Mental health effects of long work hours, night and weekend work, and short rest periods

Extrinsic goals benefit capitalism but not well-being. Rethinking the economy's goal for a healthier future

The dramatic rise in non-communicable diseases around the world but notably in high-income countries like the UK is a manifestation of a global economic system-capitalism-that prioritizes wealth over health. A decade ago, the former WHO Director-General, Margaret Chan highlighted how 'efforts to prevent non-communicable diseases go against the business interests of powerful economic operators' [United Nations. (2013) Take Action for the Sustainable Development Goals. https://www.un.org/sustainabledevelopment/sustainable-development-goals/ (last accessed 16 February 2024)]. While there is a growing literature on how politics and economics influence population health-for better or worse-less attention has been given to exploring how economic systems like capitalism influence people's psychological well-being. To fill this gap, the following article examines how the continued pursuit of economic growth under capitalism (neoliberal free-market forms especially) impacts well-being through challenging basic psychological needs for security, autonomy, competence and relatedness. In doing so, I hope to shed important light on the sources and possible solutions to our growing health and social problems, and stimulate a conversation on how to achieve a healthier future for us all.

Caring is not always sharing: A scoping review exploring how COVID-19 containment measures have impacted unpaid care work and mental health among women and men in Europe

INTRODUCTION

Unpaid care work is mainly performed by women, whose mental health is more affected by caregiving burden and work-family conflict compared to men. COVID-19 containment measures may have exacerbated existing gender inequalities in both unpaid care work and adverse mental health outcomes. This scoping review provides an overview of recent evidence on the impact of COVID-19 containment measures on unpaid care work and mental health for subgroups of caregivers at the intersection of gender and other social differences (e.g., ethnicity, age, class) in Europe.

METHODS AND ANALYSIS

Our study was informed and guided by Arksey and O'Malley's methodological framework. We searched six academic databases (Medline, PsycInfo, Scopus, CINAHL, Social Sciences Abstracts, Sociological Abstracts, ASSIA) and hand-searched the reference lists of selected articles to identify relevant peer-reviewed research articles published between 1 March 2020 and 7 September 2022. In addition, we conducted a grey literature search using Google Scholar and a targeted hand search on known international and European websites. We included studies that reported gender-disaggregated results on unpaid care work and mental health in the context of COVID-19 containment measures in Europe. Two reviewers independently screened all abstracts and full texts for eligibility and extracted the relevant data. The results were synthesised narratively.

RESULTS AND DISCUSSION

Our results suggest a greater gender gap in unpaid care work division and, to a lesser extent, in mental health, which is unfavourable towards women and mothers. Despite this, we see a break in the traditional division of childcare, with fathers taking on a greater role in family work, which makes us optimistic about the division of care work in the post-COVID-19 era. This research also shows that among European women, population groups often understudied, such as women who are single parents, disabled or of colour, have the highest increase in unpaid care work and greatest deterioration in wellbeing.

Exploring the Impact of Workplace Violence on the Mental Health of Chinese Correctional Officers: A JD-R Model Approach

Background

Correctional officers face widespread workplace violence and the resulting overwork that can profoundly damage their physical and mental health.

Purpose

This study aims to investigate the mediating role of overwork in the relationship between workplace violence and the manifestation of physical and mental health issues among correctional officers.

Methods

This study enlisted 472 eligible participants. Cross-sectional data were obtained using the Chinese version of the Workplace Violence Scale (WVS), while the physical and mental health of correctional officers was evaluated through relevant scales. Analysis involved descriptive statistics, correlation analyses, and tests for mediation models.

Results

The study found significant correlations between workplace violence, overwork, and various mental health variables (depression, anxiety, stress, suicidal ideation, and insomnia), with correlations ranging from 0.135 to 0.822 (p < 0.01). Mediation analysis revealed that workplace violence directly impacts correctional officers' physical and mental health (p < 0.001) and also has an indirect effect through overwork (p < 0.023). These findings underscore the substantial impact of workplace violence on the health of correctional officers, both directly and indirectly.

Conclusion

Workplace violence and overwork significantly contribute to the physical and mental health challenges faced by correctional officers. Overwork acts as a mediator in the relationship between workplace violence and these health issues. The study suggests addressing workplace violence and mental health issues among correctional officers by increasing their numbers, improving the work environment, and implementing enhanced welfare policies.

Association Between Economic Activity and Depressive Symptoms Among Women With Parenting Children

BACKGROUND

Balancing parenting and work life poses challenges for women with children, potentially making them vulnerable to depression owing to their dual responsibilities. Investigating working mothers' mental health status is important on both the individual and societal levels. This study aimed to explore the relationship between economic activity participation and depressive symptoms among working mothers.

METHODS

This study was a cross-sectional study and used data from the Korea National Health and Nutrition Examination Survey collected in 2014, 2016, 2018, and 2020. The participants in the study were women aged 19 to 50 who were residing with their children. In the total, 3,151 participants were used in the analysis. The independent variable was economic activity, categorized into two groups: 1) economically active and 2) economically inactive. The dependent variable was the depressive symptoms, categorized as present for a Patient Health Questionnaire-9 score of ≥ 10 and absent for a score < 10. Multiple logistic regression analysis was performed to assess the association between economic activity and depressive symptoms, and sensitivity analyses were performed based on the severity of depressive symptoms.

RESULTS

Among women with children, economically active women had reduced odds ratio of depressive symptoms compared with economically inactive women (odds ratio [OR], 0.54; 95% confidence interval [CI], 0.36-0.80). In additional analysis, women working as wage earners had the lowest odds of depressive symptoms (OR, 0.43; 95% CI, 0.28-0.66). Women working an average of 40 hours or less per week were least likely to have depressive symptoms (OR, 0.42; 95% CI, 0.25-0.69).

CONCLUSION

Economic activity is significantly associated with depressive symptoms among women with children. Environmental support and policy approaches are needed to ensure that women remain economically active after childbirth.

Impact of Long Working Hours on Mental Health Status in Japan: Evidence from a National Representative Survey

Using the 2010-2019 Comprehensive Survey of Living Conditions (CSLC) conducted in Japan, we examined the impact of long working hours on mental health in Japan while addressing the endogeneity issue arising from non-random selection bias. We assessed the variations in the effects of long working hours on mental health across different groups. The results show that first, individuals working longer hours (55 h or more per week) exhibited a higher likelihood of developing mental illness than those working regular hours or fewer hours. Second, the negative effect of long working hours on mental health is more pronounced among non-regular workers than among regular workers. Third, the effect of long working hours on mental health varies among different demographic groups, with a greater impact observed among women, managers, non-regular workers, employees in small- or large-sized firms, and those in smaller cities compared to their counterparts. Thus, to enhance worker productivity, the Japanese government should address the issue of long working hours to improve employees' mental well-being. Initiatives aimed at promoting work-life balance, family-friendly policies, and measures to ameliorate working conditions are expected to help mitigate the challenges associated with long working hours and mental health issues, especially among non-regular workers.

