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Billiau L, Bolliger L, Clays E, Eeckloo K, Ketels M. Flemish critical care nurses' experiences regarding the influence of work-related demands on their health: a descriptive interpretive qualitative study. BMC Nurs 2024; 23:387. [PMID: 38844928 PMCID: PMC11155134 DOI: 10.1186/s12912-024-02032-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 05/21/2024] [Indexed: 06/10/2024] Open
Abstract
BACKGROUND Critical care nurses (CCNs) around the globe face other health challenges compared to their peers in general hospital nursing. Moreover, the nursing workforce grapples with persistent staffing shortages. In light of these circumstances, developing a sustainable work environment is imperative to retain the current nursing workforce. Consequently, this study aimed to gain insight into the recalled experiences of CCNs in dealing with the physical and psychosocial influences of work-related demands on their health while examining the environments in which they operate. The second aim was to explore the complex social and psychological processes through which CCNs navigate these work-related demands across various CCN wards. METHODS A qualitative study following Thorne's interpretive descriptive approach was conducted. From October 2022 to April 2023, six focus groups were organised. Data from a diverse sample of 27 Flemish CCNs engaged in physically demanding roles from three CCN wards were collected. The Qualitative Analysis Guide of Leuven was applied to support the constant comparison process. RESULTS Participants reported being exposed to occupational physical activity, emotional, quantitative, and cognitive work-related demands, adverse patient behaviour, and poor working time quality. Exposure to these work-related demands was perceived as harmful, potentially resulting in physical, mental, and psychosomatic strain, as well as an increased turnover intention. In response to these demands, participants employed various strategies for mitigation, including seeking social support, exerting control over their work, utilising appropriate equipment, recognising rewards, and engaging in leisure-time physical activity. CONCLUSIONS CCNs' health is challenged by work-related demands that are not entirely covered by the traditional quantitative frameworks used in research on psychologically healthy work. Therefore, future studies should focus on improving such frameworks by exploring the role of psychosocial and organisational factors in more detail. This study has important implications for workplace health promotion with a view on preventing work absenteeism and drop-out in the long run, as it offers strong arguments to promote sufficient risk management strategies, schedule flexibility, uninterrupted off-job recovery time, and positive management, which can prolong the well-being and sustainable careers of the CCN workforce.
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Affiliation(s)
- Lukas Billiau
- Strategic Policy Cell, Ghent University Hospital, Corneel Heymanslaan 10, Ghent, 9000, Belgium.
| | - Larissa Bolliger
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, Ghent, 9000, Belgium
| | - Els Clays
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, Ghent, 9000, Belgium
| | - Kristof Eeckloo
- Strategic Policy Cell, Ghent University Hospital, Corneel Heymanslaan 10, Ghent, 9000, Belgium
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, Ghent, 9000, Belgium
| | - Margo Ketels
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, Ghent, 9000, Belgium
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Ketels M, Belligh T, De Bacquer D, Clays E. Are Psychosocial Resources Buffering the Relation Between Physical Work Behaviors and Need for Recovery? Int J Public Health 2022; 67:1604787. [PMID: 36589477 PMCID: PMC9800507 DOI: 10.3389/ijph.2022.1604787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 12/02/2022] [Indexed: 12/23/2022] Open
Abstract
Objectives: We investigate whether job control and/or social support at work play a buffering role in the relation between various physical work behaviors and Need for Recovery (NFR) among employees with physically demanding jobs. Methods: Our findings are based on data from 332 workers. The Job Content Questionnaire was used to assess job control, social support and specific physically demanding tasks. General physical work behaviors were measured by two Axivity AX3 accelerometers. The NFR Scale (0-11) was used to assess NFR. We used multiple linear regression models. Results: Sitting at work turned out to be negatively associated with NFR, whereas physically demanding tasks were associated positively with NFR. Our results show a significant buffering role for job control on the correlation between sitting, physically demanding tasks and NFR, but not for social support. Conclusion: Our findings suggest that higher job control might be beneficial to reduce high NFR and eventually may help to reduce early drop-out and sickness absence. Further research is called for to confirm the buffering role of job control and to investigate the underlying mechanisms.
