Meta-analytic study on substance intake and work-related accidents calls for attention to bio-psycho-social factors

Accidents at work are a major concern because of their social and economic impact. The causes are highly variable and often linked to risk behaviors that could be avoided, of which substance use is a prime example. The aim of this paper was to meta-analytically review the scientific literature on substance intake and its link to work-related accidents. From an initial pool of 19954 papers, we considered a final sample of 27 clustered in three groups according to substances class (alcohol, recreational drugs, medicines). Despite different pharmacological effects, substances consumed for recreational purposes significantly increased the risk of work-related accidents (odds ratio: alcohol 1.78, recreational drugs 1.47), whereas medicines did not: however, these results require caution due to the heterogeneity of the included studies and suspected publication bias. While bio-psycho-social factors could have helped to understand this association, selected studies neglected both the variegated effects and the root causes of recreational substance consumption. Future studies and interventions should consider these complexity factors to transcend the mere description of the phenomenon.

Impacts of presenteeism on work-related injury absence and disease absence

Background

Many studies have been conducted on presenteeism and absenteeism, but the relationship between presenteeism and absenteeism is unclear. This study was undertaken to investigate the effect of presenteeism on future absenteeism.

Methods

This study was conducted on non-white collar workers that underwent general health examinations in 2014 and 2015. We asked subjects to fill out a questionnaire about their experiences of presenteeism for the past one year in 2014. In 2015, it was checked whether the same subjects had any experience of absence from work due to injury or disease during the past year. The χ² test was used to analyze relationships between sociodemographic and occupational characteristics, presenteeism, and absence. Odds ratios (ORs) were calculated by logistic regression analysis controlled for confounding factors.

Results

A total of 12,572 workers were included in the study. For workers who experienced presenteeism, the OR for injury absence was 2.705 (95% confidence interval [CI]: 2.044-3.581), and the OR for disease absence was 4.906 (95% CI: 3.996-6.024) after adjusting for sociodemographic and occupational confounding factors. For men that experienced presenteeism, the OR for injury absence was 3.035 (95% CI: 2.258-4.081), and the OR for disease absence was 5.508 (95% CI: 4.340-6.989). For women that experienced presenteeism, the OR for injury absence was 1.322 (95% CI: 0.577-3.028), which was not significant, and the OR for disease absence was 3.629 (95% CI: 2.405-5.475).

Conclusions

This study suggests that presenteeism can influence future absenteeism. The effect of presenteeism may depend on cause of absence. Men who experienced presenteeism showed greater effects on injury and disease absence than women. For women, experience of presenteeism had a significant effect on disease absence but not on injury absence.

Chronic Diseases and Labor Force Participation Among Presenile and Senile Chinese

Background: The incidence of chronic diseases has increased dramatically due to rapid aging and lifestyle changes of China in recent decades. The population aged more than 45 years is an important participant in the labor force market, and the health status directly affects their labor force participation decision. This study aims to explore the relationship between chronic diseases and the labor force participation among the elderly Chinese population aged more than 45 years.

Method: We employ a multivariate probit (MVP) model to construct five structural equations for an analysis. The advantage of this model is that it can deal with the endogeneity of chronic diseases.

Results: Firstly, compared with the elderly, younger people are more likely to participate in the labor force market; the influence of chronic diseases is the largest for presenile women in the decision-making of labor force participation; the impact of psychological problems on labor force participation cannot be ignored, especially for men aged more than 45 years. In addition, sociodemographic factors such as geographical location and marital status also have direct effects on the probability of labor force participation while the impact of both family wealth and family number is much smaller. Finally, unhealthy lifestyles through chronic diseases have negative and indirect marginal effects on labor force participation.

Conclusions: This article proves that chronic diseases have a negative impact on the labor force participation for Chinese aged more than 45 years. The public should give more tolerance and opportunities to these groups. The population aged more than 45 years are more vulnerable and face more psychological problems, which will lead to a decline in labor force participation. Psychological health counseling and services are urgently needed. As the urban areas enjoy more social welfare, Chinese welfare policy needs to be tilted toward the rural elderly. For individuals, maintaining healthy lifestyles can help you stay away from chronic diseases and stay in the labor force market.