Suicide among psychiatrists: From healers to seekers of mental health care

Addressing suicide and mental health issues among psychiatrists, particularly during a crisis such as the COVID-19 pandemic is important. several factors contribute to this risk, such as long duty hours, burnout, emotional exhaustion, exposure to secondary trauma, and the impact of the pandemic on the mental health of healthcare workers. This paper emphasizes the urgent need for interventions at individual and organizational levels to address burnout and mental health issues among psychiatrists. Supporting the mental resilience of mental health professionals will improve the mental health of the community.

Association Between Days of the Week and Intraocular Pressure: Japan Ningen Dock Study

PRCIS

The analysis of intraocular pressure (IOP) by day of the week using the mega database showed a periodic weekly pattern with the highest value on Monday.

PURPOSE

To evaluate IOP by the day of the week.

PATIENTS AND METHODS

Annual health checkup examinees between April 2014 and March 2015 were cross-sectionally evaluated. As a result, 655,818 participants [51.5±10.5 (range: 20-96) years, 40.1% women] from 103 medical centers were included. IOP was measured using a noncontact tonometer. The mean IOPs of each day of the week were compared using multiple comparison test and multiple linear regression analysis. Wednesday was set as the reference. Moreover, weekly IOP variations stratified by sex and age were also evaluated.

RESULTS

Mean IOPs from Monday to Sunday were 13.19±2.97, 13.06±2.92, 13.05±2.91, 13.05±2.92, 13.12±2.94, 13.10±2.96, and 13.16±2.78 mm Hg. IOP was significantly higher on Monday, Friday, and Saturday than those on Wednesday ( P <0.001, <0.001, 0.002). After adjusting for factors affecting IOP, the IOPs on Monday and Saturday were higher than those on Wednesday [β=0.097 (95% CI: 0.074-0.121), P <0.001; β=0.032 (95% CI: 0.005-0.059), P =0.019]. Men had significantly higher IOPs on Monday and Saturday than on Wednesday [β=0.142 (95% CI: 0.110-0.173), P <0.001; β=0.053 (95% CI: 0.017-0.089), P =0.004], whereas women did not have a significant trend. Participants aged below 65 years had higher IOPs on Monday ( P <0.001 in under 60 years; P =0.003 in 60-64 years), while those aged 65 years or older did not ( P =0.856).

CONCLUSION

IOP values may have a periodic weekly pattern. The high IOP on Monday was more pronounced in men aged less than 65 years.

Household unclean fuel use, indoor pollution and self-rated health: risk assessment of environmental pollution caused by energy poverty from a public health perspective

The lack of access to clean energy remains one of the major challenges in the global energy sector. Access to clean, sustainable and affordable energy, outlined in the seventh Sustainable Development Goals (SDG 7) of the United Nations, plays a crucial role in advancing health (SDG 3), as unclean cooking energy may endanger people's health by causing air pollution. However, due to endogeneity problems such as reverse causality, the health consequences of environmental pollution caused by unclean fuel usage are difficult to be scientifically and accurately evaluated. This paper aims to systematically assess the health cost of unclean fuel usage based on tackling endogeneity, using the data from Chinese General Social Survey. The ordinary least squares model, ordered regression methods, instrumental variable approach, penalized machine learning methods, placebo test, and mediation models are applied in this research. Analytical results demonstrate that households' unclean fuel use significantly damages people's health. Specifically, the use of dirty fuel leads to an average of about a one-standard-deviation decline in self-rated health, demonstrating its notable negative effect. The findings are robust to a series of robustness and endogeneity tests. The impact mechanism is that unclean fuel usage reduces people's self-rated health through increasing indoor pollution. Meanwhile, the negative effect of dirty fuel use on health has significant heterogeneity among different subgroups. The consequences are more prominent for the vulnerable groups who are female, younger, living in rural areas and older buildings, with lower socio-economic status and uncovered by social security. Therefore, necessary measures should be taken to improve energy infrastructure to make clean cooking energy more affordable and accessible as well as to enhance people's health. Besides, more attention should be paid to the energy needs of the above specific vulnerable groups faced with energy poverty.

Female workers with long working hours are more likely to have depressive symptoms when having family-to-work conflict

PURPOSE

Workers' health can be influenced by risk factors from their family environments as well as their work environments. This paper sought to examine how the association between long working hours and depressive symptoms differs based on the level of FWC after being stratified by worker's gender.

METHODS

We used the dataset of 20,384 full-time wage workers from the sixth Korean Working Conditions Survey (2020). Long working hours were defined as working 52 h or more per week. FWC was measured using a 2-item questionnaire, and depressive symptoms were measured using the WHO-5 well-being index. Applying modified Poisson regression, we evaluated how the association between long working hours and depressive symptoms differs by the level of FWC male and female workers separately.

RESULTS

In the analysis of the female workers, long working hours were associated with depressive symptoms in the high FWC group (PR 1.35, 95% CI 1.17, 1.55) after adjusting for potential confounders whereas no association was observed in the low FWC group. Among the male workers, a statistically significant association was observed in both high FWC (PR 1.22, 95% CI 1.07, 1.38) and low FWC (PR 1.28, 95% CI 1.12, 1.47) groups.

CONCLUSION

FWC may act as a workplace stressor that potentially amplifies the health impact of long working hours among female workers.

The impact of maternal occupation on children's health: A mediation analysis using the parametric G-formula

BACKGROUND

Previous studies have found that maternal occupational choice can directly impact fetal health and mothers' energy and time available for childcare. Moreover, reduced caregiving time is associated with poorer child health. However, how maternal occupational factors (work nature/income/stress) affect child health has not been fully explored.

METHODS

Data were extracted from China Family Panel Studies (CFPS) from 2014 to 2020. A parametric G-formula Model was constructed to simulate the direct impact of maternal occupational factors (work nature, income, and stress) on child health. Furthermore, we explored their indirect effects mediated by maternal physical health, mental health, or occupational factors for the overall sample and by different age groups of the children.

RESULTS

Maternal work nature and income had positive direct impacts on child health, especially for children whose mothers were employers of budgeted positions. Maternal work stress had a negative direct impact on children's health. Maternal work stress mediated the positive impact of maternal work income (9%). Maternal work stress affected children's health directly for children aged under 6, while for children aged 7-15, it had an indirect impact mediated by maternal physical health (43%), mental health (44%), and income (47%).

