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Kyriakidis S, Rasmussen CL, Søgaard K, Holtermann A, Rasmussen CDN, Gupta N. The "sweet- and sour-spot" of occupational physical activity for back pain: a prospective accelerometer study among eldercare workers. Scand J Work Environ Health 2024; 50:341-350. [PMID: 38874546 PMCID: PMC11239222 DOI: 10.5271/sjweh.4170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Indexed: 06/15/2024] Open
Abstract
OBJECTIVES Both high and low levels of occupational physical activity are associated with back pain. Thus, there might be a "sweet- and sour-spot" of occupational physical activity for back pain. Our aim was to investigate if there exists an occupational physical activity "sweet- (lowest risk) and sour-spot" (highest risk) for back pain. METHODS A total of 396 eldercare workers from 20 Danish nursing homes participated. Occupational physical activity was measured between 1-4 working days using thigh-worn accelerometry. Back pain intensity was reported monthly on a scale from 0-10 over 1-year. A zero-inflated mixed-effects model was developed regressing occupational physical activity against back pain, adjusted for confounders. The "sweet- and sour-spot" were defined as the occupational physical activity compositions (sitting, standing, light, and moderate-to-vigorous) associated with the 5% lowest and highest risk for back pain, respectively. RESULTS The composition associated with the lowest risk of back pain - the "sweet-spot"- consisted of 71% worktime spent sitting, 18% spent standing, 5% spent on light physical activity and 6% spent on moderate-to-vigorous physical activity. The composition associated with highest risk for back pain -the "sour-spot"- consisted of 8% worktime spent sitting, 66% spent standing, 4% spent on light physical activity, and 21% spent on moderate-to-vigorous physical activity. CONCLUSIONS The "sweet-spot" of occupational physical activity for back pain among eldercare workers involves more sitting and light physical activity time, while the "sour-spot" involves more standing and moderate-to-vigorous physical activity time. Research on the occupational physical activity "sweet- and sour-spot" is needed.
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Affiliation(s)
- Stavros Kyriakidis
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 København Ø, Copenhagen, Denmark.
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Alkaabi FA, Maghelal PK. Early retirement intentions among Abu Dhabi Police: investigating the role of psychosocial work factors and sickness absenteeism. BMC Public Health 2023; 23:1221. [PMID: 37353845 PMCID: PMC10288693 DOI: 10.1186/s12889-023-16129-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/15/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND Police departments are encouraged to integrate their health and safety management systems with the operational arrangements to demonstrate commitment to the improvement of working environment in the police is by the collection and analysis of occupational health data such as sickness absence and early retirement intention. METHODS About 760 responses to the Occupational Health and Safety Survey by the Abu Dhabi Police employees was used to analyse the early retirement intentions considering the work-related factors and sickness absence data. RESULTS Logistic regression results of the unadjusted model reported higher odds that lower levels of co-worker support, supervisor support, workplace support related to intentions of early retirement. Also, unfavourable perception of health management increases the odds to early retirement among the employees. CONCLUSION The outcome of this study provides insights into the determinants of early retirement intentions in the less explored region of middle-east, specifically in Abu Dhabi. Thorough analysis of such data will help police organisations to prioritise plans and improve the health and wellbeing of officers, in turn contributing to strengthening the fight against crime and minimizing the number of occupational injuries and premature exit from paid work.
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Physical activity and gender buffer the association of retirement with functional impairment in Ghana. Sci Rep 2022; 12:12832. [PMID: 35896681 PMCID: PMC9329384 DOI: 10.1038/s41598-022-17178-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 07/21/2022] [Indexed: 11/30/2022] Open
Abstract
Females on average live longer but with higher rates of functional impairment and lower physical and economic activities than men. However, research linking retirement to functional impairment and the modifying role of gender and physical activity (PA) is limited especially in low- and middle-income countries. This paper examines the association between retirement and functional impairment in Ghana and evaluates the effect modification of the association by gender and PA. The sample included 1201 adults aged ≥ 50 years from a population-based study. Functional impairment was assessed with the activities of daily living scale. Ordinary least squares regression models adjusted for confounding variables and estimated gender-wise and PA heterogeneity effect of retirement on functional impairment. Regressions showed that retirement predicted an increase in functional impairment score in the full sample (β = .76, p < .001) and in men (β = 1.96, p < .001), but not in women. Interestingly, retirement significantly increased functional impairment in ≥ 65 age cohort (full sample: β = .71, p < .005; men: β = 1.86, p < .001) although not in women. However, the effect was significantly moderated by PA such that retirement × PA predicted a decrease in functional impairment in the full sample (β = −.81, p < .005) and the ≥ 65 age group (β = −.43, p < .005). Functional impairment risk of retirement is gender-specific, but PA buffers the relationship. Retirement is generally commonplace, but these findings imply that promoting PA may hold promise for addressing functional impairment in old age. Attending to the physical health needs of men during retirement should be a social policy priority.
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Alkaabi FA. Predicting disability retirement among Abu Dhabi police using multiple measure of sickness absence. BMC Public Health 2022; 22:1318. [PMID: 35810280 PMCID: PMC9270810 DOI: 10.1186/s12889-022-13713-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 06/24/2022] [Indexed: 11/15/2022] Open
Abstract
Background Disability retirement has been investigated in the last two decades using predictors such as measures of sickness absence, psychological, social, and organizational work factors. The impact of various health-related and sickness measures on disability retirement across various occupational group reveal a significant relation. However, current literature lacks understanding in police personnel. Methods This study examines the roles of demographic and measures of sickness absence on disability retirement among police personnel in Abu Dhabi, UAE. The case–control design was used to predict disability retirement wherein controls were matched with cases according to age and gender from those who worked in the same administration as the case at baseline, to reduce the possible confounding influence of these variables. Conditional logistic regression models were used determine the odds-ratio of various measures of sickness absence in predicting disability retirement. Results Results indicate that increased number of spells, and number of days of sickness absence can predict disability retirements among police personnel in the UAE. Results indicate that odds ratios for disability retirement for the total exposure period increased from 1.76 (95% CI = 1.42-2.20) for spells of 4-7d to 2.47 (95%CI = 1.79-3.40) for spells of > 4 weeks. When compared with their married counterparts, non-married police employees had a statistically significant increase in odds of disability retirement of almost three fold (OR = 2.93, 95% CI = 1.55-5.56). Non-field and field police officers, on the other hand, had significantly reduced odds of disability retirement compared with admin/supportive staff (OR = 0.43 and 0.28 with 95% CI = 0.19-0.96 and 0.13-0.61 respectively). Odds ratios of disability retirement at end of the exposure period for the matching variables with those obtained after additionally adjusting for all demographic variables (model b), namely, marital status, occupation, employment grade and type, and educational level. The odds ratios of disability retirement remained significantly raised for the total number of days of sickness absence and for the number of spells of sickness absence for all spell types. Conclusions Recommendation to reduce the number of future disability retirements among Abu Dhabi Police include structured problem-solving process addressed through stepwise meetings between the line-managers and the employee.
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d'Errico A, Falkstedt D, Almroth M, Badarin K, Hemmingsson T, Kjellberg K. Long-term sick leave for back pain, exposure to physical workload and psychosocial factors at work, and risk of disability and early-age retirement among aged Swedish workers. Int Arch Occup Environ Health 2022; 95:1521-1535. [PMID: 35451628 PMCID: PMC9424129 DOI: 10.1007/s00420-022-01862-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 03/27/2022] [Indexed: 11/30/2022]
Abstract
Purpose To assess the risk of disability and early-age retirement associated with previous long-term sickness absence for back pain (back-pain SA), exposure to high physical workload, low job control, high demands and high strain, and to evaluate effect modification by work factors on the relationship between back-pain SA and premature retirement. Methods All employed Swedish residents born 1946–1955 (n = 835,956) were followed up from 2010 to 2016 for disability (DP) and early-age pension (EAP). Associations of premature retirement with exposure to work factors and back-pain SA in the 3 years before follow-up were estimated through proportional hazards models. Retirement, back-pain SA and covariates were assessed through administrative sources, and exposure to work factors through a job-exposure matrix. Results In both genders, back-pain SA was associated with DP (> 1 episode: HR 3.23 among men; HR 3.12 among women) and EAP (> 1 episode: HR 1.24 among men; HR 1.18 among women). Higher physical workload and lower job control were also associated with an increased DP risk in both genders, whereas higher job demands showed a decreased risk. For EAP, associations with work factors were weak and inconsistent across genders. No effect modification by work factors was found, except for a negative effect modification by job strain on DP risk among women, i.e. a reduced effect of back-pain SA with increasing exposure. Conclusion Back-pain SA was a significant predictor of both DP and EAP, while work factors were consistently associated only with DP. Our results indicate that the joint effect of back-pain SA and work factors on DP is additive and does not support effect modification by work factors. Supplementary Information The online version contains supplementary material available at 10.1007/s00420-022-01862-8.