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Affiliation(s)
- Margo Ketels
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium,*Correspondence: Margo Ketels,
| | - Thomas Belligh
- Department of Linguistics, Faculty of Arts and Philosophy, Ghent University, Ghent, Belgium
| | - Dirk De Bacquer
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Els Clays
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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The physical activity paradox: a longitudinal study of the implications for burnout. Int Arch Occup Environ Health 2021; 95:965-979. [PMID: 34611746 PMCID: PMC9203402 DOI: 10.1007/s00420-021-01759-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 09/09/2021] [Indexed: 11/18/2022]
Abstract
Purpose This study investigates the independent and interactive associations of physical job demands and three types of off-job physical activity (during transportation, household, and recreation) with burnout. We use a recently proposed new conceptualization and assessment of burnout including core and secondary burnout symptoms. We predicted that physical job demands would be positively and the three types of off-job physical activity would be negatively related to burnout. Further, we hypothesized that the negative relations between the three types of off-job physical activity and burnout would be stronger for employees with low (vs. high) physical job demands. Methods To test our hypotheses, we conducted a two-wave survey study among a heterogeneous sample of full-time workers (N = 355), using a longitudinal design with a half-year time lag. We tested cross-sectional, prospective and longitudinal relations. Results Hierarchical regression analyses partly confirmed our predictions. Cross-sectionally and prospectively, it was shown that physical job demands were positively related to burnout symptoms. In addition, off-job physical activity was negatively related to primary and secondary burnout symptoms among employees with low physical job demands and positively related to burnout symptoms among employees with high physical job demands. However, these relationships disappeared when investigated longitudinally. Conclusion Together, these findings suggest that not all off-job physical activities can prevent burnout, and that potential positive effects of physical activity during off-job time may depend on employees’ physical activity level at work. Supplementary Information The online version contains supplementary material available at 10.1007/s00420-021-01759-y.
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Cumulative Risks from Stressor Exposures and Personal Risk Factors in the Workplace: Examples from a Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115850. [PMID: 34072475 PMCID: PMC8199163 DOI: 10.3390/ijerph18115850] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/18/2021] [Accepted: 05/27/2021] [Indexed: 11/17/2022]
Abstract
Protecting worker and public health involves an understanding of multiple determinants, including exposures to biological, chemical, or physical agents or stressors in combination with other determinants including type of employment, health status, and individual behaviors. This has been illustrated during the COVID-19 pandemic by increased exposure and health risks for essential workers and those with pre-existing conditions, and mask-wearing behavior. Health risk assessment practices for environmental and occupational health typically do not incorporate multiple stressors in combination with personal risk factors. While conceptual developments in cumulative risk assessment to inform a more holistic approach to these real-life conditions have progressed, gaps remain, and practical methods and applications are rare. This scoping review characterizes existing evidence of combined stressor exposures and personal factors and risk to foster methods for occupational cumulative risk assessment. The review found examples from many workplaces, such as manufacturing, offices, and health care; exposures to chemical, physical, and psychosocial stressors combined with modifiable and unmodifiable determinants of health; and outcomes including respiratory function and disease, cancers, cardio-metabolic diseases, and hearing loss, as well as increased fertility, menstrual dysfunction and worsened mental health. To protect workers, workplace exposures and modifiable and unmodifiable characteristics should be considered in risk assessment and management. Data on combination exposures can improve assessments and risk estimates and inform protective exposure limits and management strategies.
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Wang C, Lê‐Scherban F, Taylor J, Salmoirago‐Blotcher E, Allison M, Gefen D, Robinson L, Michael YL. Associations of Job Strain, Stressful Life Events, and Social Strain With Coronary Heart Disease in the Women's Health Initiative Observational Study. J Am Heart Assoc 2021; 10:e017780. [PMID: 33618543 PMCID: PMC8174284 DOI: 10.1161/jaha.120.017780] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Background The association between psychosocial stress and coronary heart disease (CHD) may be stronger in women than men and may differ across types of stressors. In this study, we assessed associations of psychosocial stressors, including job strain, stressful life events, and social strain with the incidence of CHD in women. Methods and Results We used longitudinal data from 80 825 WHI‐OS (Women's Health Initiative Observational Study) participants with a mean age of 63.4 years (7.3 years) at baseline. Job strain was assessed through linkage of Standard Occupational Classification codes to the Occupational Information Network. Stressful life events and social strain were assessed via validated self‐reported questionnaires. Cox proportional hazard models were used to evaluate associations of each stressor with CHD separately and jointly. A total of 3841 (4.8%) women developed CHD during an average of 14.7 years of follow‐up. After adjustment for age, other stressors, job tenure, and socioeconomic factors, high stressful life events score was associated with a 12% increased CHD risk, and high social strain was associated with a 9% increased CHD risk. Job strain was not independently associated with CHD risk, but we observed a statistically significant interaction between job strain and social strain (P=0.04), such that among women with high social strain, passive job strain was associated with a 21% increased CHD risk. Conclusions High stressful life events and social strain were each associated with higher CHD risk. Job strain and social strain work synergistically to increase CHD risk.