CONCLUSION

Attention should be paid to maternal occupational factors (especially to work stress) and to the varying care needs of children from their mothers at different ages to improve children's health and prevent the transmission of maternal occupation to children's health.

Effect of long working hours on psychological distress among young workers in different types of occupation

BACKGROUND

We investigated how the association between long working hours and psychological distress varies across different employment and occupation types in young workers.

METHODS

Examining a nationally representative sample of 7246 Korean workers (3621 women) aged 15 to 40, we analyzed 23,492 observations spanning from 2016 to 2020. Psychological distress was measured using the Brief Encounter Psychosocial Instrument. We employed a generalized estimating equation to estimate odds ratios (ORs) and 95% confidence intervals (CIs).

RESULTS

Of the total observations, 5.2% worked <35 h/week, 52.9% worked 35-40 h/week, 23.5% worked 41-48 h/week, 10.3% worked 49-54 h/week, and 8.2% worked ≥55 h/week. The OR (95% CI) of the association between long working hours and psychological distress was 1.38 (1.11-1.72) for <35 h/week, 1.47 (1.32-1.65) for 41-48 h/week, 1.74 (1.49-2.04) for 49-54 h/week, and 2.11 (1.75-2.55) for ≥55 h/week compared to 35-40 h/week. The OR (95% CI) of the association between working ≥55 h/week and psychological distress was significantly higher among wage workers (OR [95% CI]: 2.37 [1.94-2.89]) compared to self-employed workers (OR [95% CI]: 0.84 [0.52-1.36]). Additionally, the OR (95% CI) of the association between working ≥55 h/week and psychological distress was significantly higher among white-collar workers (OR [95% CI]: 3.24 [2.54-4.13]) compared to service/sales workers (OR [95% CI]: 1.22 [0.86-1.72]) or blue-collar workers (OR [95% CI]: 1.71 [1.10-2.67]). No clear gender differences were observed.

CONCLUSION

Psychological distress caused by long working hours can be pronounced among white-collar and wage workers.

Effect of Mandatory and Voluntary Overtime Hours on Stress Among 9-1-1 Telecommunicators

BACKGROUND

9-1-1 telecommunicators are frequently exposed to indirect traumatic events that impact their mental and physical health and are often required to work overtime with rotating shifts. Previous studies reported various harmful effects of overtime on the health and well-being of workers, such as musculoskeletal injuries, burnout, low job satisfaction, fatigue, and intent to leave. However, there is limited research on the impact of overtime hours on 9-1-1 telecommunicators' stress symptoms, especially mandatory overtime hours. This study aimed to examine the relationship between overtime hours-mandatory and voluntary-and the level of stress symptoms among 9-1-1 telecommunicators.

METHODS

We used secondary data from the surveys of the "Multi-tasking to hyper-tasking: Investigating the impact of Next Generation 9-1-1" study for analysis. Linear mixed-effects regression was applied to examine the association of overtime hours with the stress level.

RESULTS

Of the 403 participants, 47.6% reported that they were required to work mandatory overtime, and the mean mandatory overtime was 7.51 (SD = 12.78) hours in the past month. 58.3% reported working voluntary overtime, and the mean voluntary overtime was 11.63 (SD = 17.48) hours. This study found that mandatory overtime hours were associated with an increase in self-reported stress symptoms (β = 0.30, p = .002), whereas no significant association was found between voluntary overtime and the level of stress symptoms (β = -0.01, p = .885).

CONCLUSION/APPLICATION TO PRACTICE

Study results highlight the importance of reducing mandatory overtime in call centers as one possible strategy for reducing stress levels among this critical workforce.

Prevalence and risk factors of physical and psychological health among readymade garment workers in Bangladesh

Objective. Poor health outcomes of Bangladeshi readymade garment (RMG) workers tend to be associated with a variety of occupational factors. This study aimed to investigate the prevalence of, and risk factors associated with, the physical and psychological health outcomes of Bangladeshi RMG workers. Methods. Responses to a cross-sectional survey from a convenience sample of 411 adult Bangladeshi RMG workers (mean age = 26.24 years; SD 6.40 years; female = 80%) were analysed using bivariate and multivariate (logistic regression models) analyses. Results. More than half of the participants reported headaches (61.6%) and colds/flu (51.3%), followed by fever (37.2%), diarrhoea (32.8%), bodily pain (29.9%) and respiratory infections (20.9%). For psychological health, stress (69.1%), anxiety (66.2%) and boredom (64.5%) were most prevalent, followed by sleeplessness (51.3%), depression (48.2%) and fear (34.3%). RMG workers from the factories located in Chattogram (a peripheral region compared to Dhaka) reported poorer physical and psychological health outcomes than those working in factories in Dhaka (the capital city of Bangladesh). Overall, compared to males, female RMG workers were more likely to be vulnerable to both physical and psychological health outcomes. Conclusion. Improvement in workplace conditions and safety programmes is needed to safeguard the overall health outcomes of Bangladeshi RMG workers.

Unsupervised clustering analysis of comprehensive health status and its influencing factors on women of childbearing age: a cross-sectional study from a province in central China

BACKGROUND

Most previous studies on women of childbearing age have focused on reproductive health and fertility intentions, and evidence regarding the comprehensive health status of women of childbearing age is limited. This study aimed to comprehensively examine the health status of women of childbearing age through a multi-method and multi-indicator evaluation, analyze the factors that influence their overall health, and provide sound recommendations for the improvement and promotion of healthy behaviors.

METHODS

Data on women of childbearing age living in Shanxi Province were collected between September 2021 and January 2022 through online and offline surveys. The k-means algorithm was used to assess health-related patterns in women, and multivariate nonconditional logistic regression was used to assess the influencing factors of women's overall health.

RESULTS

In total, 1,258 of 2,925 (43%) participants were classified as having a good health status in all five domains of the three health dimensions: quality of life, mental health, and illness. Multivariate logistic regression showed that education level, gynecological examination status, health status of family members, access to medical treatment, age, cooking preferences, diet, social support, hand washing habits, attitude toward breast cancer prevention, and awareness of reproductive health were significantly associated with different health patterns.

CONCLUSIONS

The comprehensive health status of women of childbearing age in Shanxi Province is generally good; however, a large proportion of women with deficiencies in some dimensions remains. Since lifestyle greatly impacts women's health, health education on lifestyle and health-related issues should be strengthened.

Synergistic interaction between long shifts and short rest periods on depression in shift workers: A cross-sectional study from Korea

BACKGROUND

Long shifts and short rest periods (SRP) between shifts are important factors that greatly affect shift workers' health. However, reports on the psychological effects of shift work, such as depression, have been inconsistent. Therefore, this study aimed to investigate the combined effect of long shifts and SRP on depression in shift workers.

