Understanding coastal public health: Employment, behavioural and psychosocial factors associated with geographical inequalities. The HUNT study, Norway

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.

Factor structure and measurement invariance of the psychosocial risk factors inventory of NOM-035-STPS-2018

The primary objective of this study was to analyze the psychometric properties of the Inventory for the Identification and Analysis of Psychosocial Risk Factors (IIA-PRF) of Reference Guide III proposed in NOM-035-STPS-2018. A total of 2,149 workers in Baja California, Mexico's industrial and education-government sectors, were administered an online inventory version. Preliminary analyses were performed, as well as a Confirmatory Factor Analysis (CFA) based on two models proposed by the standard itself: an eight-factor model (8-FM) and a four-factor model (4-FM). Likewise, based on the results and with the recommendations of the specialists, a threefactor model (3-FM) was proposed. In addition, nested model sequencing methods were subsequently applied to validate the invariance between the origin of the activity. The dimensionality of 3-FM was found to have adequate fit values according to a-priori established criteria. It is concluded that the IIAPRF does not have the reliability and validity parameters necessary to support interpretations, uses and consequences based on the theoretical structure established by NOM-035-STPS-2018 and that, although the 3-FM presents better reliability and validity indices, it is not invariant in terms of the origin of the activity. Finally, we discuss the implications and recommend reviewing and adjusting the design of the IIAPRF items to extend the measurement of invariance to other groups of relevance for decision making in the improvement of the work environment.

Psychosocial risk factors identification in Mexican workers and RGIII validation

BACKGROUND

Since 2018, NOM-035-STPS-2018 has been applied in Mexico, focused on measuring psychosocial risk factors (PRFs) in workers and the Reference Guide III (RGIII) has been presented, however, research focused on its validation has been scarce, in very specific sectors and with small samples.

OBJECTIVE

Determine the levels of PRFs of five work centers and reliability and validity aspects of RGIII.

METHOD

The RGIII was applied to 1458 workers (806 women and 652 men) from five workplace in the industrial sector of Ensenada (Mexico), and the level of risk of the PRFs was analyzed, as well as their reliability and validity through Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA).

RESULTS

The PRFs with medium, high and very high-risk levels are Workload, Lack of control over work and Workday. The RGIII presents adequate reliability with Cronbach's α, Alpha ordinal RHO and Omega of 0.93, 0.95 and 0.95, respectively. The EFA shows all five subscales maintain factor loadings greater than 0.43, although Leadership and relationships at work has better saturation values, and Work environment ended with only three items. The CFA indicates Leadership and work relationships with a Root Mean Square Error of Approximation (RMSEA) goodness of fit index of 0.072.

CONCLUSION

The RGIII allows the identification and evaluation of the level of risk of PRFs. It complies with sufficient internal consistency. It does not have a clear factorial structure, because it does not meet the minimum values of goodness-of-fit indexes that would allow confirming the structure proposed in RGIII.

Childhood hearing impairment and fertility in Norway

There is a lack of studies assessing how hearing impairment relates to reproductive outcomes. We examined whether childhood hearing impairment (HI) affects reproductive patterns based on longitudinal Norwegian population level data for birth cohorts 1940-1980. We used Poisson regression to estimate the association between the number of children ever born and HI. The association with childlessness is estimated by a logit model. As a robustness check, we also estimated family fixed effects Poisson and logit models. Hearing was assessed at ages 7, 10 and 13, and reproduction was observed at adult ages until 2014. Air conduction hearing threshold levels were obtained by pure-tone audiometry at eight frequencies from 0.25 to 8 kHz. Fertility data were collected from Norwegian administrative registers. The combined dataset size was N = 50,022. Our analyses reveal that HI in childhood is associated with lower fertility in adulthood, especially for men. The proportion of childless individuals among those with childhood HI was almost twice as large as that of individuals with normal childhood hearing (20.8% vs. 10.7%). The negative association is robust to the inclusion of family fixed effects in the model that allow to control for the unobserved heterogeneity that are shared between siblings, including factors related to the upbringing and parent characteristics. Less family support in later life could add to the health challenges faced by those with HI. More attention should be given to how fertility relates to HI.

Trends in absolute and relative educational inequalities in health during times of labour market restructuring in coastal areas: The HUNT Study, Norway

BACKGROUND

Restructuring labour markets offers natural population-level experiments of great social epidemiological interest. Many coastal areas have endured substantial restructuring of their local labour markets following declines in small-scale fishing and transitions to new employment opportunities. It is unknown how educational inequalities in health have developed in formerly fishery-dependent communities during such restructuring. In this study, we compare trends in social inequalities in health in Norwegian coastal areas with adjacent geographical areas between 1984 and 2019.

METHODS

We used cross-sectional population-based data from the Trøndelag Health Study (HUNT), collected four times: HUNT1 (1984-86), HUNT2 (1995-97), HUNT3 (2006-08) and HUNT4 (2017-19). Adults above 30 years of age were included. Using Poisson regression, we calculated absolute and relative educational inequalities in self-rated health, using slope (SII) and relative (RII) indices of inequality.

RESULTS

Trends in absolute and relative inequalities in rural coastal health were generally more favourable than in adjacent geographical areas. We found a statistically significant trend of declining relative educational inequalities in self-rated health in the rural coastal population from HUNT1 to HUNT4. Absolute inequalities overall increased from HUNT1 to HUNT4, although a declining trend followed HUNT2. Nonetheless, the rural coastal population exhibited the highest prevalence of poor self-rated health across the four decades.

CONCLUSIONS

Although absolute educational inequalities in self-rated health widened in all geographical areas, the smallest increase was in rural coastal areas. Relative educational inequalities narrowed in this rural coastal population. Considering the concurrent processes of large-scale investments in the Norwegian public sector and welfare schemes, increased fishing fleet safety, and employment opportunities in aquaculture, our findings do not suggest that potential positive effects on public health of this restructuring have benefitted inhabitants with higher educational attainment more than inhabitants with lower educational attainment in this rural coastal population.