.64), working >48 h per week (adjusted OR 2.51, 95% CI 1.44-4.39) and job insecurity (adjusted OR 1.14, 95% CI 1.02-1.27). One protective factor for high job strain was the scale 'created skill', which is part of skill discretion (adjusted OR 0.70, 95% CI 0.57-0.86).

CONCLUSIONS

About one in five workers in this study experience high job strain. Work improvement measures include reducing long working hours and job insecurity and giving workers the opportunity to learn, use creativity and develop abilities.

Association of short sleep duration with weight gain and obesity at 1-year follow-up: a large-scale prospective study

STUDY OBJECTIVES

To investigate the association between short sleep duration and elevated body mass index (BMI) and obesity in a large sample of Japanese adults over a short period.

DESIGN

Prospective design with baseline in 2006 and 1-year follow-up.

SETTING

Workplaces of an electric power company in Japan.

PARTICIPANTS

35,247 company employees (31,477 men, 3,770 women) distributed throughout Japan.

MEASUREMENTS AND RESULTS

Measured weight and height and self-reported sleep duration were obtained at annual health checkup in 2006 and 2007. Weight change was defined as the difference in body mass index (BMI) between the baseline and 1 year later. Relative to the reference category (sleep duration 7-8 h), short sleep duration (< 5 and 5-6 h) and long sleep duration > or = 9 h were associated with an increased risk of weight gain among men after adjustment for covariates. Of the non-obese (BMI < 25) men at baseline, 5.8% became obese (BMI > or = 25) 1 year later. Higher incidence of obesity was observed among the groups with shorter sleep duration. Adjusted odds ratios for the development of obesity were 1.91 (95% CI 1.36, 2.67) and 1.50 (95% CI 1.24, 1.80) in men who slept < 5 and 5-6 h, respectively. No significant association between sleep duration and weight gain or obesity was found for women.

CONCLUSIONS

Short sleep duration was associated with weight gain and the development of obesity over 1 year in men, but not in women.

Trends in the prevalence of short sleepers in the USA: 1975-2006

STUDY OBJECTIVES

To determine (1) whether short sleep has increased over 31 years; (2) whether trends in short sleep differed by employment status; (3) which sociodemographic factors predict short sleep; and (4) how short sleepers spend their time.

DESIGN

Time diaries from eight national studies conducted between 1975 and 2006.

PATIENTS OR PARTICIPANTS

U.S. adults > or = 18 years.

MEASUREMENTS AND RESULTS

Short sleepers were defined as those reporting < 6 hours of sleep in their time diary. Unadjusted percentages of short sleepers ranged from 7.6% in 1975 to 9.3% in 2006. The 1998-99 study had the highest odds of short sleep. The odds ratio for the 31-year period predicting short sleep was 1.14 (95% CI: 0.92, 1.50, P = 0.22), adjusting for age, sex, education, employment, race, marital status, income, and day of week. When stratified by employment, there was a significant increase for full-time workers (P = 0.05), who represented over 50% of participants in all studies, and a significant decrease for students (P = 0.01), who represented < 5% of participants. The odds of short sleep were lower for women, those > or = 65 years, Asians, Hispanics, and married people. The odds were higher for full-time workers, those with some college education, and African Americans. Short sleepers in all employment categories spent more time on personal activities. Short sleepers who were full- and part-time workers spent much more time working.

CONCLUSIONS

Based on time diaries, the increase in the odds of short sleep over the past 31 years was significant among full-time workers only. Work hours are much longer for full-time workers sleeping < 6 hours.

Job strain and hypertension in women: Estudo Pro-Saúde (Pro-Health Study)

This study aimed to analyze the association between job strain and hypertension in the female population. A cross-sectional study was performed with 1,819 women who participated in the Estudo Pró-Saúde (Pro-Health Study), in the city of Rio de Janeiro, Southeastern Brazil, between 1999 and 2001. The Brazilian version of the short version of the Job Stress Scale (demand-control model) was used. Overall prevalence of measured hypertension (> or =140/90 mmHg and/or antihypertensive drug use) was 24%. Compared to participants with jobs classified as low strain, adjusted prevalence ratios for hypertension in women who performed passive and active high-strain jobs were, respectively, 0.93 (95% CI: 0.72;1.20), 1.06 (95% CI: 0.86;1.32) and 1.14 (95% CI: 0.88;1.47). Longitudinal analyses should be performed to clarify the role of these work environment psychosocial characteristics as a determinant of hypertension.

Association of workplace chronic and acute stressors with employee weight status: data from worksites in turmoil

OBJECTIVES

To examine the independent and joint effects of psychosocial chronic and acute stressors with weight status and to report the intraclass correlation coefficient for body mass index (BMI).

METHODS

Baseline data on 2782 employees from a group-randomized weight gain prevention intervention were examined to investigate the effect of high job strain and job insecurity on BMI and on the odds of overweight/obesity including potential confounders and mediating variables. Data were analyzed using mixed models.