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Affiliation(s)
- Angelo d'Errico
- Department of Epidemiology, Local Health Unit ASL TO 3, Via Sabaudia 164, 10095, Grugliasco, Turin, Italy.
| | - Daniel Falkstedt
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Melody Almroth
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Kathryn Badarin
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Tomas Hemmingsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Katarina Kjellberg
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
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Pain management in eldercare employees - the role of managers in addressing musculoskeletal pain and pain-related sickness absence. BMC Public Health 2022; 22:432. [PMID: 35246080 PMCID: PMC8895519 DOI: 10.1186/s12889-022-12785-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 02/16/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose Managers’ knowledge and behaviors in addressing musculoskeletal pain and sickness absence is not well understood. We investigated the association between managers’ knowledge and behaviours in relation to employees’ pain and their future risk of musculoskeletal pain and associated sickness absence. Methods The prospective study included 535 eldercare employees, and 42 managers from 20 nursing homes. Managers’ self-reported knowledge and behaviors in relation to employees’ pain were grouped using Principal Components Analysis. Eldercare employees reported pain-related sickness absence, and number of days with musculoskeletal pain repeatedly over 1 year. We investigated associations using mixed-effects regression models. Results We identified four types of managers’ knowledge and behaviors: 1) Pain-prevention (actions for prevention of employee pain), 2) Pain-management (actions to assist employees manage pain), 3) Pain-entitlements (communicating entitlements to employees with pain), and 4) Pain-accommodations (ability to facilitate workplace accommodations for employees with pain). The employees of managers with higher scores on knowledge of pain-entitlements reported fewer days of pain-related sickness absence (β = -0.62; 95%CI [-1.14; -0.10]). The employees of managers with higher scores on pain-management were more likely to report low back pain (β = 0.57; 95%CI [0.02; 1.11]). We found several key associations between the knowledge and behaviors measures and pain-related sickness absence (interactions). Conclusion Managers’ knowledge and behaviors in relation to employees’ pain were associated with employees’ future musculoskeletal pain and sickness absence. The relationships are complex, suggesting that a multifaceted approach is needed to ensure that managers are adequately informed on how to manage and accommodate employees with musculoskeletal pain to reduce sickness absence. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12785-x.
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Karstad K, Rasmussen CDN, Rasmussen CL, Rugulies R, Søgaard K, Burdorf A, Holtermann A. The influence of organizational factors, eldercare worker characteristics and care situation on the use of assistive devices during resident handling in eldercare work. APPLIED ERGONOMICS 2022; 98:103533. [PMID: 34419784 DOI: 10.1016/j.apergo.2021.103533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 07/09/2021] [Accepted: 07/12/2021] [Indexed: 06/13/2023]
Abstract
We evaluated the influence of organization, eldercare worker and care situation on the use of assistive devices during resident handling in eldercare work. We conducted a multi-level study among 20 nursing homes, 126 wards within the nursing homes, 549 eldercare workers within the wards, who performed a total of 1306 care episodes including 3695 resident handlings. The influence of organization (i.e. nursing home and ward), eldercare worker and care situation (i.e. care episode and resident handling) on the use of assistive devices was evaluated using variance components analysis and multivariate generalized linear mixed model. Nursing homes, wards, eldercare workers, care episodes and 'within care episode' all contributed to the total variance in use of assistive devices. Organizational factors and care situation factors were significantly associated with use of assistive devices. All levels of the nursing homes, but in particular care situation, influence the use of assistive devices during resident handling.
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Affiliation(s)
- Kristina Karstad
- National Research Centre for the Working Environment (NRCWE), Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark.
| | - Charlotte D N Rasmussen
- National Research Centre for the Working Environment (NRCWE), Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark
| | - Charlotte Lund Rasmussen
- National Research Centre for the Working Environment (NRCWE), Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark
| | - Reiner Rugulies
- National Research Centre for the Working Environment (NRCWE), Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark; Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen K, Denmark; Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353, Copenhagen K, Denmark
| | - Karen Søgaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark; Department of Clinical Research, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Alex Burdorf
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - Andreas Holtermann
- National Research Centre for the Working Environment (NRCWE), Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark
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Kyriakidis S, Stevens ML, Karstad K, Søgaard K, Holtermann A. The Influence of Nursing Home, Ward, and Eldercare Workers on the Number of Resident Handlings Performed per Shift in Eldercare. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111040. [PMID: 34769559 PMCID: PMC8583325 DOI: 10.3390/ijerph182111040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/15/2021] [Accepted: 10/18/2021] [Indexed: 11/21/2022]
Abstract
The purpose of our study was to investigate which organizational levels and factors determine the number of resident handlings in eldercare. We conducted a multi-level study, stratified on day and evening shifts, including information on four levels: nursing homes (n = 20), wards within nursing homes (day, n = 120; evening, n = 107), eldercare workers within wards (day, n = 619; evening, n = 382), and within eldercare workers (i.e., days within eldercare workers; day, n = 5572; evening, n = 2373). We evaluated the influence of each level on the number of resident handlings using variance components analysis and multivariate generalized linear mixed models. All four levels contributed to the total variance in resident handlings during day and evening shifts, with 13%/20% at “nursing homes”, 21%/33% at “wards within nursing homes”, 25%/31% at “elder-care workers within wards”, and 41%/16% “within eldercare workers”, respectively. The percentage of residents with a higher need for physical assistance, number of residents per shift, occupational position (only within day shifts), and working hours per week (only within day shifts) were significantly associated with the number of resident handlings performed per shift. Interventions aiming to modify number of resident handlings in eldercare ought to target all levels of the eldercare organization.
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Affiliation(s)
- Stavros Kyriakidis
- National Research Centre for the Working Environment (NRCWE), Lersø Parkallé 105, 2100 Copenhagen, Denmark; (S.K.); (M.L.S.); (K.K.)
| | - Matthew L. Stevens
- National Research Centre for the Working Environment (NRCWE), Lersø Parkallé 105, 2100 Copenhagen, Denmark; (S.K.); (M.L.S.); (K.K.)
| | - Kristina Karstad
- National Research Centre for the Working Environment (NRCWE), Lersø Parkallé 105, 2100 Copenhagen, Denmark; (S.K.); (M.L.S.); (K.K.)
| | - Karen Søgaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark;
- Department of Clinical Research, University of Southern Denmark, Winsløwparken 19, 5000 Odense, Denmark
| | - Andreas Holtermann
- National Research Centre for the Working Environment (NRCWE), Lersø Parkallé 105, 2100 Copenhagen, Denmark; (S.K.); (M.L.S.); (K.K.)
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark;
- Correspondence:
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Bláfoss R, Vinstrup J, Skovlund SV, López-Bueno R, Calatayud J, Clausen T, Andersen LL. Musculoskeletal pain intensity in different body regions and risk of disability pension among female eldercare workers: prospective cohort study with 11-year register follow-up. BMC Musculoskelet Disord 2021; 22:771. [PMID: 34507585 PMCID: PMC8431848 DOI: 10.1186/s12891-021-04655-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 08/21/2021] [Indexed: 11/18/2022] Open
Abstract
Background Musculoskeletal pain is a risk factor for leaving the labour market temporarily and permanently. While the presence of multi-site pain increases the risk of disability pension, we lack detailed knowledge about pain intensity as a risk factor. This study investigated the association between musculoskeletal pain intensity in different body regions and risk of future disability pension among eldercare workers. Methods Eight thousand seven hundred thirty-one female eldercare workers replied to a questionnaire on work and health in 2005 and were followed for 11 years in the Danish Register for Evaluation of Marginalization. Time-to-event analyses estimated hazard ratios (HR) for disability pension from pain intensities (0–9 numeric rating scale (NRS)) in the low-back, neck/shoulders, and knees during the previous 3 months. Analyses were mutually adjusted for pain regions, age, education, lifestyle, psychosocial work factors, and physical exertion at work. Results During 11-year follow-up, 1035 (11.9%) of the eldercare workers received disability pension. For all body regions among all eldercare workers, dose-response associations were observed between higher pain intensity and risk of disability pension (p < 0.001). The risk for disability pension was increased when reporting “very high” pain levels (≥7 points on the 0–9 NRS) in the low-back (HR 2.19, 95% CI 1.70–2.82), neck/shoulders (HR 2.34, 95% CI 1.88–2.92), and knees (HR 1.89, 95% CI 1.44–2.47). Population attributable risks (PAR) were 15.5, 23.2, and 9.6% for pain > 2 on NRS in the low-back, neck/shoulders, and knees, respectively, indicating that 15.5, 23.2, and 9.6% fewer eldercare workers would likely receive disability pension if the pain intensity was reduced to 2 or less. For workers ≤45 years and > 45 years, PAR was highest for neck/shoulder pain (27.6%) and low-back pain (18.8%), respectively. Conclusions The present study found positive dose-response associations between pain intensity in the low-back, neck/shoulders, and knees, and risk of disability pension during 11-year follow-up. Moderate to very high levels of musculoskeletal pain in eldercare workers should, therefore, be considered an early warning sign of involuntary premature exit from the labour market. These findings underscore the importance of preventing, managing, and reducing musculoskeletal pain to ensure a long and healthy working life.