METHODS

This cross-sectional study included 3295 shift workers in the sixth Korean Working Conditions Survey. The relative excess risk due to interaction (RERI) was computed to estimate the combined effect of long shifts and SRP on depression.

RESULTS

Depression in shift workers was not significantly associated with long shifts or SRP after adjustment, but the risk was significantly increased when exposed to both factors simultaneously (odds ratio 1.36, 95% confidence interval 1.03-1.79). The RERI between the two factors was statistically significant (p = 0.020), indicating a synergistic interaction with depression. Sensitivity analysis by occupation showed a significant interaction in the combined group of office and service workers (p = 0.034).

CONCLUSIONS

Simultaneous exposure to SRP and long shifts should be avoided when planning shift work schedules or devising health policies for shift workers. Special consideration is needed for healthcare and service workers, who may be particularly vulnerable to negative health impacts due to shift work.

Psychophysiological coherence training to moderate air traffic controllers' fatigue on rotating roster

The nature of the current rotating roster, providing 24-h air traffic services over five irregular shifts, leads to accumulated fatigue which impairs air traffic controllers' cognitive function and task performance. It is imperative to develop an effective fatigue risk management system to improve aviation safety based upon scientific approaches. Two empirical studies were conducted to address this issue. Study 1 investigated the mixed effect of circadian rhythm disorders and resource depletion on controllers' accumulated fatigue. Then, study 2 proposed a potential biofeedback solution of quick coherence technique which can mitigate air traffic controllers' (ATCOs') fatigue while on controller working position and improve ATCOs' mental/physical health. The current two-studies demonstrated a scientific approach to fatigue analysis and fatigue risk mitigation in the air traffic services domain. This research offers insights into the fluctuation of ATCO fatigue levels and the influence of a numbers of factors related to circadian rhythm and resource depletion impact on fatigue levels on study 1; and provides psychophysiological coherence training to increase ATCOs' fatigue resilience to mitigate negative impacts of fatigue on study 2. Based on these two studies, the authors recommended that an extra short break for air traffic controllers to permit practicing the quick coherence breathing technique for 5 min at the sixth working hour could substantially recharge cognitive resources and increase fatigue resilience. Application: Present studies highlight an effective fatigue intervention based on objective biofeedback to moderate controllers' accumulated fatigue as a result of rotating shift work. Accordingly, air navigation services providers and regulators can develop fatigue risk management systems based on scientific approaches to improve aviation safety and air traffic controller's wellbeing.

Impact of Long Working Hours on Mental Health: Evidence from China

Although previous studies have examined the impact of long working hours on mental health in China, they have not addressed the initial value and reverse causality issues. To bridge this gap in the literature, I conducted a dynamic longitudinal analysis to investigate the association between long working hours and the risk of mental illness nationwide. Using three-wave longitudinal data from the China Family Panel Studies conducted in 2014, 2016, and 2018, I adopted dynamic regression models with lagged long working hours variables to examine their association with the risk of mental illness. The results indicate that long working hours have positive and significant (p < 0.01 or p < 0.05) associations with the risk of mental illness (OR: 1.12~1.22). The effect is more significant for women, white-collar workers, and employees in micro-firms, compared with their counterparts (i.e., men, pink- and blue-collar workers, employees of large firms, and self-employed individuals). The results provide empirical evidence of the effects of long working hours on mental health in China, confirming the need to enforce the regulations regarding standard working hours and monitor regulatory compliance by companies, as these factors are expected to improve mental health.

Do employees' work schedules put them at-risk? The role of shift scheduling and holidays in predicting near miss and incident likelihood

INTRODUCTION

Using crew scheduling and injury incident data from a Fortune 500 manufacturing company, this study analyzed the effect of consecutive shifts and shifts near holidays on near misses and incidents.

METHODS

Logistic regressions were conducted with consecutive workdays, days near holidays, and time of shift as predictors of incident and near miss outcomes.

RESULTS

The logistic regression analysis indicated that working consecutive day shifts increases the probability of an incident occurring, with the fourth consecutive shift resulting in the most risk. The consecutive shift pattern did not replicate to employees working the night shift. However, the first and second shifts when transferring to a night schedule appear to have a greater chance of incident. Shifts near holidays did not have a significantly higher risk than other shifts.

PRACTICAL APPLICATION

The current research suggests that organizations can use similar analytic techniques to determine if shift scheduling might be related to increased risk and allocate resources to mitigate hazards during those peak probability shifts.

Does voluntary health insurance improve health and longevity? Evidence from European OECD countries

The financing structure of the healthcare system and, particularly, the voluntary health insurance (VHI) constituent, has been a vital pillar in improving the overall quality of life. Consequently, this study aims to shed light on the effect of VHI on the population's health and longevity in a sample of 26 European OECD countries. The methodology employed covers both hierarchical clustering and the novel dynamic panel threshold technique. First, the descriptive cluster analysis unveils a delimitation of the countries into four main groups with respect to a broad set of health status indicators. Second, the estimates show that VHI is a significant determinant of health and longevity. More specifically, we find that the relationship between variables is characterized by a threshold effect, whose estimated value is roughly 6.3% of the total healthcare financing. Also, the heterogeneity analysis unveils consistent differences regarding the impact of VHI on health and longevity for the supplementary and complementary types of VHI. Overall, results are strongly robust, the signs and the significance of the coefficients being preserved in the presence of several additional control factors. From a policy perspective, the study's findings can be used nationwide to stimulate regulatory policies to encourage the achievement of a satisfactory level of private health insurance.

Determinants of symptom burden related to bowel preparation for colonoscopy

BACKGROUND

Symptoms developing during bowel preparation are major concerns among subjects who refuse the procedure.

AIMS

We aimed to explore the determinants of symptoms occurring during preparation among patients undergoing elective colonoscopy.

METHODS

This is a prospective multicenter study conducted in 10 Italian hospitals. A multidimensional approach collecting socio-demographic, clinical, psychological and occupational information before colonoscopy through validated instruments was used. Outcome was a four-category cumulative score based on symptoms occurring during preparation, according to the Mayo Clinic Bowel Prep Tolerability Questionnaire, weighted by intensity. Missing values were addressed through multiple imputation. Odds ratios (OR) and 95% confidence intervals (CI) were estimated through multivariate logistic regression models.

RESULTS

1137 subjects were enrolled. Severe symptoms were associated with female sex (OR=3.64, 95%CI 1.94-6.83), heavier working hours (OR=1.13, 95% CI=1.01-1.25), previous gastrointestinal symptoms (OR=7.81, 95% CI 2.36-25.8 for high score), somatic symptoms (OR=2.19, 95% CI=1.06-4.49 for multiple symptoms), day-before regimen (OR=2.71, 95%CI 1.28-5.73). On the other hand, age ≥60 years (OR=0.10, 95% CI 0.02-0.44) and good mood (p=0.042) were protective factors. A high-risk profile was identified, including women with low mood and somatic symptoms (OR=15.5, 95%CI 4.56-52.7).