Pain intensity, alcohol use motives, and alcohol use among firefighters: The moderating role of pain-related anxiety

Firefighters are an understudied population that reports high rates of alcohol use and hazardous drinking. Pain, which is also commonly experienced by firefighters, may be associated with alcohol use and alcohol use motives, as research among the general population suggests that pain is associated with coping-oriented drinking. Pain-related anxiety, reflecting a tendency to respond to pain with anxiety or fear, may link pain to coping-oriented drinking among firefighters. Therefore, the current study examined the moderating role of pain-related anxiety on the association between pain intensity and alcohol use motives as well as alcohol use severity. The sample was comprised of 189 (M_age = 40.33, SD = 9.97, 89.9% male) firefighters. Results from the current study supported a significant moderation effect of pain-related anxiety on the association between pain intensity and alcohol use coping motives, whereby the association between pain intensity and coping motives was stronger for those with high compared to low pain-related anxiety. No significant moderation effects were documented for social, enhancement, or conformity motives; and no significant moderation effect was found for alcohol use severity. These results highlighted the potential importance of pain intensity and pain-related anxiety in coping-oriented alcohol use among firefighters.

Characteristics of Workplace Injuries among Nineteen Thousand Korean Firefighters

To determine the actual firefighter injury statistics in Korea, we conducted a survey on the nature of on-duty injuries among all male firefighters in Korea. We distributed questionnaires to all Korean male firefighters via email, and data from the 19,119 workers that responded were used for data analysis. The job types were categorized into fire suppression, emergency medical service (EMS) and officers. As estimated of age standardized injury prevalence per one thousand workers, 354 fire extinguishing personnel, 533 EMS workers, and 228 officers experienced one or more injuries during the previous 12 months. The odds ratio (95% confidence interval) of injuries was 1.86 (1.61-2.15) for fire suppression and 2.93 (2.51-3.42) for EMS personnel compared to officers after adjusting for age, marital status, smoking habit and career period. Age standardized absence days from work due to injuries per one thousand workers were 1,120, 1,337, and 676 for fire suppression, EMS and officers, respectively. Car accident (24.5%) was the most common cause and wound (42.3%) was the most common type of injuries. Our nationwide representative study showed that fire suppression and EMS workers are at greater risk of on-duty injuries compared to officers. We observed different injury characteristics compared to those reported in other countries.

Occupational Injuries in Germany: Population-Wide National Survey Data Emphasize the Importance of Work-Related Factors

Unintentional injuries cause much of the global mortality burden, with the workplace being a common accident setting. Even in high-income economies, occupational injury figures remain remarkably high. Because risk factors for occupational injuries are prone to confounding, the present research takes a comprehensive approach. To better understand the occurrence of occupational injuries, sociodemographic factors and work- and health-related factors are tested simultaneously. Thus, the present analysis aims to develop a comprehensive epidemiological model that facilitates the explanation of varying injury rates in the workplace. The representative phone survey German Health Update 2010 provides information on medically treated occupational injuries sustained in the year prior to the interview. Data were collected on sociodemographics, occupation, working conditions, health-related behaviors, and chronic diseases. For the economically active population (18-70 years, n = 14,041), the 12-month prevalence of occupational injuries was calculated with a 95% confidence interval (CI). Blockwise multiple logistic regression was applied to successively include different groups of variables. Overall, 2.8% (95% CI 2.4-3.2) of the gainfully employed population report at least one occupational injury (women: 0.9%; 95% CI 0.7-1.2; men: 4.3%; 95% CI 3.7-5.0). In the fully adjusted model, male gender (OR 3.16) and age 18-29 (OR 1.54), as well as agricultural (OR 5.40), technical (OR 3.41), skilled service (OR 4.24) or manual (OR 5.12), and unskilled service (OR 3.13) or manual (OR 4.97) occupations are associated with higher chances of occupational injuries. The same holds for frequent stressors such as heavy carrying (OR 1.78), working in awkward postures (OR 1.46), environmental stress (OR 1.48), and working under pressure (OR 1.41). Among health-related variables, physical inactivity (OR 1.47) and obesity (OR 1.73) present a significantly higher chance of occupational injuries. While the odds for most work-related factors were as expected, the associations for health-related factors such as smoking, drinking, and chronic diseases were rather weak. In part, this may be due to context-specific factors such as safety and workplace regulations in high-income countries like Germany. This assumption could guide further research, taking a multi-level approach to international comparisons.

Chronic diseases and functional limitations among older construction workers in the United States: a 10-year follow-up study

OBJECTIVES

To examine the health status of older construction workers in the United States, and how occupation and the aging process affect health in workers' later years.

METHODS

We analyzed six waves (1998 to 2008) of the Health and Retirement Study, a longitudinal survey of US residents age 50+. The study sample totaled 7200 male workers (510 in construction trades) in the baseline. Multiple logistic regression and paired t tests were conducted to compare health outcomes across occupations and within individuals over time.

RESULTS

Compared with white-collar workers, construction workers had increased odds of arthritis, back problems, chronic lung disease, functional limitations, work disability, and work-related injuries after controlling for possible confounders.

CONCLUSIONS

Safety and health interventions, as well as retirement and pension policy, should meet the needs of older construction workers, who face increasingly chronic health conditions over time.