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Affiliation(s)
- Rúni Bláfoss
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark. .,Research Unit for Muscle Physiology and Biomechanics, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
| | - Jonas Vinstrup
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark
| | - Sebastian Venge Skovlund
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark.,Research Unit for Muscle Physiology and Biomechanics, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Rubén López-Bueno
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark.,Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain
| | - Joaquin Calatayud
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark.,Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Thomas Clausen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark
| | - Lars Louis Andersen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark.,Sport Sciences, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
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Stevens ML, Karstad K, Mathiassen SE, Januario LB, Holtermann A, Hallman DM. What Determines Step-Rate at Work? An Investigation of Factors at the Shift, Worker, Ward, and Nursing Home Levels in Eldercare. Ann Work Expo Health 2021; 65:919-927. [PMID: 34137433 PMCID: PMC8501986 DOI: 10.1093/annweh/wxab027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 03/23/2021] [Accepted: 03/28/2021] [Indexed: 11/17/2022] Open
Abstract
Objectives Current knowledge on the determinants of step-rate at different organizational levels is limited. Thus, our aim was to identify, in eldercare, at what workplace level differences in step-rate occur and to identify determinants of workers’ step-rate at these levels. Methods Participants were 420 eldercare workers from 17 nursing homes (126 wards) in Denmark. Accelerometry was used to assess step-rate (steps per hour) of workers over multiple shifts. We assessed various determinants at different levels of the workplace, i.e. at the (i) shift, (ii) worker, (iii) ward, and (iv) nursing home levels. Variance components analysis identified the percentage contribution to total variance in step-rate from each respective level. Multi-level linear regression modelling was used to investigate the association between candidate determinants at each level and step-rate. Results Differences in eldercare workers’ step-rate occurred primarily between shifts (within workers; 44.9%) and between workers (within wards; 49.1%). A higher step-rate was associated with: (i) weekend and evening shifts (versus weekday/day); (ii) job as a care helper (versus care aide) and an increased proportion of time spent on direct care tasks; (iii) working in a somatic ward (versus dementia), an increased resident–staff ratio and permission to take unscheduled breaks; and (iv) lack of elevators. Conclusions We found that nearly all variability in step-rate in eldercare work occurs between shifts (within workers) and between workers (within wards). The main determinants of step-rate were related to the type of shift, type of work tasks, staffing ratio, break policy, and availability of elevators.
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Affiliation(s)
- Matthew L Stevens
- Department of Musculoskeletal Disorders and Physical Workload, The National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 København Ø, Denmark
| | - Kristina Karstad
- Department of Musculoskeletal Disorders and Physical Workload, The National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 København Ø, Denmark
| | - Svend Erik Mathiassen
- Centre for Musculoskeletal Research, Department of Occupational Health Sciences and Psychology, University of Gävle, Kungsbäcksvägen 47, 801 76 Gävle, Sweden
| | - Leticia Bergamin Januario
- Centre for Musculoskeletal Research, Department of Occupational Health Sciences and Psychology, University of Gävle, Kungsbäcksvägen 47, 801 76 Gävle, Sweden
| | - Andreas Holtermann
- Department of Musculoskeletal Disorders and Physical Workload, The National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 København Ø, Denmark.,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark
| | - David M Hallman
- Centre for Musculoskeletal Research, Department of Occupational Health Sciences and Psychology, University of Gävle, Kungsbäcksvägen 47, 801 76 Gävle, Sweden
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Januario LB, Stevens ML, Mathiassen SE, Holtermann A, Karstad K, Hallman DM. Combined Effects of Physical Behavior Compositions and Psychosocial Resources on Perceived Exertion Among Eldercare Workers. Ann Work Expo Health 2021; 64:923-935. [PMID: 32729914 PMCID: PMC7751016 DOI: 10.1093/annweh/wxaa079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 06/03/2020] [Accepted: 07/08/2020] [Indexed: 11/15/2022] Open
Abstract
Objectives High perceived physical exertion is common in eldercare workers and a strong predictor for impaired health. However, little is known on how physical behaviors at work associate with physical exertion in this group. The aim of this study was to determine the extent to which the composition of physical behaviors at work is associated with perceived physical exertion in nursing home eldercare workers, and the extent to which these associations are modified by psychosocial resources. Methods Our population consisted of 399 female eldercare workers from 126 wards in 20 different nursing homes. We evaluated time spent in physical behaviors at work [sitting, standing still, light activities (LAs), and moderate to vigorous activities (MVAs)] using triaxial accelerometers worn, on average, for three working days. We accounted for inherent codependency between the behaviors using compositional data analysis. We used multilevel linear mixed regression models to determine associations between the behaviors and perceived exertion, measured on a numeric rating scale (0–10), and included interactions between each behavior and psychosocial resources (influence at work, social support, and quality of leadership) to determine a possible moderating effect of resources. Regression results were illustrated using isotemporal substitution. Results Sitting was negatively (β: −0.64; P < 0.01) while MVA was positively (β: 0.95; P = 0.02) associated with perceived exertion. According to isotemporal substitution, replacing 30 min of MVA by sitting would, for an average worker, be associated with a decrease in physical exertion by −0.14 on the 0–10 scale. Job resources marginally moderated the association between LA and exertion. Thus, among workers with low influence and low social support, we found a positive association between LA and exertion, while that was not found for workers with medium or high influence and support (interactions for influence and support: P = 0.08 and P = 0.10). Conclusions Our findings suggest that reallocating time from MVA to sitting can mitigate perceived physical exertion in eldercare workers. More time in LA increased physical exertion only for workers with low psychosocial resources, supporting a positive effect of a better psychosocial work environment in elderly care.
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Affiliation(s)
- Leticia Bergamin Januario
- Centre for Musculoskeletal Research, Department of Occupational Health Sciences and Psychology, University of Gävle, Gävle, Sweden
| | - Matthew L Stevens
- Musculoskeletal Disorders and Physical Workload, National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Svend Erik Mathiassen
- Centre for Musculoskeletal Research, Department of Occupational Health Sciences and Psychology, University of Gävle, Gävle, Sweden
| | - Andreas Holtermann
- Musculoskeletal Disorders and Physical Workload, National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Kristina Karstad
- Musculoskeletal Disorders and Physical Workload, National Research Centre for the Working Environment, Copenhagen, Denmark
| | - David M Hallman
- Centre for Musculoskeletal Research, Department of Occupational Health Sciences and Psychology, University of Gävle, Gävle, Sweden
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Sundstrup E, Hansen ÅM, Mortensen EL, Poulsen OM, Clausen T, Rugulies R, Møller A, Andersen LL. Cognitive Ability in Midlife and Labor Market Participation Among Older Workers: Prospective Cohort Study With Register Follow-up. Saf Health Work 2020; 11:291-300. [PMID: 32995054 PMCID: PMC7502611 DOI: 10.1016/j.shaw.2020.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 03/02/2020] [Accepted: 06/23/2020] [Indexed: 11/17/2022] Open
Abstract
Background The study aimed to determine the association of individual cognitive ability in late midlife with labor market participation among older workers. Methods This prospective cohort study estimates the risk of long-term sickness absence, disability pension, early retirement, and unemployment from scores on the Intelligenz-Struktur-Test 2000R by combining data from 5076 workers from the Copenhagen Aging and Midlife Biobank with a register on social transfer payments. Analyses were stepwise adjusted for age, gender, physical and psychosocial work environment, health behaviors, occupational social class, education, and chronic diseases. Results In the fully adjusted model, low cognitive ability (≥1 standard deviation below the mean for each gender) and high cognitive ability (≥1 standard deviation above the mean for each gender) were not associated with risk of any of the four labor market outcomes. Conclusion Individual cognitive ability in late midlife was not associated with risk of long-term sickness absence, disability pension, early retirement, and unemployment in the fully adjusted model. Thus, no direct effect of individual cognitive ability in late midlife was observed on the risk of permanently or temporarily leaving the labor market.
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Affiliation(s)
- Emil Sundstrup
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Corresponding author. National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark.
| | - Åse M. Hansen
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Denmark
| | - Erik L. Mortensen
- Department of Public Health, University of Copenhagen, Denmark
- Center for Healthy Aging, University of Copenhagen, Denmark
| | - Otto M. Poulsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Thomas Clausen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Denmark
| | - Anne Møller
- Department of Occupational Medicine, Copenhagen University Holbæk, Denmark
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Denmark
| | - Lars L. Andersen
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Sport Sciences, Department of Health Science and Technology Aalborg University, Denmark
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Nygaard PP, Skovlund SV, Sundstrup E, Andersen LL. Is low-back pain a limiting factor for senior workers with high physical work demands? A cross-sectional study. BMC Musculoskelet Disord 2020; 21:622. [PMID: 32958013 PMCID: PMC7507239 DOI: 10.1186/s12891-020-03643-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 09/10/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Low-back pain (LBP) is highly prevalent among senior workers and may affect work ability, especially among those with hard physical work. This study determined the joint association of LBP intensity and physical work demands with work limitiations due to pain in senior workers. METHODS In the SeniorWorkingLife study (2018), 11,738 senior workers (≥50 years) replied to questions about physical work demands, LBP intensity, and work limitations due to pain. Using logistic regression analyses and controlling for potential confounders, associations between the physical work demands and LBP intensity (interaction) with work limitiations due to pain (outcome) was modeled. RESULTS Higher LBP intensity, as well as higher physical work demands, significantly increased the odds of experiencing work limitiations due to pain, and these two factors interacted with each other (p < 0.0001). In analyses stratified for LBP intensity, higher physical work demands gradually increased the odds of experiencing work limitiations due to pain. CONCLUSIONS Senior workers with a combination of physically demanding work and LBP are more affected by their pain during everyday work tasks compared to workers with similar LBP-intensity in sedentary occupations. Accommodation of work demands seems especially relevant for this group of workers.