CONCLUSIONS

We identified previously unreported determinants of symptoms burdening bowel preparation and identified a particularly vulnerable phenotype. Symptoms during preparation especially impact heavier working activity.

Protective and Vulnerability Factors of Municipal Workers' Mental Health: A Cross-Sectional Study

Work is fundamental to an individual's mental health; however, an unfavourable work environment can lead to mental health problems. Despite existing studies addressing workers' mental health, it is essential to understand the reality of specific contexts to design effective tailored interventions. Thus, this study aimed to examine the influence of potential protective and vulnerability factors on municipal workers' depressive symptoms, anxiety and stress levels, and burnout. A cross-sectional study was conducted with data collection performed between July and December 2021 using online self-report measures. The sample comprised 115 municipal workers. The findings revealed that psychological vulnerability is a significant vulnerability factor for the presence of mental health symptoms. In addition, job satisfaction was found to be a significant protective factor for depressive symptoms, anxiety, and burnout of the municipal workers. The results of this study enhance the understanding of factors that influence worker mental health, which may facilitate the proper planning of specific interventions to promote mental health in the workplace.

Mental health assessment of Spanish frontline healthcare workers during the SARS-CoV-2 pandemic

BACKGROUND AND OBJECTIVE

The Covid-19 pandemic continues challenging health systems globally, exposing healthcare workers to constant physical and psychological stressors. To date, several studies have already shown the catastrophic impact on the mental health of medical personnel during the early period of the pandemic. Nevertheless, literature evidences the dearth of works that evaluate the effect over time, understanding the pandemic as a sustained extreme stressor. The present study examines the effect of the pandemic on the mental health of Covid-19 frontline healthcare workers at six months follow-up.

MATERIAL AND METHODS

A total of 141 frontline healthcare workers from two tertiary hospitals were recruited between July and November 2020. Healthcare workers were evaluated psychologically at baseline and six months follow-up (January to May 2021) using psychometric tests for the assessment of acute stress (VASS, PSS-10, PCL-5), anxiety (STAI) and depression (PHQ-2) RESULTS: Overall, there was a general worsening of the mental health between the two psychological assessments, especially regarding depression and predisposition to perceiving the situations as a threat. Nurses and nurse aides showed poorer mental health while physicians improved over time. Reduced working hours and higher physical exercise resulted in better mental health among healthcare workers. Women and nursing staff were the most affected by psychological distress at baseline and six months follow-up.

CONCLUSION

Reduced working hours, adequate resting periods, physical exercise, and efficient intervention strategies are of utmost importance in preventing, controlling, and reducing psychological distress among healthcare workers when coping with critical scenarios such as the current pandemic.

Mental health assessment of Spanish frontline healthcare workers during the SARS-CoV-2 pandemic

Background and objective

The Covid-19 pandemic continues challenging health systems globally, exposing healthcare workers to constant physical and psychological stressors. To date, several studies have already shown the catastrophic impact on the mental health of medical personnel during the early period of the pandemic. Nevertheless, literature evidences the dearth of works that evaluate the effect over time, understanding the pandemic as a sustained extreme stressor. The present study examines the effect of the pandemic on the mental health of Covid-19 frontline healthcare workers at six months follow-up.

Material and methods

A total of 141 frontline healthcare workers from two tertiary hospitals were recruited between July and November 2020. Healthcare workers were evaluated psychologically at baseline and six months follow-up (January to May 2021) using psychometric tests for the assessment of acute stress (VASS, PSS-10, PCL-5), anxiety (STAI) and depression (PHQ-2).

Results

Overall, there was a general worsening of the mental health between the two psychological assessments, especially regarding depression and predisposition to perceiving the situations as a threat. Nurses and nurse aides showed poorer mental health while physicians improved over time. Reduced working hours and higher physical exercise resulted in better mental health among healthcare workers. Women and nursing staff were the most affected by psychological distress at baseline and six months follow-up.

Conclusion

Reduced working hours, adequate resting periods, physical exercise, and efficient intervention strategies are of utmost importance in preventing, controlling, and reducing psychological distress among healthcare workers when coping with critical scenarios such as the current pandemic.

Gendered impact of COVID-19 containment measures on unpaid care work and mental health in Europe: a scoping review protocol

INTRODUCTION

Women are more likely than men to provide unpaid care work. Previous research has shown that lack of support for various forms of unpaid care work and work-family conflicts have negative impacts on caregivers' mental health, especially among female caregivers. COVID-19 containment measures may exacerbate existing gender inequalities both in terms of unpaid care work and adverse mental health outcomes. This scoping review protocol describes the systematic approach to review published literature from March 2020 onwards to identify empirical studies and grey literature on the mental health impact of COVID-19 containment measures on subgroups of unpaid caregivers at the intersection of gender and other categories of social difference (eg, ethnicity, age, class) in Europe.

METHODS AND ANALYSIS

This scoping review is informed and guided by Arksey and O'Malley's methodological framework. We will search the databases Medline, PsycINFO, Scopus, CINAHL, Social Sciences Abstracts, Sociological Abstracts as well as Applied Social Sciences Index & Abstracts (ASSIA) and hand-search reference lists of selected articles to identify relevant peer-reviewed studies. We will conduct a grey literature search using Google Scholar and targeted hand-search on known international and European websites and include reports, working papers, policy briefs and book chapters that meet the inclusion criteria. Studies that report gender-segregated findings for mental health outcomes associated with unpaid care work in the context of COVID-19 containment measures in Europe will be included. Two reviewers will independently screen all abstracts and full texts for inclusion, and extract general information, study characteristics and relevant findings. Results will be synthesized narratively.

ETHICS AND DISSEMINATION

This study is a review of published literature; ethics approval is not warranted. The findings of this study will inform public health research and policy. The results will be disseminated through a peer-reviewed publication and conference presentations.

Parenting in a 24/7 Economy: Mothers’ Non-standard Work Schedules and Involvement in Children’s Education

Evidence suggests that parental involvement in children’s education has a positive impact on children’s educational achievements and wellbeing outcomes. The trend toward 24/7 economies has obliged many mothers to work non-standard schedules (i.e., schedules outside traditional daytime, Monday–Friday work schedules). This has raised concerns over how non-standard work schedules affect parenting behaviors, including paternal involvement in children’s education. Using data from mothers of young children (age 5–6) in Hong Kong (N = 433), this study examined the association between maternal work schedules and involvement in children’s home and school activities. The results of structural equation modeling found that weekend work was associated with lower levels of home-based involvement. By contrast, working non-standard hours was linked with higher levels of school-based involvement. This pattern suggested that non-standard work schedules could make it either easier or harder for mothers to balance work and family responsibilities, depending on the circumstances (i.e., whether they work non-standard hours or weekends). These findings, indicating that the effects of non-standard work schedules are not uniformly negative or positive, warrant sophisticated policy efforts to address the potential adverse effects of non-standard work schedules and avoid undermining their potential to be used as a family-friendly option.