RESULTS

The mediating variables removed the effect of high job strain on weight (beta = 0.68, P = 0.07; odds ratios = 1.34, confidence interval = 1.00 to 1.80) whereas job insecurity was never significant. Intraclass correlation coefficient for BMI is 0.0195, 0.0193, and 0.0346 overall, for men and women, respectively.

CONCLUSION

Worksite wellness should target health enhancing behaviors to minimize the health effects of psychosocial work conditions.

Knowledge, attitude, and prevalence of overweight and obesity among civil servants in Nepal

Obesity threatens developing countries as urbanization increases, with civil servants being particularly vulnerable. The authors assess overweight/obesity prevalence among Nepalese civil servants along with their knowledge and attitudes. A cross-sectional questionnaire survey conducted among 341 participants (97.4% response rate) also recorded height and weight. Participants were 40 ± 6.6 years, mostly males, married, and from a single ethnic group. Overweight/obesity prevalence was 33.4%. Knowledge of obesity was good. However, some attitudes toward obese people were negative, despite half of the participants believing obesity to indicate prosperity. Logistic regression indicated marriage and/or having a better job increased the overweight/obese risk by nearly 8 and 9 times, respectively. Heavier people were more likely to disagree with attitudes that obese people were "lazier" and "untidy." Obesity prevalence among Nepalese civil servants is already higher than the general population level. Health education and interventions are needed to translate knowledge into attitude and behavior changes in order to prevent this becoming an epidemic.

Socioeconomic inequalities in physical and mental functioning of British, Finnish, and Japanese civil servants: role of job demand, control, and work hours

This study aims to evaluate whether the pattern of socioeconomic inequalities in physical and mental functioning as measured by the Short Form 36 (SF-36) differs among employees in Britain, Finland, and Japan and whether work characteristics contribute to some of the health inequalities. The participants were 7340 (5122 men and 2218 women) British employees, 2297 (1638 men and 659 women) Japanese employees, and 8164 (1649 men and 6515 women) Finnish employees. All the participants were civil servants aged 40-60 years. Both male and female low grade employees had poor physical functioning in all cohorts. British and Japanese male low grade employees tended to have poor mental functioning but the associations were significant only for Japanese men. No consistent employment-grade differences in mental functioning were observed among British and Japanese women. Among Finnish men and women, high grade employees had poor mental functioning. In all cohorts, high grade employees had high control, high demands and long work hours. The grade differences in poor physical functioning and disadvantaged work characteristics among non-manual workers were somewhat smaller in the Finnish cohort than in the British and Japanese cohorts. Low control, high demands, and both short and long work hours were associated with poor functioning. When work characteristics were adjusted for, the socioeconomic differences in poor functioning were mildly attenuated in men, but the differences increased slightly in women. This study reconfirms the generally observed pattern of socioeconomic inequalities in health for physical functioning but not for mental functioning. The role of work characteristics in the relationship between socioeconomic status and health differed between men and women but was modest overall. We suggest that these differences in the pattern and magnitude of grade differences in work characteristics and health among the 3 cohorts may be attributable to the different welfare regimes among the 3 countries.

Social class differences in health behaviours among employees from Britain, Finland and Japan: the influence of psychosocial factors

This study aims to examine social class differences in smoking, heavy drinking, unhealthy food habits, physical inactivity and obesity, and work-related psychosocial factors as explanations for these differences. This is done by comparing employee cohorts from Britain, Finland and Japan. Social class differences in health behaviours are found in the two western European countries, but not in Japan. The studied psychosocial factors related to work, work-family interface and social relationships did not explain the found class differences in health behaviours.

Strong association of physical job demands with functional limitations among active people: a population-based study in North-eastern France

PURPOSE

To assess the association between physical job demands (PJD) and physical/cognitive functional limitations, and the role of adverse health behaviours, obesity, and socio-demographic factors as confounders of those associations.

METHODS

The sample included 3,368 active subjects aged 18-64 years, randomly selected from North-eastern France. Subjects completed a post-mailed questionnaire. PJD score was defined as the product of years of employment with the cumulative number of a wide range of high job demands. Data were analysed through the logistic regression models.

RESULTS

The physical and cognitive functional limitations affected 16.9 and 28.6% of subjects, respectively. A strong relationship was found between PJD and physical functional limitation: significant odds ratios (OR) adjusted for all the factors studied 1.41 for PJD1-29, 1.72 for PJD30-99, and 2.57 for PJD >or=100 versus PJD0; and between PJD and cognitive functional limitation: OR 1.28 for PJD1-29, 1.60 for PJD30-99, and 2.00 for PJD >or=100 versus PJD0. Adverse health behaviours, obesity and job category were modest confounders of those associations.

CONCLUSIONS

This study identified a wide range of job demands and individual characteristics related to physical/cognitive functional limitations. Prevention should aim at improving working conditions and adverse health behaviours.