Work and high-risk alcohol consumption in the Canadian workforce

This study examined the associations between occupational groups; work-organization conditions based on task design; demands, social relations, and gratifications; and weekly high-risk alcohol consumption among Canadian workers. A secondary data analysis was performed on Cycle 2.1 of the Canadian Community Health Survey conducted by Statistics Canada in 2003. The sample consisted of 76,136 employees 15 years of age and older nested in 2,451 neighbourhoods. High-risk alcohol consumption is defined in accordance with Canadian guidelines for weekly low-risk alcohol consumption. The prevalence of weekly high-risk alcohol consumption is estimated to be 8.1% among workers. The results obtained using multilevel logistic regression analysis suggest that increased work hours and job insecurity are associated with elevated odds of high-risk alcohol consumption. Gender female, older age, being in couple and living with children associated with lower odds of high-risk drinking, while increased education, smoking, physical activities, and, and economic status were associated with higher odds. High-risk drinking varied between neighbourhoods, and gender moderates the contribution of physical demands. The results suggest that work made a limited contribution and non-work factors a greater contribution to weekly high-risk alcohol consumption. Limits and implications of these results are discussed.

Occupation, work organization conditions, and alcohol misuse in Canada: an 8-year longitudinal study

This study investigated the specific contribution of occupations and work organization conditions to the onset and recurrent alcohol misuse in Canadian workers between 1994-1995 and 2002-2003. Longitudinal data were derived from Statistics Canada's National Population Health Survey, totaling 6,526 and 6,582 workers (45% females) nested in 1,337 and 1,413 neighborhoods for onset and recurrent alcohol misuse, respectively. Data were analyzed with multilevel logistic regression models. Results suggested a limited contribution for work factors to the onset of alcohol misuse, a stronger influence for them on recurrent alcohol misuse. The study's limitations are discussed.

The Short‐Term Effects and Unintended Long‐Term Consequences of Binge Drinking in College: A 10‐Year Follow‐Up Study

This study addresses binge drinking in college as a risk factor for heavy drinking and alcohol dependence after college. A national probability sample of 1972 college students from the National Longitudinal Surveys of Youth (NLSY79) was interviewed in 1984 and reinterviewed again as adults in 1994. The short-term effects of binge drinking in college were assessed as well as the extent to which experiences of negative effects in college predicted patterns of alcohol use across the transition from college into postcollege years. As expected, college binge drinkers were comparatively more likely than nonbinge drinkers to experience one or more alcohol-related problems while in college. In addition, weighted estimates of DSM-IV-defined diagnostic criteria in logistic regression models indicated that the binge drinking patterns exhibited during the college years, for some former college students of both genders, posed significant risk factors for alcohol dependence and abuse 10 years after the initial interview, in conjunction with evidence of academic attrition, early departure from college and less favorable labor market outcomes.

Substance Abuse and the Uninsured Worker in the United States

Although millions of US workers lack health insurance, the relationship of insurance coverage with substance abuse and access to workplace treatment services remains unexplored. Our analysis shows uninsured workers have higher rates of heavy drinking and illicit drug use than insured workers. Young and part-time workers are, moreover, less likely to have insurance coverage than workers with lower substance abuse risks. Compared to the insured, uninsured workers have less access to employee assistance programs (EAPs) and less drug and alcohol testing by employers. The effectiveness of workplace substance abuse programs and policies designed for insured populations is untested among uninsured workers. Issues include EAP effectiveness with referrals to public treatment and the return on investment for adding coverage of substance abuse treatment. Workers in countries with universal health insurance but inadequate treatment capacity may face similar problems to uninsured workers in the US.

Characterizing alcohol dependence: transitions during young and middle adulthood

Community and high-risk sample studies suggest that alcohol dependence is relatively stable and chronic. By contrast, epidemiological studies demonstrate a strong age-graded decline whereby alcohol dependence tends to peak in early adulthood and declines thereafter. The authors identified the latent trajectory structure of past-year alcohol dependence to investigate (a) whether the syndrome is characterized by symptom profiles and (b) the extent to which the syndrome is stable and persistent. Data from current drinkers (N = 4,003) in the National Longitudinal Survey of Youth were analyzed across two waves: 1989 (ages 24-32 years) and 1994 (ages 29-37 years). Three classes of alcohol dependence were observed; symptom endorsement probabilities increased across successively severe classes. Latent transition analyses showed high rates of stability, supporting alcohol dependence as a relatively chronic condition. Although there was evidence of progression to more severe dependence, there was greater syndrome remission. Trajectory classes and transition probabilities were generalizable across race and sex and, to a lesser extent, age cohort and family history of alcoholism.