Long Work Hours, Overtime, and Worker Health Impairment: A Cross-Sectional Study among Stone, Sand, and Gravel Mine Workers

Background: Research has shown that long work hours and overtime are associated with health impairment, including stress, burnout, and overall health. However, this has not been thoroughly assessed among stone, sand, and gravel mine workers. As such, this study examined whether significant differences in stress, burnout, and overall health existed among workers that worked different hours each week. Methods: ANOVA analyses were completed for the outcome variables (stress, burnout, and health status). Each analysis included three categorical independent variables: age, sex, and work hours. Age and sex were control variables. BMI was added to the health status analysis as an additional control variable. Results: There were significant differences between work hour groups for all three outcomes. Post hoc analyses determined that workers working >60 h/week had more stress, more burnout, and lower health. Differences were not found between age or sex. There were no differences in health status for different BMI groups, but the interaction of BMI and work hours was significant. Conclusions: Working more than 60 h per week was problematic. Mine and safety administrators should enact programs to protect and promote worker health, particularly among those working long hours, especially if more than 60 h per week.

Child Gender and Married Women’s Overwork: Evidence from Rural–Urban Migrants in China

Overwork is one of the risk factors for the work-related burden of disease. In China, nearly a quarter of migrant women are overworked. Working long hours can significantly increase the possibility of migrant women suffering from hypertension and hyperglycemia. The phenomenon of overtime work of migrant women and their health conditions deserves attention. Based on the China Migrants Dynamic Survey in 2016, this study indicates that giving birth to a boy may exacerbate overtime work among migrant women and having more boys in a family increases the probability of women’s overwork. Empirical results confirmed the existence of son preferences in China. Compared with women who gave birth to boys, women who gave birth to girls have a lower probability of being a workaholic due to a future fertility plan. Furthermore, the overwork of women is also due to the great economic burden on families to buy a wedding house, brought on by the birth of boys. To overcome the endogenous problem caused by this omitted explanatory variable, this study uses each province’s relative sex ratio at birth in 2010 as the instrumental variable of the firstborn’s gender. The IV results illustrate that the birth of boys still significantly exacerbates women’s overwork. Furthermore, considering age heterogeneity, the influence of son preference on women’s overtime work exists throughout their labor life cycle. This paper provides a new perspective for understanding migrant women’s overtime work and their health issues in urban China.

Development of Digital Biomarkers of Mental Illness via Mobile Apps for Personalized Treatment and Diagnosis

The development of precision psychiatry is largely based on multi-module measurements from the molecular, cellular, and behavioral levels, which are integrated to assess neurocognitive performances and clinically observed psychopathology. Nevertheless, quantifying mental activities and functions accurately and continuously has been a major difficulty within this field. This article reviews the latest efforts that utilize mobile apps to collect human–smartphone interaction data and contribute towards digital biomarkers of mental illnesses. The fundamental principles underlying a behavioral analysis with mobile apps were introduced, such as ways to monitor smartphone use under different circumstances and construct long-term patterns and trend changes. Examples were also provided to illustrate the potential applications of mobile apps that gain further insights into traditional research topics in occupational health and sleep medicine. We suggest that, with an optimized study design and analytical approach that accounts for technical challenges and ethical considerations, mobile apps will enhance the systemic understanding of mental illnesses.

Effects of Serving as a State Functionary on Self-Rated Health: Empirical Evidence From China

Purpose

There is a strong link between occupation and self-rated health. Existing research has revealed the effects of occupation on self-rated health outcomes and the corresponding mechanisms. However, there is a lack of research on the effects of state services on self-rated health in China. Therefore, this study focuses on exploring the effects of serving as a state functionary in China on self-rated health to enrich research in related fields.

Method

Based on the data of 14,138 individuals collected from the 2016 China Labour-Force Dynamics Survey, the logit model was used to investigate the effects of serving as a state functionary on self-rated health and the difference in the effects across different populations.

Results

The results show that (1) serving as a state functionary has a significant positive effect on self-rated health; (2) self-rated health of elderly state functionaries is higher than that of younger state functionaries; (3) self-rated health of state functionaries in non-eastern regions is higher than that of state functionaries in eastern regions; and (4) state functionaries with lower education have higher self-rated health than highly-educated state functionaries; (5) Higher self-rated health of state functionaries is achieved primarily through better work time, better work environment and lower relative deprivation.

Conclusion

Serving as a state functionary in China has a significant positive correlation with self-rated health, with differences across populations of state functionaries. This study expands the current literature on the effects of occupation on self-rated health in the context of China.

Factors associated with symptoms of poor mental health among women factory workers in China's supply chain

OBJECTIVE

Foreign direct investment (FDI) to China has motivated increased labor migration to export processing zones (EPZs). Work environments with high occupational stress, such as production line jobs typical in EPZs, have been associated with adverse mental health symptoms.

METHODS

A cross-sectional survey that examined occupational stress and symptoms of poor mental health was implemented among Chinese women factory workers in three electronic factories in the Tianjin Economic-Technological Development Area. Symptoms of mental health measured in the survey were hopelessness, depression, not feeling useful or needed, and trouble concentrating. Crude and adjusted prevalence odds ratios and their 95% confidence intervals were calculated with logistic regression.

RESULTS

Responses were collected from 696 women factory workers. Participants were aged 18-56 years (mean 28 ± 5.8), 66% of whom were married and 25% of whom were migrants. Nearly 50% of participants reported at least one symptom of poor mental health. After adjusting for covariates associated with each outcome in the bivariate analysis, high job strain was associated with hopelessness (OR 2.68, 95% CI 1.58, 4.56), not feeling useful (OR 2.05, 95% CI 1.22, 3.43), and feeling depressed (OR 1.78, 95% CI 1.16, 2.72).

CONCLUSION

This study expands on the international body of research on the well-being of women working in the global supply chain and provides evidence on the associations between occupational stressors, migration, and social support on symptoms of poor mental health among women workers. Future research to better understand and improve psychological health and to prevent suicide among workers in China's factories is critical to improve the health of China's labor force.

Mental health assessment of Spanish healthcare workers during the SARS-CoV-2 pandemic. A cross-sectional study

INTRODUCTION

The SARS-CoV-2 outbreak is posing unprecedented care scenarios, increasing the psychological distress among healthcare workers while reducing the efficiency of health systems. This work evaluated the psychological impact of the Covid-19 pandemic on Spanish frontline healthcare workers of two tertiary hospitals.