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Affiliation(s)
- Patrick Pascal Nygaard
- Musculoskeletal Disorders and Physical Workload, National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark.
| | - Sebastian Venge Skovlund
- Musculoskeletal Disorders and Physical Workload, National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark
| | - Emil Sundstrup
- Musculoskeletal Disorders and Physical Workload, National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark
| | - Lars Louis Andersen
- Musculoskeletal Disorders and Physical Workload, National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark.,Sport Sciences, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
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Amiri S, Behnezhad S. Smoking and disability pension: a systematic review and meta-analysis. Public Health 2020; 186:297-303. [PMID: 32882482 DOI: 10.1016/j.puhe.2020.04.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 04/03/2020] [Accepted: 04/14/2020] [Indexed: 01/09/2023]
Abstract
OBJECTIVES Smoking has negative consequences on occupational health. The current meta-analysis was conducted with the aim to pool the studies about smoking and increased disability pension. STUDY DESIGN Systematic review and meta-analysis. METHODS Articles were found in the scientific literature using keywords, and searching was limited to prospective cohort studies that had been published before August 2018. Based on the inclusion and exclusion criteria, 23 prospective cohort studies were selected. The analyses were carried out on the basis of the random-effects method. Subgroup analysis was also carried out. Finally, the bias of publication was examined using Begg's test, the Egger test, the trim-and-fill method, and the funnel plot. RESULTS Twenty-three studies were included. The results showed a positive association between smoking and disability pension, with a risk ratio (RR) of 1.41 and 95% confidence interval (95% CI) of 1.30-1.53 (P < 0.001). In men, the RR was equal to 1.48 and 95% CI was equal to 1.30-1.68 (P < 0.001). In women, the RR was equal to 1.23 and 95% CI was equal to 1.09-1.37 (P = 0.001). In current smokers, the RR was equal to 1.41 and 95% CI was equal to 1.26-1.57 (P < 0.001). In former smokers, the RR was equal to 1.16 and 95% CI was equal to 1.05-1.29 (P = 0.003). Qualitative evaluation showed that the studies had a low level of selection bias, data collection bias, and withdrawal and dropout bias. CONCLUSIONS Smoking is a risk factor for increasing disability pension, and men are at higher risk of disability pension. In addition, both current and former smokers are in high risk of disability pension. Overall, it can be concluded that smoking is a risk factor for occupational health.
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Affiliation(s)
- S Amiri
- Behavioral Sciences Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | - S Behnezhad
- Department of Psychology, Kharazmi University, Tehran, Iran
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15
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de Breij S, Huisman M, Deeg DJH. Educational differences in macro-level determinants of early exit from paid work: a multilevel analysis of 14 European countries. Eur J Ageing 2020; 17:217-227. [PMID: 32547349 PMCID: PMC7292834 DOI: 10.1007/s10433-019-00538-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The aim of this study was to identify macro-level determinants of early work exit and investigate whether the effects of these determinants differ across educational groups. We used data from the Survey on Health, Ageing and Retirement in Europe (SHARE) (2011–2013) and the English Longitudinal Study of Ageing (ELSA) (2010/2011–2012/2013) as well as macro-level data and included 10,584 participants in 14 European countries. We used logistic multilevel analyses to examine educational differences in macro-level determinants of early work exit. Macro-level determinants were: minimum unemployment replacement rates, expenditure on active labour market policies (aimed to help the unemployed find work) and passive labour market policies (unemployment and early retirement benefits), employment protection legislation (costs involved in dismissing individuals), unemployment rates, statutory pension age and implicit tax on continued work. We found low-educated workers to be more at risk of early work exit than higher educated workers. In low-educated men, higher unemployment replacement rates, higher expenditure on passive labour market policies, stricter employment protection legislation and a higher implicit tax on continued work were associated with a higher risk of early work exit, whereas no macro-level factors were associated with early work exit in highly educated men. In women, a higher expenditure on passive labour market policies and a higher implicit tax on continued work were determinants of early work exit, regardless of educational level. To conclude, low-educated men seem to be especially responsive to the effects of pull factors that make early retirement financially more attractive.
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Affiliation(s)
- Sascha de Breij
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1089A, 1081 HV Amsterdam, The Netherlands
| | - Martijn Huisman
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1089A, 1081 HV Amsterdam, The Netherlands.,Department of Sociology, VU University Amsterdam, De Boelelaan 1081, 1081 HV Amsterdam, The Netherlands
| | - Dorly J H Deeg
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1089A, 1081 HV Amsterdam, The Netherlands
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Rasmussen CDN, Højberg H, Larsen AK, Munch PK, Osborne R, Kwak L, Jensen I, Linnan L, Jørgensen MB. Evaluation and Dissemination of a Checklist to Improve Implementation of Work Environment Initiatives in the Eldercare Sector: Protocol for a Prospective Observational Study. JMIR Res Protoc 2020; 9:e16039. [PMID: 32401212 PMCID: PMC7254284 DOI: 10.2196/16039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 01/13/2020] [Accepted: 02/04/2020] [Indexed: 02/04/2023] Open
Abstract
Background To measure sustainable improvements in the work environment, a flexible and highly responsive tool is needed that will give important focus to the implementation process. A digital checklist was developed in collaboration with key stakeholders to document the implementation of changes in eldercare sector workplaces. Objective This paper describes the study protocol of a dissemination study that aims to examine when, why, and how the digital checklist is spread to the Danish eldercare sector following a national campaign particularly targeting nursing homes and home care. Methods This prospective observational study will use quantitative data from Google Analytics describing use of the checklist as documented website engagement, a survey among members in the largest union in the sector, information from a central business register, and monitoring of campaign activities. The evaluation will be guided by the five elements of the RE-AIM framework: reach, effectiveness, adoption, implementation, and maintenance. Results The study was approved in June 2016 and began in October 2018. The campaign that is the foundation for the evaluation began in 2017 and ended in 2018. However, the webpage where we collect data is still running. Results are expected in 2020. Conclusions This protocol provides a working example of how to evaluate dissemination of a checklist to improve implementation of work environment initiatives in the eldercare sector in Denmark. To our knowledge, implementation in a nationwide Danish work environment has not been previously undertaken. Given that the checklist is sector-specific for work environment initiatives and developed through systematic collaboration between research and practice, it is likely to have high utility and impact; however, the proposed evaluation will determine this. This study will advance dissemination research and, in particular, the evaluation of the impact of these types of studies. Finally, this study advances the field through digital tools that can be used for evaluation of dissemination efforts (eg, Google Analytics associated with website) in the context of a rigorous research design activity. International Registered Report Identifier (IRRID) DERR1-10.2196/16039
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Affiliation(s)
| | - Helene Højberg
- The National Research Centre for the Working Environment, København Ø, Denmark
| | - Anne Konring Larsen
- The National Research Centre for the Working Environment, København Ø, Denmark
| | - Pernille Kold Munch
- The National Research Centre for the Working Environment, København Ø, Denmark
| | - Richard Osborne
- Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, Australia
| | - Lydia Kwak
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Irene Jensen
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Laura Linnan
- Carolina Collaborative for Research on Work & Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States
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Gustafsson K, Marklund S, Aronsson G, Leineweber C. Interaction effects of physical and psychosocial working conditions on the risk of disability pension among nursing professionals and care assistants in Sweden: A prospective study. Int J Nurs Stud 2019; 102:103484. [PMID: 31841740 DOI: 10.1016/j.ijnurstu.2019.103484] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 08/19/2019] [Accepted: 11/14/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Nursing professionals and care assistants are often subject to a combination of negative physical and psychosocial work environment factors, but most disability pension studies on such occupations have focused on one or the other of these factors. As they often coexist, there are reasons to assume that simultaneously being exposed to both types of exposures will increase the risk of disability more than being exposed to either. OBJECTIVES The study examined combinations of physical and psychosocial work conditions as predictors of future disability pension among nursing professionals and care assistants in Sweden. PARTICIPANTS The study was based on a random and representative sample of 79,004 participants in any of the Swedish Work Environment Surveys from 1993 to 2013. A total of 2576 nursing professionals, 10,175 care assistants, and 66,253 workers in other occupations were included. METHODS Information on background factors and disability pension was obtained from population registers. Cox proportional hazard regressions with 95% confidence intervals (CI) were performed to study if pairs of combinations of physical and psychosocial factors were related to an increased risk of disability pension. Additionally, measures of synergistic effects were estimated. The analyses were stratified on occupation group, with adjustment for selected confounders. RESULTS The results indicated increased hazard ratios (HR) for disability pension for most combinations of physical and psychosocial working conditions. The hazard ratios for joint exposure to high demands and heavy physical work were high among both nursing professionals (HR 1.91; CI 1.06-3.44) and care assistants (HR 2.09; CI 1.63-2.69). Also, the combination of high demands and strenuous postures resulted in significantly elevated risks of disability pension among nursing professionals (HR 1.95; CI 1.20-3.16) and care assistants (HR 2.18; CI 1.71-2.77). The HRs for joint exposure to low control and both heavy physical work and strenuous postures were significant among all other occupations (HR 2.30; CI 2.05-2.58 and HR 2.24; CI 2.01-2.51), and among care assistants (HR 1.52; CI 1.26-1.85 and HR 1.61; CI 1.34-1.93), but not significant among nursing professionals. The synergistic effects on disability pension from combined exposures were generally positive among all three occupational groups. CONCLUSION Nursing professionals and care assistants exposed to both negative physical and psychosocial conditions had an increased risk of disability pension. A synergistic effect with respect to disability pension was found among care assistants who reported low control and strenuous postures at work.