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Affiliation(s)
- Conglong Wang
- Dornsife School of Public HealthDrexel UniversityPhiladelphiaPA
| | | | - Jennifer Taylor
- Dornsife School of Public HealthDrexel UniversityPhiladelphiaPA
| | - Elena Salmoirago‐Blotcher
- The Miriam HospitalCenters for Behavioral and Preventive Medicine Warren Alpert School of Medicine of Brown UniversityProvidenceRI
| | | | - David Gefen
- LeBow College of BusinessDrexel UniversityPhiladelphiaPA
| | - Lucy Robinson
- Dornsife School of Public HealthDrexel UniversityPhiladelphiaPA
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Januario LB, Stevens ML, Mathiassen SE, Holtermann A, Karstad K, Hallman DM. Combined Effects of Physical Behavior Compositions and Psychosocial Resources on Perceived Exertion Among Eldercare Workers. Ann Work Expo Health 2021; 64:923-935. [PMID: 32729914 PMCID: PMC7751016 DOI: 10.1093/annweh/wxaa079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 06/03/2020] [Accepted: 07/08/2020] [Indexed: 11/15/2022] Open
Abstract
Objectives High perceived physical exertion is common in eldercare workers and a strong predictor for impaired health. However, little is known on how physical behaviors at work associate with physical exertion in this group. The aim of this study was to determine the extent to which the composition of physical behaviors at work is associated with perceived physical exertion in nursing home eldercare workers, and the extent to which these associations are modified by psychosocial resources. Methods Our population consisted of 399 female eldercare workers from 126 wards in 20 different nursing homes. We evaluated time spent in physical behaviors at work [sitting, standing still, light activities (LAs), and moderate to vigorous activities (MVAs)] using triaxial accelerometers worn, on average, for three working days. We accounted for inherent codependency between the behaviors using compositional data analysis. We used multilevel linear mixed regression models to determine associations between the behaviors and perceived exertion, measured on a numeric rating scale (0–10), and included interactions between each behavior and psychosocial resources (influence at work, social support, and quality of leadership) to determine a possible moderating effect of resources. Regression results were illustrated using isotemporal substitution. Results Sitting was negatively (β: −0.64; P < 0.01) while MVA was positively (β: 0.95; P = 0.02) associated with perceived exertion. According to isotemporal substitution, replacing 30 min of MVA by sitting would, for an average worker, be associated with a decrease in physical exertion by −0.14 on the 0–10 scale. Job resources marginally moderated the association between LA and exertion. Thus, among workers with low influence and low social support, we found a positive association between LA and exertion, while that was not found for workers with medium or high influence and support (interactions for influence and support: P = 0.08 and P = 0.10). Conclusions Our findings suggest that reallocating time from MVA to sitting can mitigate perceived physical exertion in eldercare workers. More time in LA increased physical exertion only for workers with low psychosocial resources, supporting a positive effect of a better psychosocial work environment in elderly care.