MATERIAL AND METHODS

Healthcare workers were recruited from the medical units designated for the care of Covid-19 patients. The psychological assessment consisted of an individual, face-to-face session where gold-standard psychometric tests were administered to assess stress (VASS & PSS-10), anxiety (STAI), depression (PHQ-2) and posttraumatic stress disorder (PCL-5). Regression models were also fitted to identify predictors of psychological distress.

RESULTS

Overall, almost 13% of healthcare workers showed severe anxiety, while more than 26% had high levels of perceived stress. More than 23% presented severe posttraumatic stress symptoms, and another 13% had PHQ-2 scores equal to or above 3, compatible with Major Depressive Disorder (MDD) diagnosis, respectively. Women, stress-related medication, overworking, performing in Covid-19 wards, and substance abuse were risk factors for increased psychological distress. Instead, practising exercise reduced the burden.

CONCLUSION

This study outlines the severe psychological impact of the Covid-19 pandemic on Spanish frontline healthcare workers. The stress, depression and anxiety levels found were similar to those reported in similar works but much higher than in Wuhan healthcare workers. Knowledge of risk factors for increased psychological distress may help to develop comprehensive intervention strategies to prevent, control and reduce the mental health exacerbation of healthcare workers, thereby maintaining the effectiveness of health systems in critical scenarios.

Changes in the quantity and quality of time use during the COVID-19 lockdowns in the UK: Who is the most affected?

We investigated changes in the quantity and quality of time spent on various activities in response to the COVID-19-induced national lockdowns in the UK. We examined effects both in the first national lockdown (May 2020) and the third national lockdown (March 2021). Using retrospective longitudinal time-use diary data collected from a demographically diverse sample of over 760 UK adults in both lockdowns, we found significant changes in both the quantity and quality of time spent on broad activity categories (employment, housework, leisure). Individuals spent less time on employment-related activities (in addition to a reduction in time spent commuting) and more time on housework. These effects were concentrated on individuals with young children. Individuals also spent more time doing leisure activities (e.g. hobbies) alone and conducting employment-related activities outside normal working hours, changes that were significantly correlated with decreases in overall enjoyment. Changes in quality exacerbated existing inequalities in quantity of time use, with parents of young children being disproportionately affected. These findings indicate that quality of time use is another important consideration for policy design and evaluation.

Overtime working patterns and adverse events in work-related suicide cases: hierarchical cluster analysis of national compensation data in Japan (fiscal year 2015-2016)

Background

Although various work-related adverse events affect workers’ mental health, the association between long working hours and mental disorders remains unclear. We investigated the characteristics of overtime work and work-related adverse events among all cases of compensated work-related suicide in Japan to empirically reveal the context of the serious consequences.

Methods

We analysed all 167 cases of mental disorders resulting in suicide that were compensated in fiscal year 2015–2016. Hierarchical clustering was applied to the overtime working history. Work-related adverse events were also evaluated as the qualitative aspects of their jobs.

Results

More than half of the cases committed suicide within a month of developing a mental disorder. The Administrative and professional or engineering workers had a higher suicide rate. The clustering analysis revealed chronic long working hours (19%), gradual increase (27%), or rapid increase (25%) in working hours before the onset of a mental disorder. A group of cases with less overwork experienced more interpersonal conflicts.

Conclusion

This is the first study to employ a clustering technique to objectively reveal the actual working patterns behind suicide. The patterns of working overtime before the onset of mental disorders varied considerably among the cases. Taking the transition of working overtime into account may provide clearer insight into the relationship between long working hours and workers’ mental health. These results highlight the need for countermeasures especially for causes of chronic overworking, drastic increases in working hours, and interpersonal conflicts to prevent work-related suicide.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00420-021-01760-5.

Spatiotemporal Patterns of the Use of Green Space by White-Collar Workers in Chinese Cities: A Study in Shenzhen

White-collar workers, with tremendous work pressure, excessive working hours, and poor physical condition, need green spaces not only to have physical exercise and social gatherings, but also to become closer to nature and to relieve stress for their mental health. In China, the 996 office schedule, working from 09:00 to 17:00 six days a week, has become popular in the workplace; under such high-intensity work and pressure, white-collar workers have limited time to access green space for leisure, and their use of green space for health benefits is compromised. This study selected Shenzhen Futian Central Business District to find out the green space use patterns and preferences of white-collar workers based on GPS data and questionnaire surveys. In addition, the value of green exposure in the time dimension was calculated according to individuals’ actual behaviors. Based on cluster analysis, this study summarized the typical green space use patterns of three groups of white-collar workers, which reflects the hidden inequity of white-collar groups who are subjected to varying degrees of spatiotemporal constraints in using green space. This paper puts forward three directions for the optimization of green space allocation, functional facilities, and improved walkability in employment-intensive urban areas. The results provide certain guiding significance for alleviating the mismatch of time and space in green space enjoyment and for improving the spatiotemporal inclusiveness of green spaces in urban central business districts.

Parents' Nonstandard Work and Children's Sleep: The Mediating Role of Bedtime Routines

OBJECTIVE

The present study examined if caregivers' long work hours or shift work are related to children's sleep duration through the disruption of bedtime routines.

METHOD

Work hours and schedules, bedtime routines and sleep (actigraph assessments) were examined in a sample of 250 caregivers and their preschool children.

RESULTS

Results revealed that consistent bedtime routines mediated the relationship between caregiver's work and children's sleep, such that longer hours and shift work predicted fewer routines that, in turn, predicted less child sleep.

CONCLUSION

These results point to the crucial role of bedtime routines as a promising point of intervention for working parents. While caregivers may not be able to change their work hours or schedules, they can create more stable and consistent bedtime routines to mitigate the negative effects of their work on children's sleep.

Gender differences in unpaid care work and psychological distress in the UK Covid-19 lockdown

OBJECTIVE

To describe how men and women divided childcare and housework demands during the height of the first Covid-19 lockdown in the UK, and whether these divisions were associated with worsening mental health during the pandemic.

BACKGROUND

School closures and homeworking during the Covid-19 crisis have resulted in an immediate increase in unpaid care work, which draws new attention to gender inequality in divisions of unpaid care work.

METHODS

Data come from the wave 9 (2017-19) of Understanding Society and the following April (n = 15,426) and May (n = 14,150) waves of Understanding Society Covid-19 study. Psychological distress was measured using the General Health Questionnaire (GHQ) at both before and during the lockdown, and unpaid care work was measured during the lockdown. Linear regression models were used.