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Affiliation(s)
- Klas Gustafsson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77 Stockholm, Sweden.
| | - Staffan Marklund
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77 Stockholm, Sweden.
| | - Gunnar Aronsson
- Department of Psychology, Stockholm University, SE-106 91 Stockholm, Sweden.
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Gustafsson K, Marklund S, Aronsson G, Leineweber C. Physical work environment factors affecting risk for disability pension due to mental or musculoskeletal diagnoses among nursing professionals, care assistants and other occupations: a prospective, population-based cohort study. BMJ Open 2019; 9:e026491. [PMID: 31619414 PMCID: PMC6797279 DOI: 10.1136/bmjopen-2018-026491] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To study the influence of physical work factors on the risks of future disability pension (DP) due to mental or musculoskeletal diagnoses among nursing professionals, care assistants and all other occupations in the general working population in Sweden. METHODS The prospective population study was based on representative samples of working individuals (n=79 004) aged 16-64, interviewed in the Swedish Work Environment Survey between 1993 and 2013. Information on diagnosed DP in 1994-2014 was gathered from the Social Insurance Agency's database. The focus was on nursing professionals (registered nurses and midwives) and care assistants, for example, assistant nurses and hospital ward assistants. The outcome was DP, classified into two diagnostic groups. Associations between physical work factors and risk of DP were calculated using Cox regression with HR and 95% CI. RESULTS Physical work factors were associated with future DP after adjusting for sociodemographic conditions and psychosocial work factors among care assistants (n=10 175) and among all other occupations (n=66 253), but not among nursing professionals (n=2576). The increased risk among care assistants (n=197) exposed to heavy physical work was 66% (HR 1.66, 95% CI 1.39 to 1.97), and for those exposed to strenuous work postures (n=420) it was 56% (HR 1.56, 95% CI 1.35 to 1.80). Physical work indicators were mainly associated with musculoskeletal DP diagnoses among care assistants, but two indicators were significant also for mental diagnoses. An increased risk of DP was found among nursing professionals (n=102) exposed to detergents or disinfectants (HR 1.48, 95% CI 1.06 to 2.05), but not among care assistants. CONCLUSIONS Heavy physical work and strenuous postures are predictors of future DP, particularly among care assistants and in the general working population. In order to reduce early exit from the workforce, efforts should be made to improve physical and ergonomic working conditions.
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Affiliation(s)
- Klas Gustafsson
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Staffan Marklund
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Gunnar Aronsson
- Department of Psychology, Stockholm University, Stockholm, Sweden
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Association between Psychosocial Working Conditions and Perceived Physical Exertion among Eldercare Workers: A Cross-Sectional Multilevel Analysis of Nursing Homes, Wards and Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193610. [PMID: 31561538 PMCID: PMC6801705 DOI: 10.3390/ijerph16193610] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 09/20/2019] [Accepted: 09/21/2019] [Indexed: 11/17/2022]
Abstract
This cross-sectional multilevel study aims at investigating the associations between psychosocial working conditions of different workplace levels and perceived physical exertion among eldercare workers. Data were obtained from the 'Danish Observational Study of Eldercare work and musculoskeletal disorderS' (DOSES) study, including 536 eldercare workers, nested in 126 wards and 20 nursing homes. Psychosocial working conditions were measured by the Copenhagen Psychosocial Questionnaire (COPSOQ). The physical workload was measured with a self-administered scale (0-10) rating perceived physical exertion. Multilevel linear mixed models were used to determine associations of psychosocial conditions between nursing homes, wards, and workers with physical exertion. Most of the variance in the perceived physical exertion was explained by differences between workers (83%), but some variance was explained by wards (11%) and nursing homes (6%). Workers employed in nursing homes with low influence (p = 0.01) and poor leadership (p = 0.02), and in wards with high quantitative demands (p = 0.03), high work pace (p < 0.001), and low justice (p = 0.01) were at increased risk of reporting higher physical exertion. The strongest associations were found for low influence, low quality of leadership, and high work pace at nursing homes and ward levels. In conclusion, improving specific psychosocial working conditions at nursing home and ward levels may be of particular importance to reduce excessive physical workload in eldercare workers.
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Kusma B, Pietsch A, Riepenhof H, Haß S, Kuhn D, Fischer K, Nienhaus A. The Back College for nurses - an evaluation of intermediate effects. J Occup Med Toxicol 2019; 14:19. [PMID: 31249605 PMCID: PMC6584993 DOI: 10.1186/s12995-019-0239-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 06/10/2019] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Nursing staff and care workers run an increased risk of work related musculoskeletal disorders such as low back pain. The Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW) offers its insured persons the opportunity to participate in a three-week Back College with the aim of preventing them having to abandon their profession due to back problems. The aim of the study was to record the effectiveness and sustainability of the Back College on an intermediate basis (6 months). METHODS As part of a single-group pre-post measurement on three survey dates - at the start (T0) and end (T1) of rehabilitation and 6 months later (T2) - in 2013 all participants in the Back College at three locations were surveyed using a standard questionnaire. Wilcoxon signed-rank tests were performed to evaluate statistically significant changes. RESULTS For measurement dates T0 to T2 we had 570 complete datasets (response rate 70.81%). There was a significant decrease in reported back pain and the general state of health and quality of life index improved. Participants' emotional strain decreased and they showed an improved understanding of illness as well as of having acquired knowledge-based abilities and skills for dealing with the disease. After training, they recorded back-friendly behaviour in everyday life and opportunities to relieve strain on the spinal column were utilised at work more often. Participants' subjective assessment of their ability to work (Work Ability Index) improved. CONCLUSION The present study proved the intermediate effectiveness of the Back College curriculum. Whether these effects remain stable in the long term will be tested on the subsequent measurement date (T3, after 24 months).
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Affiliation(s)
- Bianca Kusma
- Institution for Statutory Accident Insurance in the Health and Welfare Services, Pappelallee 35/37, 22089 Hamburg, Germany
| | - Aki Pietsch
- BG Hospital Hamburg, Bergedorfer Straße 10, 21033 Hamburg, Germany
| | - Helge Riepenhof
- BG Hospital Hamburg, Bergedorfer Straße 10, 21033 Hamburg, Germany
| | - Sören Haß
- BG Nordsee Reha-Klinik, Wohldweg 7, 25826 St. Peter-Ording, Germany
| | - Daniel Kuhn
- BG Hospital Bergmannstrost Halle, Merseburger Straße 165, 06112 Halle (Saale), Germany
| | - Klaus Fischer
- BG Hospital Bergmannstrost Halle, Merseburger Straße 165, 06112 Halle (Saale), Germany
| | - Albert Nienhaus
- Institution for Statutory Accident Insurance in the Health and Welfare Services, Pappelallee 35/37, 22089 Hamburg, Germany
- Competence Centre for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), University Medical Centre Hamburg-Eppendorf (UKE), Martinistrasse 52, 20246 Hamburg, Germany
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Andersen LL, Villadsen E, Clausen T. Influence of physical and psychosocial working conditions for the risk of disability pension among healthy female eldercare workers: Prospective cohort. Scand J Public Health 2019; 48:460-467. [PMID: 30813841 PMCID: PMC7263041 DOI: 10.1177/1403494819831821] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aim: To investigate the influence of physical and psychosocial working conditions on the risk of disability pension among eldercare workers. Methods: After responding to a questionnaire in 2005, 4699 healthy female eldercare workers – free from chronic musculoskeletal pain, depressive symptoms and long-term sickness absence – were followed for 11 years in the Danish Register for Evaluation of Marginalization. Time-to-event analyses estimated the hazard ratio (HR) for disability pension from physical exertion during work, emotional demands, influence at work, role conflicts, and quality of leadership. Analyses were mutually adjusted for these work environmental factors as well as for age, education, smoking, leisure physical activity and body mass index. Results: During follow-up, 7.6% received disability pension. Physical exertion and emotional demands were associated with risk of disability pension, and both interacted with age. In age-stratified analyses, older eldercare workers (mean age 53 years at baseline) with moderate and high physical exertion (reference: low) were at increased risk with HRs of 1.51, 95% CI [1.06–2.15] and 2.54, 95% CI [1.34–4.83], respectively. Younger eldercare workers (mean age 36 years at baseline) with moderate emotional demands (reference: low) were at decreased risk with an HR of 0.57, 95% CI [0.37–0.85]. Conclusions: While a higher level of physical exertion is a risk factor for disability pension among older female eldercare workers, a moderate level of emotional demands is associated with lower risk among the younger workers. The age of the worker may be an important factor when providing recommendations for promoting a long and healthy working life.