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Affiliation(s)
- Leticia Bergamin Januario
- Centre for Musculoskeletal Research, Department of Occupational Health Sciences and Psychology, University of Gävle, Gävle, Sweden
| | - Matthew L Stevens
- Musculoskeletal Disorders and Physical Workload, National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Svend Erik Mathiassen
- Centre for Musculoskeletal Research, Department of Occupational Health Sciences and Psychology, University of Gävle, Gävle, Sweden
| | - Andreas Holtermann
- Musculoskeletal Disorders and Physical Workload, National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Kristina Karstad
- Musculoskeletal Disorders and Physical Workload, National Research Centre for the Working Environment, Copenhagen, Denmark
| | - David M Hallman
- Centre for Musculoskeletal Research, Department of Occupational Health Sciences and Psychology, University of Gävle, Gävle, Sweden
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Nabe‐Nielsen K, Holtermann A, Gyntelberg F, Garde AH, Islamoska S, Prescott E, Schnohr P, Hansen ÅM. The effect of occupational physical activity on dementia: Results from the Copenhagen Male Study. Scand J Med Sci Sports 2020; 31:446-455. [DOI: 10.1111/sms.13846] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/02/2020] [Accepted: 09/22/2020] [Indexed: 12/24/2022]
Affiliation(s)
| | - Andreas Holtermann
- The National Research Centre for the Working Environment Copenhagen Denmark
| | - Finn Gyntelberg
- The National Research Centre for the Working Environment Copenhagen Denmark
| | - Anne Helene Garde
- Department of Public Health University of Copenhagen Copenhagen Denmark
- The National Research Centre for the Working Environment Copenhagen Denmark
| | - Sabrina Islamoska
- Department of Public Health University of Copenhagen Copenhagen Denmark
| | - Eva Prescott
- Center for Cardiovascular Research Bispebjerg‐Frederiksberg Hospital Copenhagen Denmark
| | - Peter Schnohr
- The Copenhagen City Heart Study Bispebjerg‐Frederiksberg Hospital Frederiksberg Denmark
| | - Åse Marie Hansen
- Department of Public Health University of Copenhagen Copenhagen Denmark
- The National Research Centre for the Working Environment Copenhagen Denmark
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Helgesson M, Marklund S, Gustafsson K, Aronsson G, Leineweber C. Interaction Effects of Physical and Psychosocial Working Conditions on Risk for Sickness Absence: A Prospective Study of Nurses and Care Assistants in Sweden. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7427. [PMID: 33053900 PMCID: PMC7601317 DOI: 10.3390/ijerph17207427] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/08/2020] [Accepted: 10/09/2020] [Indexed: 11/16/2022]
Abstract
Employees in health and social care are often simultaneously exposed to both physical and psychosocial challenges that may increase their risk for sickness absence. The study examines interaction effects of physical and psychosocial work conditions on the future risk for sickness absence among nurses and care assistants in Sweden. The study was based on 14,372 participants in any of the Swedish Work Environment Surveys conducted during the years 1993-2013 with linked register information on background factors and compensated sickness absence. Adjusted hazard ratio (HR), stratified by occupation, and measures of additive interaction effects were estimated. The combinations of high psychosocial job demands and heavy physical work and strenuous postures, respectively, significantly increased the risks for sickness absence among nurses (HR 1.43; CI 1.09-1.88 and HR 1.42; CI 1.16-1.74, respectively), as well as among care assistants (HR 1.51; CI 1.36-1.67 and HR 1.49; CI 1.36-1.63, respectively). The combinations of low job control and both heavy physical work (HR 1.44; CI 1.30-1.60) and strenuous postures (HR 1.42; CI 1.30-1.56) were also associated with excess risk for sickness absence among care assistants. We also found interaction effects among care assistants but not among nurses. The results indicate that the high sickness absence rate among care workers in Sweden can be reduced if the simultaneous exposures of high psychosocial and high physical challenges are avoided. Management policies for reduced time pressure, improved lifting aids, and measures to avoid awkward work postures are recommended. For care assistants, increased influence over work arrangements is likely to lower their sickness absence risk.