RESULTS

Women spent much more time on unpaid care work than men during lockdown, and it was more likely to be the mother than the father who reduced working hours or changed employment schedules due to increased time on childcare. Women who spent long hours on housework and childcare were more likely to report increased levels of psychological distress. Working parents who adapted their work patterns increased more psychological distress than those who did not. This association was much stronger if he or she was the only member in the household who adapted their work patterns, or if she was a lone mother. Fathers increased more psychological distress if they reduced work hours but she did not, compared to neither reducing work hours.

CONCLUSION

There are continued gender inequalities in divisions of unpaid care work. Juggling home working with homeschooling and childcare as well as extra housework is likely to lead to poor mental health for people with families, particularly for lone mothers.

Gender differences in unpaid care work and psychological distress in the UK Covid-19 lockdown

OBJECTIVE

To describe how men and women divided childcare and housework demands during the height of the first Covid-19 lockdown in the UK, and whether these divisions were associated with worsening mental health during the pandemic.

BACKGROUND

School closures and homeworking during the Covid-19 crisis have resulted in an immediate increase in unpaid care work, which draws new attention to gender inequality in divisions of unpaid care work.

METHODS

Data come from the wave 9 (2017-19) of Understanding Society and the following April (n = 15,426) and May (n = 14,150) waves of Understanding Society Covid-19 study. Psychological distress was measured using the General Health Questionnaire (GHQ) at both before and during the lockdown, and unpaid care work was measured during the lockdown. Linear regression models were used.

RESULTS

Women spent much more time on unpaid care work than men during lockdown, and it was more likely to be the mother than the father who reduced working hours or changed employment schedules due to increased time on childcare. Women who spent long hours on housework and childcare were more likely to report increased levels of psychological distress. Working parents who adapted their work patterns increased more psychological distress than those who did not. This association was much stronger if he or she was the only member in the household who adapted their work patterns, or if she was a lone mother. Fathers increased more psychological distress if they reduced work hours but she did not, compared to neither reducing work hours.

CONCLUSION

There are continued gender inequalities in divisions of unpaid care work. Juggling home working with homeschooling and childcare as well as extra housework is likely to lead to poor mental health for people with families, particularly for lone mothers.

Beyond single sleep measures: A composite measure of sleep health and its associations with psychological and physical well-being in adulthood

RATIONALE

Sleep is important for many functions including body and mind restoration. Studies report the association of sleep with stress and physical deterioration, often focusing only on sleep duration; yet, sleep health needs to be understood by multiple dimensions to comprehensively capture its impact on well-being.

OBJECTIVE

This study examined cross-sectional and longitudinal associations of multidimensional sleep health with perceived stress and chronic physical conditions.

METHODS

We used a sample of 441 adults (M age = 57 years) who participated in the biomarker project of the Midlife in the United States Study. Participants provided self-report and actigraphy sleep data in 2004-2009 (T1). We created a composite score of sleep health (Range = 0-6; higher indicating more sleep problems) encompassing: actigraphy-measured regularity, timing, efficiency, duration, and self-reported satisfaction and alertness. Participants responded to the perceived stress scale and chronic physical conditions checklist at T1; chronic physical conditions were reassessed in 2013-2015 (T2).

RESULTS

Cross-sectionally, a composite score of sleep health problems was uniquely associated with higher perceived stress and more chronic conditions, explaining additional variance that each individual sleep variable did not explain. Sleep duration - one of the most commonly researched dimensions of sleep - was not associated with either perceived stress or chronic conditions. Longitudinally, for individuals who had fewer chronic conditions at T1, having more sleep health problems was associated with an increase in chronic conditions at T2. Among the multiple dimensions, sleep satisfaction was most consistently and strongly associated with the outcomes.

CONCLUSION

Findings suggest the importance of considering multiple sleep dimensions concerning psychological and physical well-being in adulthood.

Prevalence and risk factors of self-reported wrist and hand symptoms and clinically confirmed carpal tunnel syndrome among office workers in China: a cross-sectional study

Background

Carpal tunnel syndrome (CTS) is a common cause of pain, numbness and tingling in the wrist and hand region and is associated with repetitive wrist and hand use in office workers. However, scarce knowledge exists about the epidemiology of clinically confirmed CTS among Chinese office workers. This study aimed to investigate the prevalence of wrist/hand symptoms and CTS in office workers in China and to identify associated risk factors.

Methods

A cross-sectional survey was carried out in a metropolitan city in China involving 969 respondents (aged 17–49 years) from 30 workplaces. A questionnaire was distributed to each participant to collect their demographic, work-related physical and psychosocial factors, and wrist and hand symptoms. The wrist and hand pain/numbness symptoms were marked on a body chart and the nature and intensity of symptoms, nocturnal symptoms, as well as aggravating activities were also recorded. Clinically confirmed CTS cases were screened based on the history, Phalen’s test, Tinel Sign and skin sensation testing among symptomatic respondents. Logistic regression was employed to estimate the odds ratio (OR) and 95% confidence interval (95% CI) for the occurrence of self-reported wrist and hand symptoms and clinically confirmed CTS.

Results

The clinically confirmed CTS prevalence was 9.6%. The prevalence of wrist and hand symptoms were 22 and 15%, respectively. Frequently working in pain was associated with higher odds of CTS. Multivariate modelling adjusted for age and gender showed that prolonged computer use time and working without breaks were associated with presence of wrist/hand symptoms (adjusted ORs: 1.11 (95% CI 1.02–1.22) and 1.88 (95% CI 1.12–3.14)). Educational level was inversely associated with CTS and smoking was associated with wrist/hand complaints (adjusted OR: 2.20 (95% CI 1.19–4.07)).

Conclusions

The prevalence of work-related clinically confirmed CTS symptoms among young office workers in China is high. Frequently working in pain is closely associated with clinically confirmed CTS. Intense computer use and no breaks at work are associated with wrist and hand symptoms.

Depression Levels of State Functionaries: Empirical Evidence From China

This study aimed to explore the depression levels of those serving as state functionaries in China. We used data from the 2016 China Labor-force Dynamics Survey and the ordinary least squares model for the regression analysis. The results found: i) The degree of depression of state functionaries was found to be lower than that of other workers; that is, the overall depression index of state functionaries was 1.010 points lower, and the result was significant at the degree of 1%; ii) state functionaries had a lower degree of depression than workers in all other occupation groups; iii) older state functionaries had lower depression than their younger counterparts; iv) the degree of depression of state functionaries in the provinces involved in China's three major urban agglomerations was higher than that of those in other provinces; and v) the degree of depression of female state functionaries was lower than that their male peers. Thus, there is an association between serving as a state functionary in China and depression. State functionaries have lower levels of depression than other working groups. These levels were generally lower but varied according to age, sex, and province.