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Affiliation(s)
- L L Andersen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - E Villadsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - T Clausen
- National Research Centre for the Working Environment, Copenhagen, Denmark
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Work-related psychosocial risk factors and risk of disability pension among employees in health and personal care: A prospective cohort study. Int J Nurs Stud 2019; 93:12-20. [PMID: 30836235 DOI: 10.1016/j.ijnurstu.2018.10.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 10/19/2018] [Accepted: 10/19/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND Researchers have suggested that psychological factors at work contribute to early retirement due to disability pension in the general working population. Disability pension is a problem that shortens working careers among nursing professionals and personal care or related workers, but few researchers have focused on these occupational groups. Also, a need for studies based on measurements of specific work exposure instead of combined measures has been identified. OBJECTIVES The aim was to study the potential influence of work-related psychosocial risk factors on the future risk of disability pension among nursing professionals and care assistants in Sweden. Those occupational groups are compared to all other occupations in Sweden. A specific aim was to describe differences in associations to cause-specific disability, and how the results were modified by occupation categories. PARTICIPANTS A representative sample of 79,004 women and men in Sweden comprising 2,576 nursing professionals, 10,175 care assistants and 66,253 workers in other occupations. METHODS Factors of the psychosocial work environment were obtained from questionnaire data of the Swedish Work Environment Surveys (SWES) 1993-2013. Information on cause-specific disability pension during follow-up was added from the Social Insurance Agency's database (1994-2014). We calculated Cox's proportional hazards with 95% confidence intervals. RESULTS During a mean follow-up time of 11.1 years, 6.6% of nursing professionals and 9.4% of care assistants, as compared to 6.1% among all other occupations, received disability pension. Among nursing professionals and care assistants, high quantitative job demands and low social support, but not job control, were associated with future disability pension also after controlling for age, year of interview, socio demographic conditions, and physical work factors. An increase in risk was also noticeable among nursing professionals and care assistants who reported an active job in combination with low social support. An increased risk for disability pension due to mental diagnosis was found among care assistants who reported high job demands. In all other occupations, low social support was associated with an increased risk for disability pension under any condition of job strain (high strain, low strain, active, and passive jobs). CONCLUSION Based on the results we conclude that high quantitative job demands and poor social support are predictors of future disability pension.
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Abstract
Prior research on change in cognitive performance before and after retirement suffers from inattention to gender context. This study theoretically motivates the testing of gender differences in cognitive decline after retirement. I drew 67,905 observations of cognitive function based on the Telephone Interview for Cognitive Status from 18,453 participants (7,830 men and 10,623 women) in the Health and Retirement Study (1992-2014). I used fixed-effects two-stage least square models to account for unobserved heterogeneity between men and women in the sample and the endogeneity of retirement decision. I also controlled for change in depressive symptoms, mobility limitations, individual wealth, medical expenses, and spousal income. Retirement predicts a decrease in the cognitive score by 2.168 on a scale of 0-35 for women, but no change for men. Continued employment may buffer against risk factors that aggravate women's cognitive health.
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Affiliation(s)
- Katsuya Oi
- 1 Department of Sociology, Northern Arizona University, Flagstaff, AZ, USA
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Tsuboi Y, Murata S, Naruse F, Ono R. Association between pain-related fear and presenteeism among eldercare workers with low back pain. Eur J Pain 2018; 23:495-502. [PMID: 30289190 DOI: 10.1002/ejp.1323] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 08/06/2018] [Accepted: 10/01/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND Presenteeism (work productivity loss at work) and low back pain (LBP) are prevalent among eldercare workers. Presenteeism is a serious emerging problem in an occupational setting. While many studies report the impact of pain-related fear on absenteeism, its impact on presenteeism remains unclear. METHODS We conducted a cross-sectional study to investigate the association between pain-related fear and presenteeism among 505 eldercare workers with LBP. We measured pain-related fear using the 11-item Tampa Scale for Kinesiophobia (TSK-11). We used the Work Limitations Questionnaire (WLQ) to estimate productivity loss due to presenteeism with items including Time Management, Mental-Interpersonal Demands, Physical Demands and Output Demands. The presenteeism was categorized into no (<5%), mild (5%-10.9%), moderate (11%-16.9%) and severe presenteeism (≥17%). We further performed ordinal logistic regression analyses, and the covariates were age, sex, pain intensity, pain disability and psychosocial factors. Multiple imputation was conducted to provide informed estimates for observations with missing data. RESULTS After adjustment, a higher TSK score was significantly associated with a higher presenteeism (proportional OR = 1.10, 95% CI = 1.06-1.15). A significant association of TSK with all WLQ subscales was retained even after the adjustment (Time Management: proportional OR = 1.04, 95% CI = 1.01-1.08; Mental-Interpersonal Demands: proportional OR = 1.08, 95% CI = 1.04-1.12; Physical Demands: proportional OR = 1.04, 95% CI = 1.01-1.08; and Output Demands: proportional OR = 1.06, 95% CI = 1.02-1.10). CONCLUSIONS Our findings suggest that pain-related fear is an important factor related to presenteeism among eldercare workers with LBP. SIGNIFICANCE This study describes an independent association of pain-related fear with presenteeism among eldercare workers with low back pain. Pain-related fear could be considered a vital factor of presenteeism in addition to absenteeism.
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Affiliation(s)
- Yamato Tsuboi
- Department of Community Health Sciences, Graduate School of Health Sciences, Kobe University, Kobe, Hyogo, Japan.,Japan Society for the Promotion of Science, Chiyoda, Tokyo, Japan
| | - Shunsuke Murata
- Department of Community Health Sciences, Graduate School of Health Sciences, Kobe University, Kobe, Hyogo, Japan.,Japan Society for the Promotion of Science, Chiyoda, Tokyo, Japan
| | | | - Rei Ono
- Department of Public Health Sciences, Graduate School of Health Sciences, Kobe University, Kobe, Hyogo, Japan
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Merkus SL, Lunde LK, Koch M, Wærsted M, Knardahl S, Veiersted KB. Physical capacity, occupational physical demands, and relative physical strain of older employees in construction and healthcare. Int Arch Occup Environ Health 2018; 92:295-307. [PMID: 30443711 PMCID: PMC6420471 DOI: 10.1007/s00420-018-1377-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 10/29/2018] [Indexed: 01/22/2023]
Abstract
Purpose To assess age-related differences in physical capacity, occupational physical demands, and relative physical strain at a group level, and the balance between capacity and demands at an individual level, for construction and healthcare workers. Methods Shoulder strength, back strength, and aerobic capacity were assessed among construction (n = 62) and healthcare workers (n = 64). During a full working day, accelerometers estimated upper-arm elevation, trunk flexion, and occupational physical activity as indicators of occupational physical demands. Simultaneously, normalised surface electromyography (%sEMGmax) of the upper trapezius and erector spinae muscles, and normalised electrocardiography (percentage heart rate reserve (%HRR)) estimated relative physical strain. Differences between younger (≤ 44 years) and older (≥ 45 years) workers, as well as the moderating effect of age on the associations between capacity and demands, were analysed per sector. Results Compared to younger workers, older workers had similar strength and lower aerobic capacity; older construction workers had similar demands while older healthcare workers had higher demands. Compared to younger workers, older employees had unfavourable muscle activity patterns; %HRR had a tendency to be lower for older construction workers and higher for older healthcare workers. Among construction workers, age moderated the associations between shoulder strength and arm elevation (p = 0.021), and between aerobic capacity and occupational physical activity (p = 0.040). Age did not moderate these associations among healthcare workers. Conclusions In both sectors, the level of occupational physical demands and the higher relative physical strain in older employees require addressing to promote sustainable work participation among an aging population. Electronic supplementary material The online version of this article (10.1007/s00420-018-1377-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Suzanne L Merkus
- National Institute of Occupational Health, Pb 5330 Majorstuen, 0304, Oslo, Norway.
| | - Lars-Kristian Lunde
- National Institute of Occupational Health, Pb 5330 Majorstuen, 0304, Oslo, Norway
| | - Markus Koch
- National Institute of Occupational Health, Pb 5330 Majorstuen, 0304, Oslo, Norway
| | - Morten Wærsted
- National Institute of Occupational Health, Pb 5330 Majorstuen, 0304, Oslo, Norway
| | - Stein Knardahl
- National Institute of Occupational Health, Pb 5330 Majorstuen, 0304, Oslo, Norway
| | - Kaj Bo Veiersted
- National Institute of Occupational Health, Pb 5330 Majorstuen, 0304, Oslo, Norway
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Domains and determinants of retirement timing: A systematic review of longitudinal studies. BMC Public Health 2018; 18:1083. [PMID: 30170592 PMCID: PMC6119306 DOI: 10.1186/s12889-018-5983-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 08/21/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To date, determinants of retirement timing have been studied separately within various disciplines, such as occupational health and economics. This narrative literature review explores the determinants of retirement timing in countries, and relevant domains among older workers from both an economic and occupational health perspective. METHODS A literature search was conducted using 11 databases. Longitudinal studies on determinants of retirement timing were included. Study inclusion criteria were as follows: full-text article written in English or Dutch, conducted in humans, main outcome was time until retirement (i.e. retirement date or retirement age), and longitudinal design. Next, the included articles were screened for hypotheses on retirement timing and these articles with hypotheses were subjected to a quality assessment. Determinants for retirement timing were classified into multiple domains by three researchers. RESULTS The literature search identified 20 articles. The determinants of retirement timing were classified into eight domains: demographic factors, health factors, social factors, social participation, work characteristics, financial factors, retirement preferences, and macro effects. In total, we identified 49 determinants, ranging from one (social, and retirement preferences) to 21 determinants (work characteristics) per domain. CONCLUSIONS The findings suggest that there is a wide range of determinants that influence retirement timing in modern industrialized countries and that these determinants differ between countries. We recommend that researchers include determinants from various domains when studying retirement timing, while taking into account a country's context.