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Affiliation(s)
- Magnus Helgesson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77 Stockholm, Sweden; (M.H.); (S.M.); (K.G.)
| | - Staffan Marklund
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77 Stockholm, Sweden; (M.H.); (S.M.); (K.G.)
| | - Klas Gustafsson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77 Stockholm, Sweden; (M.H.); (S.M.); (K.G.)
| | - Gunnar Aronsson
- Department of Psychology, Stockholm University, SE-106 91 Stockholm, Sweden;
| | - Constanze Leineweber
- Department of Psychology, Stress Research Institute, Stockholm University, SE-106 91 Stockholm, Sweden
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Wang C, De Roos AJ, Fujishiro K, Allison MA, Wallace R, Seguin RA, Nassir R, Michael YL. Occupational Physical Activity and Coronary Heart Disease in Women's Health Initiative Observational Study. J Gerontol A Biol Sci Med Sci 2020; 74:1952-1958. [PMID: 30590438 DOI: 10.1093/gerona/gly288] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Women comprise nearly half of the labor force in our society, but the impact of the occupational psychical activity on women's heart health in later life was unclear. We conducted a case-cohort study to assess the association of occupational physical activity (OPA), alone and jointly with leisure-time physical activity (LTPA) and risk of coronary heart disease (CHD). METHODS We included women enrolled in Women's Health Initiative Observational Study who provided an occupational history at baseline and were followed until 2013 for the first occurrence of myocardial infarction or death from CHD (mean age ± SD = 63.4 ± 7.2). A total of 5,243 women free of CHD at baseline were randomly selected into a subcohort and 3,421 CHD events were adjudicated during follow-up. Through linkage of Standard Occupational Classification codes to the Occupational Information Network, we assessed cumulative and most recent exposure of OPA. LTPA was assessed through Women's Health Initiative's physical activity questionnaire. Weighted Cox proportional hazard models were used to evaluate CHD risk. RESULTS After adjustment for demographic and socioeconomic factors, levels of OPA were not associated with CHD risk. Compared with women with low OPA and high LTPA, women with moderate to high cumulative OPA and low LTPA had relative high CHD risk (hazard ratio [HR]: 1.54, 95% confidence interval [CI]: 1.26, 1.88 for moderate OPA and HR: 1.46. 95% CI: 1.20, 1.78 for high OPA). DISCUSSION Results from this study suggest no overall association between lifetime OPA and CHD risk in women, but the impact of OPA varies by LTPA levels.
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Affiliation(s)
- Conglong Wang
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Anneclaire J De Roos
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Kaori Fujishiro
- Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, Ohio
| | - Matthew A Allison
- Department of Family Medicine and Public Health University of California, San Diego, La Jolla
| | - Robert Wallace
- Department of Preventive Medicine and Environmental Health, University of Iowa, Ithaca, New York
| | - Rebecca A Seguin
- Division of Nutritional Sciences, Cornell University, Ithaca, New York
| | - Rami Nassir
- Department of Biochemistry and Molecular Medicine, University of California, Davis
| | - Yvonne L Michael
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
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Clays E, Hallman D, Oakman J, Holtermann A. Objectively measured occupational physical activity in blue-collar workers: What is the role of job type, gender and psychosocial resources? APPLIED ERGONOMICS 2020; 82:102948. [PMID: 31493536 DOI: 10.1016/j.apergo.2019.102948] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 08/28/2019] [Accepted: 08/29/2019] [Indexed: 06/10/2023]
Abstract
The aim was to describe occupational physical activity (OPA) and examine the role of psychosocial job resources among blue-collar workers. In a sample of 198 workers (57% male; mean age 44.9 (SD 9.9) year) from 7 companies in Denmark, two accelerometers (Actigraph) were placed on the thigh and trunk during 1-5 consecutive days, to determine working time spent standing, walking, on feet and in activity of moderate to vigorous intensity level (MVPA). The level of influence and social support at work were assessed by questionnaire. The exposure to OPA significantly varied by particular job type, especially in male predominant occupations. Overall, psychosocial job resources did not affect the exposure to OPA. These findings suggest that workplace interventions aiming to prevent adverse outcomes of OPA among blue-collars workers ought to focus on task redesign and target work organizational factors related to specific job type.
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Affiliation(s)
- Els Clays
- Department of Public Health and Primary Care, Ghent University, Belgium.
| | - David Hallman
- Department of Occupational and Public Health Sciences, Centre for Musculoskeletal Research, University of Gävle, Sweden.
| | - Jodi Oakman
- Department of Public Health, Centre for Ergonomics and Human Factors, La Trobe University, Australia.
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark.
