Perceived work conditions and work-related symptoms among employed Finns

Does the threshold for reporting musculoskeletal pain or the probability of attributing work-relatedness vary by socioeconomic position or sex?

OBJECTIVE

To examine the effect of sex and socioeconomic position (SEP) on individuals' perceptions of pain and its work-relatedness.

METHODS

We compared self-reported pain in neck-shoulder or arm with clinical diagnoses and workers' judgments of work-relatedness with physicians' assessments based on specific criteria, between sexes and high- and low-SEP participants in the Oslo Health Study (n = 217).

RESULTS

Clinical diagnoses were more frequent in low-SEP subjects than high-SEP subjects with pain and generally higher in women than in men. Pain attributed to work was more frequently assessed as work-related by the physicians in low-SEP subjects than high-SEP subjects and in men than in women of low SEP.

CONCLUSIONS

The threshold for reporting pain seemed higher in low-SEP subjects and among women. Physicians were more likely to agree with low-SEP workers about work-relatedness.

Self-reported work-related health problems from the Oslo Health Study

BACKGROUND

Lack of knowledge about the occurrence of work-related health problems in the general population makes it difficult to estimate the potential for their prevention in the workplace.

AIMS

To examine the prevalence of self-reported work-related health problems among adult citizens of Oslo, Norway.

METHODS

The study was part of the Oslo Health Study 2000-2001, in which all individuals in certain age cohorts were invited to a comprehensive health screening. All 30-, 40- and 45-year old subjects who attended the screening were asked if they had experienced any of 11 common health problems in the past month, and whether they considered these to be work-related. Of the 26,074 invitees in these age cohorts, 8,594 (33%) answered the questionnaire.

RESULTS

Nearly 60% of subjects reported one or more work-related health problems, most commonly reported were pain in the neck/shoulders (38%) and low back pain (23%). Neck/shoulder pain was most frequently attributed to working conditions, by 74% of subjects with this problem; followed by arm pain (72%), fatigue (51%) and low back pain (50%). Work-related fractions for eczema and asthma symptoms were 23 and 18%, respectively. There were marked gender differences, but small age differences.

CONCLUSIONS

A substantial proportion of common health problems in the Oslo population were attributed to working conditions. This implies a large preventive potential and call for increased preventive efforts targeted at known risk factors in the workplace.

Modifying effects of perceived adaptation to shift work on health, wellbeing, and alertness on the job among nuclear power plant operators

This study examined the relationship between perceived adaptation to shift work and shift-related problems. A total of 608 male operators at nuclear power plants completed a set of validated questionnaires including a modified version of the Standard Shiftwork Index, which covered adaptation to shift work, fit to job content, chronotypes, chronic fatigue, sleep, naps, shift work locus of control (SHLOC), psychological health, social/family life, daytime sleepiness, workload, alertness on the job, and lifestyle factors. Participants were divided into two groups according to their perceived level of adaptation to shift work. The good adaptation group showed better outcomes than the poor adaptation group in terms of fit to job content, chronic fatigue, daytime sleep before night shifts, social and family disruption, SHLOC, psychological health, and alertness during night shifts (ps<0.001). Operators who reported good adaptation also took a more frequent, longer nap and more cigarettes during night shifts (ps<0.05). The cross-sectional study design cannot determine a causal relationship between perceived adaptation and shift work problems, yet the present results suggest that the effects of working shifts may be modified by perceptions of shift work adaptation.

Perceived physical demands and reported musculoskeletal problems in registered nurses

BACKGROUND

Nursing is physically demanding, and nurses have higher rates of musculoskeletal disorders (MSDs) than most other occupational groups. The physical demands of nursing may lead some nurses to leave the profession, contributing to the shortage of registered nurses in many workplaces that is a major concern today. As a first step toward reducing MSDs and their consequences, this study was designed to examine the relationship between perceived physical demands and reported neck, shoulder, and back MSDs in nurses.

METHODS

Data were collected anonymously from 1163 randomly selected working nurses (74% response rate) using a cross-sectional survey. The 12-item survey scale (internal reliability coefficient=0.89), rated perceived physical demands such as force, awkward postures, and heavy lifting. Nurses with a presumed MSD case reported relevant past-year symptoms in the neck, shoulder, and/or back lasting >or=1 weeks, or at least monthly, with moderate or more pain, on average.

RESULTS

Moderate and high perceived physical demands were significantly associated with reported neck, shoulder, and back MSD cases, even after adjustments for demographic and lifestyle-related covariates. Adjusted odds ratios for highly demanding work (vs low) ranged from 4.98 to 6.13 depending on body site. When analyses were restricted to staff nurses only, the odds ranged from 9.05 to 11.99.

CONCLUSIONS

Perceived physical demands are associated with reported MSD in registered nurses, and the association is stronger in staff nurses.

The social ecology of health: leverage points and linkages

The authors demonstrate the usefulness of social ecology theory for improving the treatment and prevention of poor health. The social ecology of health, unlike the topics of previous triptychs in Behavioral Medicine, is a field without a clearly defined body of literature. We begin with an overview of the ecological perspective and ecological theory as outlined by Bronfenbrenner and colleagues, provide examples of how ecological concepts have been demonstrated to influence health, and discuss how these concepts can be used by health professionals. We present a heuristic model illustrating leverage points and linkages (i.e., socioeconomic status, family, work, and school), for health, and we conclude with a consideration of the benefits of social ecology to health professionals and a summary of the limitations of the ecological model.

The effect of disease prevention and health promotion on workplace productivity: a literature review

This report was prepared by the Center for Disease Prevention and Health Promotion in the Institute for Health and Productivity Management as part of an effort to improve understanding of the connection between employee health and performance and to begin to identify new strategies through which treating health as an investment in human capital can lead to greater business success. Computer database searches of peer-reviewed literature published between 1993 and 1998 and manual reviews of 20 journals were used to identify research on the link between employee health and performance. Data was extracted to summarize the overall findings on the magnitude of health problems addressed by health promotion and disease prevention programs, and the impact of interventions on improving health risk, reducing medical care cost, and improving worker performance. From this summary, major conclusions on early detection of disease, the impact of behavior change programs, and appropriate care-seeking were drawn. This systematic review is supplemented with summaries of 15 seminal articles and descriptions of five leading-practices programs. The influence of developments in work/family issues, complementary and alternative medicine, and quality of care and health outcomes research are briefly discussed. Finally, a conceptual framework for studying the impact of health and productivity is described.

Noise and health in the urban environment

Noise, including noise from transport, industry, and neighbors, is a prominent feature of the urban environment. This paper reviews the effects of environmental noise on the non-auditory aspects of health in urban settings. Exposure to transport noise disturbs sleep in the laboratory, but generally not in field studies, where adaptation occurs. Noise interferes with complex task performance, modifies social behavior, and causes annoyance. Studies of occupational noise exposure suggest an association with hypertension, whereas community studies show only weak relations between noise and cardiovascular disease. Aircraft and road-traffic noise exposure are associated with psychological symptoms and with the use of psychotropic medication, but not with the onset of clinically defined psychiatric disorders. In carefully controlled studies, noise exposure does not seem to be related to low birth weight or to congenital birth defects. In both industrial studies and community studies, noise exposure is related to increased catecholamine secretion. In children, chronic aircraft noise exposure impairs reading comprehension and long-term memory and may be associated with increased blood pressure. Noise from neighbors causes annoyance and sleep and activity interference health effects have been little studied. Further research is needed for examining coping strategies and the possible health consequences of adaptation to noise.