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Karstad K, Rugulies R, Skotte J, Munch PK, Greiner BA, Burdorf A, Søgaard K, Holtermann A. Inter-rater reliability of direct observations of the physical and psychosocial working conditions in eldercare: An evaluation in the DOSES project. APPLIED ERGONOMICS 2018; 69:93-103. [PMID: 29477334 DOI: 10.1016/j.apergo.2018.01.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 10/31/2017] [Accepted: 01/06/2018] [Indexed: 05/14/2023]
Abstract
The aim of the study was to develop and evaluate the reliability of the "Danish observational study of eldercare work and musculoskeletal disorders" (DOSES) observation instrument to assess physical and psychosocial risk factors for musculoskeletal disorders (MSD) in eldercare work. During 1.5 years, sixteen raters conducted 117 inter-rater observations from 11 nursing homes. Reliability was evaluated using percent agreement and Gwet's AC1 coefficient. Of the 18 examined items, inter-rater reliability was excellent for 7 items (AC1>0.75) fair to good for 7 items (AC1 0.40-0.75) and poor for 2 items (AC1 0-0.40). For 2 items there was no agreement between the raters (AC1 <0). The reliability did not differ between the first and second half of the data collection period and the inter-rater observations were representative regarding occurrence of events in eldercare work. The instrument is appropriate for assessing physical and psychosocial risk factors for MSD among eldercare workers.
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Affiliation(s)
- Kristina Karstad
- National Research Centre for the Working Environment (NRCWE), Lersø Parkallé 105, 2100 Copenhagen Ø, Denmark; Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark.
| | - Reiner Rugulies
- National Research Centre for the Working Environment (NRCWE), Lersø Parkallé 105, 2100 Copenhagen Ø, Denmark; Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen K, Denmark; Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353 Copenhagen K, Denmark
| | - Jørgen Skotte
- National Research Centre for the Working Environment (NRCWE), Lersø Parkallé 105, 2100 Copenhagen Ø, Denmark
| | - Pernille Kold Munch
- National Research Centre for the Working Environment (NRCWE), Lersø Parkallé 105, 2100 Copenhagen Ø, Denmark
| | - Birgit A Greiner
- School of Public Health, University College Cork, Western Road, Cork, Ireland
| | - Alex Burdorf
- Department of Public Health, Erasmus University Medical Centre, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Karen Søgaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark; Department of Clinical Research, University of Southern Denmark, Winsløwparken 19, 5000 Odense C, Denmark
| | - Andreas Holtermann
- National Research Centre for the Working Environment (NRCWE), Lersø Parkallé 105, 2100 Copenhagen Ø, Denmark; Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
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Browne P, Carr E, Fleischmann M, Xue B, Stansfeld SA. The relationship between workplace psychosocial environment and retirement intentions and actual retirement: a systematic review. Eur J Ageing 2018; 16:73-82. [PMID: 30886562 PMCID: PMC6397102 DOI: 10.1007/s10433-018-0473-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Psychosocial work characteristics are potential determinants of retirement intentions and actual retirement. A systematic review was conducted of the influence of psychosocial work characteristics on retirement intentions and actual retirement among the general population. This did not include people who were known to be ill or receiving disability pension. Relevant papers were identified by a search of PubMed, PsycINFO and Web of Science databases to December 2016. We included longitudinal and cross-sectional papers that assessed psychosocial work characteristics in relation to retirement intentions or actual retirement. Papers were filtered by title and abstract before data extraction was performed on full texts using a predetermined extraction sheet. Forty-six papers contained relevant evidence. High job satisfaction and high job control were associated with later retirement intentions and actual retirement. No consistent evidence was found for an association of job demands with retirement intentions or actual retirement. We conclude that to extend working lives policies should increase the job control available to older employees.
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Affiliation(s)
- Peter Browne
- 1Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London, EC1M 6 BQ UK
| | - Ewan Carr
- 2Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 7HB UK.,3Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF UK
| | - Maria Fleischmann
- 2Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 7HB UK
| | - Baowen Xue
- 2Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 7HB UK
| | - Stephen A Stansfeld
- 1Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London, EC1M 6 BQ UK
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Mid-life psychosocial work environment as a predictor of work exit by age 50. PLoS One 2018; 13:e0195495. [PMID: 29621353 PMCID: PMC5886550 DOI: 10.1371/journal.pone.0195495] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 03/24/2018] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To examine whether psychosocial work characteristics at age 45 years predict exit from the labour market by the age of 50 years in data from the 1958 British Birth Cohort. METHODS Psychosocial work characteristics (decision latitude, job demands, job strain and work social support at 45 years and job insecurity at 42 years) measured by questionnaire were linked to employment outcomes (unemployment, retirement, permanent sickness, homemaking) at 50 years in 6510 male and female participants. RESULTS Low decision latitude (RR = 2.01, 95%CI 1.06,3.79), low work social support (RR = 1.96, 95%CI 1.12,3.44), and high job insecurity (RR = 2.27, 95%CI 1.41, 3.67) predicted unemployment at 50, adjusting for sex, housing tenure, socioeconomic status, marital status, and education. High demands were associated with lower risk of unemployment (RR = 0.50, 95%CI 0.29,0.88) but higher risk of permanent sickness (RR = 2.14, 95%CI 1.09,4.21). CONCLUSIONS Keeping people in the workforce beyond 50 years may contribute to both personal and national prosperity. Employers may wish to improve working conditions for older workers, in particular, increase control over work, increase support and reduce demands to retain older employees in the workforce.
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Karstad K, Jørgensen AFB, Greiner BA, Burdorf A, Søgaard K, Rugulies R, Holtermann A. Danish Observational Study of Eldercare work and musculoskeletal disorderS (DOSES): a prospective study at 20 nursing homes in Denmark. BMJ Open 2018; 8:e019670. [PMID: 29490965 PMCID: PMC5855299 DOI: 10.1136/bmjopen-2017-019670] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 01/02/2018] [Accepted: 01/26/2018] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Musculoskeletal disorders (MSDs), sickness absence and premature retirement are highly prevalent among eldercare workers. We conducted a prospective observational workplace study with the main purpose to investigate longitudinal associations between physical and psychosocial working conditions and occurrence of MSD and its consequences (pain-related interference with daily work activities and sickness absence) among Danish eldercare workers. PARTICIPANTS At 20 Danish nursing homes, a total of 941 eldercare workers employed in day and evening shifts were invited to the study. Of those, 553 participated in the baseline measurements, and 441 completed the total period of 12 months follow-up. FINDINGS TO DATE Data were collected from September 2013 to January 2016. Physical and psychosocial working conditions were assessed with multiple methods (observations, accelerometer measurements and work schedules), and multiple levels of information (nursing home, ward, resident and eldercare worker) were incorporated in the data collection. MSD and the consequences hereof were assessed monthly during a 1-year follow-up. Study participants and non-participants were comparable on most of the 27 sociodemographic, health and working condition characteristics at baseline. The exceptions were higher neck-shoulder pain intensity, less sickness absence, more exposure to negative behaviour from residents and a higher percentage of working day shifts and fewer evening shifts among participants compared with non-participants. FUTURE PLANS The first publications will report on the associations of physical and psychosocial working conditions with occurrence of MSD and its consequences. In addition, the cohort gives the opportunity to investigate the importance of organisational, management and team factors for distribution of physical work demands and development of MSD among the workers. This will provide important knowledge for future workplace interventions to reduce MSD and sickness absence.
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Affiliation(s)
- Kristina Karstad
- National Research Centre for the Working Environment (NRCWE), Copenhagen, Denmark
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Anette F B Jørgensen
- National Research Centre for the Working Environment (NRCWE), Copenhagen, Denmark
| | | | - Alex Burdorf
- Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Karen Søgaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Reiner Rugulies
- National Research Centre for the Working Environment (NRCWE), Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Andreas Holtermann
- National Research Centre for the Working Environment (NRCWE), Copenhagen, Denmark
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Sundstrup E, Hansen ÅM, Mortensen EL, Poulsen OM, Clausen T, Rugulies R, Møller A, Andersen LL. Retrospectively assessed physical work environment during working life and risk of sickness absence and labour market exit among older workers. Occup Environ Med 2017; 75:114-123. [PMID: 28819019 PMCID: PMC5800344 DOI: 10.1136/oemed-2016-104279] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 07/07/2017] [Accepted: 07/27/2017] [Indexed: 12/13/2022]
Abstract
Objective To determine the prospective association between retrospectively assessed physical work environment during working life and prospectively assessed sickness absence and labour market exit among older workers. Methods Using Cox regression analyses we estimated the 4-year to 6-year prospective risk of register-based long-term sickness absence (LTSA), disability pension, early retirement and unemployment from exposure to different physical work environmental factors during working life among 5076 older workers (age 49–63 at baseline) from the Copenhagen Aging and Midlife Biobank cohort. Results Very hard physical work throughout working life was a risk factor for LTSA (HR 1.66,95% CI 1.32 to 2.07), disability pension (HR 2.21,95% CI 1.04 to 4.72) and early retirement (HR 1.57,95% CI 1.13 to 2.17). Both short-term (<10 years) and long-term (≥20 years) exposures to lifting or carrying of heavy burdens predicted the risk of LTSA (HRs 1.49–1.56) and disability pension (HRs 2.26–3.29). In contrast, exposure to dust was associated with LTSA and disability pension only following 20 or more exposure years. Conclusions Retrospectively assessed hard physical work during working life and exposure to several factors in the physical work environment, especially heavy lifting, were important for labour market exit and sickness absence. This study underscores the importance of reducing physical work exposures throughout the working life course for preventing sickness absence and premature exit from the labour market.