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Åkerstedt T, Discacciati A, Häbel H, Westerlund H. Psychosocial work demands and physical workload decrease with ageing in blue-collar and white-collar workers: a prospective study based on the SLOSH cohort. BMJ Open 2019; 9:e030918. [PMID: 31530613 PMCID: PMC6756455 DOI: 10.1136/bmjopen-2019-030918] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 07/10/2019] [Accepted: 08/21/2019] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Psychosocial work demands and physical workload are important causes of ill health. The dramatic demographic changes in society make it important to understand if such factors change with ageing, but this is presently not known. The purpose of the present study was to investigate whether psychosocial work demands and physical workload change across 8 years of ageing, whether occupational groups show different trajectories of change and if such trajectories are reflected in sleep or fatigue. METHODS A cohort of 5377 participants (mean age: 47.6±11.6 (SD) years, 43.2% males, 40.2% blue-collar workers) was measured through self-report in five biannual waves across 8 years. Mixed model regression analyses was used to investigate change across ageing. RESULTS Psychosocial work demands decreased significantly across 8 years (Coeff: -0.016±0.001), with the strongest decrease in the high white-collar group (Coeff=-0.031±0.003) and the oldest group. Physical workload also decreased significantly (Coeff=-0.032±0.002), particularly in the blue-collar group (Coeff=-0.050±0.004) and in the oldest group. Fatigue decreased, and sleep problems increased with ageing, but with similar slopes in the occupational groups. All effect sizes were small, but extrapolation suggests substantial decreases across a working life career. CONCLUSIONS The decrease in psychosocial work demands and physical workload suggests that the burden of work becomes somewhat lighter over 8 years. The mechanism could be 'pure' ageing and/or increased experience or related factors. The gradual improvement in the work situation should be considered in the discussion of the place of older individuals in the labour market, and of a suitable age for retirement. The results also mean that prospective studies of work and health need to consider the improvement in working life with ageing.
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Affiliation(s)
- Torbjörn Åkerstedt
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Andrea Discacciati
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Henrike Häbel
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Hugo Westerlund
- Stress Research Institute, Stockholm University, Stockholm, Sweden
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Ketels M, De Bacquer D, Geens T, Janssens H, Korshøj M, Holtermann A, Clays E. Assessing physiological response mechanisms and the role of psychosocial job resources in the physical activity health paradox: study protocol for the Flemish Employees' Physical Activity (FEPA) study. BMC Public Health 2019; 19:765. [PMID: 31202266 PMCID: PMC6570960 DOI: 10.1186/s12889-019-6950-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 05/07/2019] [Indexed: 11/10/2022] Open
Abstract
Background In the current labour system many workers are still exposed to heavy physical demands during their job. In contrast to leisure time physical activity (LTPA), occupational physical activity (OPA) is associated with an increased risk of cardiovascular diseases and all-cause mortality, termed “the physical activity (PA) health paradox”. In order to gain more insight into the PA health paradox, an exploration of structural preventive measures at the workplace is needed and therefore objective field measurements are highly recommended. The objective of this paper is to provide an overview of the protocol of the Flemish Employees’ Physical Activity (FEPA) study, including objective measurements of PA, heart rate (HR) and cardiorespiratory fitness (CRF) to gain more insight into the PA health paradox. Methods A total of 401 workers participated in the FEPA study across seven companies in the service and production sector in Belgium. The participants comprised 167 men and 234 women, aged 20 to 65 years. OPA and LTPA were assessed by two Axivity AX3 accelerometers on the thigh and upper back. Ambulatory HR was measured by the Faros eMotion 90° monitor. Both devices were worn during two to four consecutive working days. In addition, CRF was estimated by using the Harvard Step Test. Statistical analyses will be performed using Pearson correlation, and multiple regression adjusted for possible confounders. Discussion This study aims to provide a better insight in the PA health paradox and the possible buffering factors by using valid and objective measurements of PA and HR (both during LTPA and OPA) over multiple working days. The results of the study can contribute to the prevention of cardiovascular disease by providing tailored recommendations for participants with high levels of OPA and by disseminating the results and recommendations to workplaces, policy makers and occupational health practitioners.