The relationship between safety climate and injury rates across industries: the need to adjust for injury hazards

Previous studies have suggested that strong safety climates (shared perceptions of safe conducts at work) are associated with lower workplace-injury rates, but they rarely control for differences in industry hazards. Based on 33 companies, we assessed its association with injury rates using three rate based injury measures (claims per 100 employees, claims per 100,000 h worked, and claims per 1 million US dollars payroll), which were derived from workers' compensation injury claims. Linear regression models were used to test the predictability of safety climate on injury rates, followed by controlling for differences in hazard across industries gauged by national industry-specific injury rates. In the unadjusted model, company level safety climate were negatively and significantly associated with injury rates. However, all of the above associations were no longer apparent when controlling for the hazardousness of the specific industry. These findings may be due to over adjustment of hazard risk, or the overwhelming effects of industry specific hazards relative to safety climate effects that could not be differentiated with the statistical power in our study. Industry differences in hazard, conceptualized as one type of injury risk, however need to be considered when testing the association between safety climate and injury across different industries.

Gender, occupational, and socioeconomic correlates of alcohol and drug abuse among U.S. rural, metropolitan, and urban residents

OBJECTIVE

To estimate the prevalence and correlates of alcohol and drug abuse and dependence among rural, urban, and metropolitan U.S. residents.

METHODS

The National Comorbidity Survey (NCS) (1990-1992) yielded lifetime risks of psychiatric disorders in a probability sample of 8098 respondents in the 48 contiguous states using DSM-III-R for diagnosis. Logistic regressions of alcohol and drug disorders were performed to compare their correlates in rural, urban, and metropolitan areas after stratifying by demographic and socioeconomic variables.

RESULTS

Household income was protective only in rural areas. High occupation strata were positively associated with alcohol disorders. Urban and metropolitan women were less likely to report drug disorders. There was no gender difference in rural drug abuse and dependence. Also, high occupation strata were positively associated with drug disorders.

CONCLUSION

Lack of gender differences in rural drug disorders may indicate an increase in drug availability, access, and use among rural women. Workplace alcohol and drug disorders, especially among metropolitan sales, crafts, and service workers should be of concern to policymakers. These results underline the usefulness of using multiple indicators of socioeconomic positions in epidemiologic studies of substance use disorders.

Chronic medical conditions and work performance in the health and work performance questionnaire calibration surveys

Associations between chronic conditions and work performance (absenteeism, presenteeism, and critical incidents) were studied in reservation agents, customer service representatives, executives, and railroad engineers. Conditions and work performance were assessed with the World Health Organization's Health and Work Performance Questionnaire. Analysis of covariance was used to estimate associations. More work performance was lost from presenteeism than absenteeism. However, chronic conditions more consistently had negative impacts on absenteeism than presenteeism. Conditions with significant effects included arthritis, asthma, chronic obstructive pulmonary disease-emphysema, depression, and chronic headaches. Arthritis had the largest aggregate effect on absenteeism-presenteeism. Only depression affected both absenteeism-presenteeism and critical incidents. Some chronic conditions have substantial workplace effects. Disease management programs for these conditions might have a positive return on investment (ROI). Health and productivity tracking surveys are needed to evaluate ROI and provide quality assurance.

Alcohol consumption patterns and work-related injuries among Colorado farm residents

BACKGROUND

Few studies have assessed the relationship between alcohol consumption patterns among farm populations and work-related injuries. The purpose of this study was to assess the role of alcohol consumption patterns on farmwork-related injuries.

METHODS

Prospective cohort study of Colorado farm residents, 1993 to 1995. Self-reported injuries, alcohol consumption, and demographics were assessed over 3 years. A stratified probability sample of farms was selected to include approximately 2.6% of Colorado farm residences with a farm operator living on the property. A total of 485 farms, including 872 individuals, were recruited in the initial cohort. In the second year, 746 individuals were re-interviewed, and in the third year, 653 of the original group participated.

RESULTS

Injuries during the study period were assessed in relationship to alcohol consumption. During the 3 years, 150 farm residents reported a total of 215 farmwork-related injuries. An increased risk of injury was associated with increased alcohol consumption. Compared to abstainers, farm residents who drank more frequently had higher farmwork injury incidence rates (3.09 and 3.35 injuries per 10,000 person-days of observation versus 1.94 injuries per 10,000). Farm residents who typically drank three or more drinks per day had a farmwork injury rate of 3.62 per 10,000 person-days (95% confidence interval [CI]=2.38-4.85). Farm residents who typically drank one to two drinks per day had a farmwork-related injury rate of 3.02 per 10,000 person-days (95% CI=2.44-3.60). In multivariate models, alcohol consumption frequency and quantity were significantly associated with farmwork-related injuries.

CONCLUSIONS

Alcohol consumption should be considered in studies of agricultural injuries.