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Affiliation(s)
- Margo Ketels
- Department of Public Health and Primary Care, University Hospital Ghent, Ghent University, entrance 42 (4K3), Corneel Heymanslaan 10, 9000, Ghent, Belgium.
| | - Dirk De Bacquer
- Department of Public Health and Primary Care, University Hospital Ghent, Ghent University, entrance 42 (4K3), Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Tom Geens
- Liantis, Occupational Health Services, Bruges, Belgium
| | | | - Mette Korshøj
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Els Clays
- Department of Public Health and Primary Care, University Hospital Ghent, Ghent University, entrance 42 (4K3), Corneel Heymanslaan 10, 9000, Ghent, Belgium
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13
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Mikkola TM, von Bonsdorff MB, Salonen MK, Kautiainen H, Ala-Mursula L, Solovieva S, Viikari-Juntura E, Eriksson JG. Physical heaviness of work and sitting at work as predictors of mortality: a 26-year follow-up of the Helsinki Birth Cohort Study. BMJ Open 2019; 9:e026280. [PMID: 31101697 PMCID: PMC6530310 DOI: 10.1136/bmjopen-2018-026280] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES To examine the relationships of late-career physical heaviness of work and sitting at work with mortality. A national-level job exposure matrix was used to determine the occupation-specific level of physical heaviness and sitting. DESIGN Prospective cohort study between years 1990 and 2015. SETTING Community. PARTICIPANTS 5210 men and 4725 women from the Helsinki Birth Cohort Study with an occupational code at baseline (ages 45-57 years). PRIMARY AND SECONDARY OUTCOME MEASURES Total, cardiovascular (International Classification of Diseases 10th Revision I00-I99), cancer (C00-C97) and external (S00-Y84) mortality. RESULTS The exposures, physical heaviness and sitting had a non-linear, inverse relationship. During the 26-year follow-up, 1536 men and 759 women died. Among men, physical heaviness of work was positively associated and sitting at work was negatively associated with all-cause, cardiovascular and external cause mortality but they were not associated with cancer mortality. The HRs for men in the highest quartile of physical heaviness of work compared with men in the lowest quartile were 1.54 (1.31-1.80) for all-cause mortality, 1.70 (1.30-2.23) for cardiovascular mortality and 3.18 (1.75-5.78) for external cause mortality (adjusted for age and years of education). Compared with the lowest quartile, the HRs for the highest quartile of sitting at work among men were 0.71 (0.61-0.82) for all-cause mortality, 0.59 (0.45-0.77) for cardiovascular mortality and 0.38 (0.22-0.66) for external cause mortality. In women, neither physical heaviness of work nor sitting at work was associated with mortality. CONCLUSIONS Men in physically heavy work at their late-work career are at higher risk of death than men in physically light work.
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Affiliation(s)
| | - Mikaela B von Bonsdorff
- Folkhälsan Research Center, Helsinki, Finland
- Gerontology Research Centre, Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | - Minna K Salonen
- Folkhälsan Research Center, Helsinki, Finland
- Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Hannu Kautiainen
- Folkhälsan Research Center, Helsinki, Finland
- Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland
| | - Leena Ala-Mursula
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | | | | | - Johan G Eriksson
- Folkhälsan Research Center, Helsinki, Finland
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
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14
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Török E, Clark AJ, Jensen JH, Lange T, Bonde JP, Bjorner JB, Rugulies R, Hvidtfeldt UA, Hansen ÅM, Ersbøll AK, Rod NH. Work-unit social capital and long-term sickness absence: a prospective cohort study of 32 053 hospital employees. Occup Environ Med 2018; 75:623-629. [PMID: 29875292 DOI: 10.1136/oemed-2017-104954] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 03/19/2018] [Accepted: 04/27/2018] [Indexed: 11/04/2022]
Abstract
OBJECTIVE There is a lack of studies investigating social capital at the workplace level in small and relatively homogeneous work-units. The aim of the study was to investigate whether work-unit social capital predicts a lower risk of individual long-term sickness absence among Danish hospital employees followed prospectively for 1 year. METHODS This study is based on the Well-being in HospitAL Employees cohort. The study sample consisted of 32 053 individuals nested within 2182 work-units in the Capital Region of Denmark. Work-unit social capital was measured with an eight-item scale covering elements of trust, justice and collaboration between employees and leaders. Social capital at the work-unit level was computed as the aggregated mean of individual-level social capital within each work-unit. Data on long-term sickness absence were retrieved from the employers' payroll system and were operationalised as ≥29 consecutive days of sickness absence. We used a 12-point difference in social capital as the metric in our analyses and conducted two-level hierarchical logistic regression analysis. Adjustments were made for sex, age, seniority, occupational group and part-time work at the individual level, and work-unit size, the proportion of female employees and the proportion of part-time work at the work-unit level. RESULTS The OR for long-term sickness absence associated with a 12-point higher work-unit social capital was 0.73 (95% CI 0.68 to 0.78). Further, we found an association between higher work-unit social capital and lower long-term sickness absence across quartiles of social capital: compared with the lowest quartile, the OR for long-term sickness absence in the highest quartile was 0.51 (95% CI 0.44 to 0.60). CONCLUSION Our study provides support for work-unit social capital being a protective factor for individual long-term sickness absence among hospital employees in the Capital Region of Denmark.
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Affiliation(s)
- Eszter Török
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Copenhagen Stress Research Center, Copenhagen, Denmark
| | - Alice Jessie Clark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Copenhagen Stress Research Center, Copenhagen, Denmark
| | - Johan Høy Jensen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Copenhagen Stress Research Center, Copenhagen, Denmark.,Department of Occupational and Environmental Medicine, Bispebjerg Frederiksberg University Hospital, Copenhagen, Denmark
| | - Theis Lange
- Department of Public Health, Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Jens Peter Bonde
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Copenhagen Stress Research Center, Copenhagen, Denmark.,Department of Occupational and Environmental Medicine, Bispebjerg Frederiksberg University Hospital, Copenhagen, Denmark
| | - Jakob Bue Bjorner
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Reiner Rugulies
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Copenhagen Stress Research Center, Copenhagen, Denmark.,National Research Centre for the Working Environment, Copenhagen, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | | | - Åse Marie Hansen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Copenhagen Stress Research Center, Copenhagen, Denmark.,National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Annette Kjær Ersbøll
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Naja Hulvej Rod
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Copenhagen Stress Research Center, Copenhagen, Denmark
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15
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Allesøe K, Holtermann A, Rugulies R, Aadahl M, Boyle E, Søgaard K. Does influence at work modify the relation between high occupational physical activity and risk of heart disease in women? Int Arch Occup Environ Health 2017; 90:433-442. [PMID: 28213739 DOI: 10.1007/s00420-017-1207-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 01/24/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE To investigate whether influence at work modifies the association between demanding and strenuous occupational physical activity (OPA) and risk of ischaemic heart disease (IHD). METHODS A sample of 12,093 nurses aged 45-64 years from the Danish Nurse Cohort Study was followed for 20.6 years by individual linkage to incident IHD in the Danish National Patient Registry. Information on OPA, influence at work, other occupational factors and known risk factors for IHD was collected by self-report in 1993. RESULTS During follow-up 869 nurses were hospitalised with incident IHD. Nurses exposed to strenuous OPA and low influence at work had a 46% increased risk of IHD [hazard ratio (HR) 1.46 (95% confidence interval (CI) 1.02-2.09)] compared to the reference group of nurses with moderate OPA and high influence at work. Nurses exposed to strenuous OPA and high influence at work were not at an increased risk of IHD [HR 1.10 (95% CI 0.59-2.06)]. An additive hazards model showed there were 18.0 (95% CI -0.01 to 36.0) additional cases of IHD per 10,000 person years among nurses with strenuous OPA and low influence at work compared to nurses with moderate OPA and high influence at work. A detrimental additive interaction between strenuous OPA and low influence at work that could explain the additional cases of IHD among nurses with strenuous OPA and low influence at work was indicated. CONCLUSION The findings suggest that high influence at work may buffer some of the adverse effects of strenuous OPA on risk of IHD.
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Affiliation(s)
- Karen Allesøe
- Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark. .,Research Centre for Prevention and Health, Centre for Health, Rigshospitalet-Glostrup, Copenhagen University, Copenhagen, Denmark.
| | - Andreas Holtermann
- Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.,National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Department of Public Health, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mette Aadahl
- Research Centre for Prevention and Health, Centre for Health, Rigshospitalet-Glostrup, Copenhagen University, Copenhagen, Denmark.,Department of Public Health, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Eleanor Boyle
- Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Karen Søgaard
- Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
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