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Affiliation(s)
- Emil Sundstrup
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Åse Marie Hansen
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Erik Lykke Mortensen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | | | - Thomas Clausen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Anne Møller
- Department of Occupational Medicine, Holbæk Hospital, Copenhagen, Denmark.,Department of Public Health, The Research Unit for General Practice and Section of General Practice, University of Copenhagen, Copenhagen, Denmark
| | - Lars L Andersen
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Department of Health Science and Technology, Physical Activity and Human Performance group, SMI, Aalborg University, Copenhagen, Denmark
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Knardahl S, Johannessen HA, Sterud T, Härmä M, Rugulies R, Seitsamo J, Borg V. The contribution from psychological, social, and organizational work factors to risk of disability retirement: a systematic review with meta-analyses. BMC Public Health 2017; 17:176. [PMID: 28178966 PMCID: PMC5299735 DOI: 10.1186/s12889-017-4059-4] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Accepted: 01/24/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Previous studies indicate that psychological, social, and organizational factors at work contribute to health, motivation, absence from work, and functional ability. The objective of the study was to assess the current state of knowledge of the contribution of psychological, social, and organizational factors to disability retirement by a systematic review and meta-analyses. METHODS Data sources: A systematic literature search for studies of retirement due to disability in Medline, Embase, and PsychINFO was performed. Reference lists of relevant articles were hand-searched for additional studies. DATA EXTRACTION Internal validity was assessed independently by two referees with a detailed checklist for sources of bias. Conclusions were drawn based on studies with acceptable quality. DATA SYNTHESIS We calculated combined effect estimates by means of averaged associations (Risk ratios) across samples, weighting observed associations by the study's sample size. Thirty-nine studies of accepted quality were found, 37 of which from the Nordic countries. RESULTS There was moderate evidence for the role of low control (supported by weighted average RR = 1.40; 95% CI = 1.21-1.61) and moderate evidence for the combination of high demands and low control (although weighted average was RR = 1.45; 95% CI = 0.96-2.19) as predictors of disability retirement. There were no major systematic differences in findings between the highest rated and the lowest rated studies that passed the criterion for adequate quality. There was limited evidence for downsizing, organizational change, lack of employee development and supplementary training, repetitive work tasks, effort-reward imbalance to increase risk of disability pension. Very limited evidence was found for job demands, evening or night work, and low social support from ones superior. CONCLUSIONS Psychological and organizational factors at work contribute to disability retirement with the most robust evidence for the role of work control. We recommend the measurement of specific exposure factors in future studies.
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Affiliation(s)
- Stein Knardahl
- Department of work psychology and physiology, National Institute of Occupational Health, Oslo, Norway
| | - Håkon A. Johannessen
- Department of Occupational Health Surveillance, National Institute of Occupational Health, Oslo, Norway
| | - Tom Sterud
- Department of Occupational Health Surveillance, National Institute of Occupational Health, Oslo, Norway
| | - Mikko Härmä
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Jorma Seitsamo
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Vilhelm Borg
- National Research Centre for the Working Environment, Copenhagen, Denmark
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Jensen LD, Bonde JPE, Christensen MV, Maribo T. Early retirement among Danish female cleaners and shop assistants according to work environment characteristics and upper extremity complaints: an 11-year follow-up study. BMC Musculoskelet Disord 2016; 17:202. [PMID: 27146856 PMCID: PMC4857433 DOI: 10.1186/s12891-016-1053-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 04/27/2016] [Indexed: 11/13/2022] Open
Abstract
Background Studies have shown a negative social gradient in the incidence of early retirement. To prevent undesired early retirement, there is a need for knowledge of specific predictors in addition to social factors with a limited potential for change. The main purpose of this study was to examine musculoskeletal complaints and working conditions as predictors of early retirement among Danish female cleaners. Methods Using Cox regression with an adjustment for extraneous factors, we compared the risk of disability pension and retirement before the nominal retirement age (65 years) in an 11-year cohort study with registry-based follow-up of 1430 female cleaners and 579 shop assistants. In subsequent analyses of female cleaners, disability pension and voluntary early retirement were modeled according to work characteristics and upper extremity complaints. Results The adjusted hazard rate (HR) for disability pension among cleaners compared to the control group was 2.27 (95 % CI 1.58 to 3.28) and, for voluntary early retirement, 1.01 (95 % CI 0.85 to 1.20). In the subset of cleaners, the predictors of disability pension were persistent shoulder pain HR: 1.98 (95 % CI 1.47 to 2.67), elbow pain HR: 1.41 (95 % CI 1.02 to 1.94) and symptoms of nerve entrapment of the hand HR: 1.58 (95 % CI 1.14 to 2.20). Predictors of voluntary early retirement were persistent shoulder pain HR: 1.40 (95 % CI 1.16 to 1.67) and floor mopping for more than 10 h per week HR: 1.20 (95 % CI 1.03 to 1.40). Conclusion Cleaners have a twofold higher risk of disability pension compared to the control group. Risk factors for disability pension among cleaners were persistent shoulder and elbow pain together with symptoms of nerve entrapment of the hand. The findings of specific health related predictors of early retirement could be used in secondary prevention with targeted temporary reduced workload.
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Affiliation(s)
- Lone Donbæk Jensen
- Department of Occupational and Environmental Medicine, Aarhus University Hospital, Aarhus, Denmark.
| | - Jens Peter Ellekilde Bonde
- Department of Occupational and Environmental Medicine, Bispebjerg-Frederiksberg University Hospital, Copenhagen, Denmark
| | | | - Thomas Maribo
- Rehabilitation Center Marselisborg, Department of Public Health, Clinical Social Medicine and Rehabilitation Section, Aarhus University, Aarhus, Denmark.,Public Health and Quality Improvement, Central Denmark Region, Aarhus, Denmark
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Karlsson KJ, Niemelä PH, Jonsson AR, Törnhage CJA. Using Shoulder Straps Decreases Heart Rate Variability and Salivary Cortisol Concentration in Swedish Ambulance Personnel. Saf Health Work 2016; 7:32-7. [PMID: 27014488 PMCID: PMC4792915 DOI: 10.1016/j.shaw.2015.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 09/08/2015] [Accepted: 09/12/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Previous research has shown that paramedics are exposed to risks in the form of injuries to the musculoskeletal system. In addition, there are studies showing that they are also at increased risk of cardiovascular disease, cancer, and psychiatric diseases, which can partly be explained by their constant exposure to stress. The aim of this study is to evaluate whether the use of shoulder straps decreases physical effort in the form of decreased heart rate and cortisol concentration. METHODS A stretcher with a dummy was carried by 20 participants for 400 m on two occasions, one with and one without the shoulder straps. Heart rate was monitored continuously and cortisol samples were taken at intervals of 0 minutes, 15 minutes, 30 minutes, 45 minutes, and 60 minutes. Each participant was her or his own control. RESULTS A significant decrease in heart rate and cortisol concentration was seen when shoulder straps were used. The median values for men (with shoulder straps) at 0 minutes was 78 bpm/21.1 nmol/L (heart rate/cortisol concentration), at 15 minutes was 85 bpm/16.9 nmol/L, and at 60 minutes was 76 bpm/15.7 nmol/L; for men without shoulder straps, these values were 78 bpm/21.9 nmol/L, 93 bpm/21.9 nmol/L, and 73 bpm/20.5 nmol/L. For women, the values were 85 bpm/23.3 nmol/L, 92 bpm/20.8 nmol/L, and 70 bpm/18.4 nmol/L and 84 bpm/32.4 nmol/L, 100 bpm/32.5 nmol/L, and 75 bpm/25.2 nmol/L, respectively. CONCLUSION The use of shoulder straps decreases measurable physical stress and should therefore be implemented when heavy equipment or a stretcher needs to be carried. An easy way to ensure that staff use these or similar lifting aids is to provide them with personalized, well-adapted shoulder straps. Another better option would be to routinely sewn these straps into the staff's personal alarm jackets so they are always in place and ready to be used.
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Affiliation(s)
- Kåre J. Karlsson
- Ambulance Service, Skaraborg Hospital, Skövde, Sweden
- Skaraborg Hospital, Skövde, Sweden
| | - Patrik H. Niemelä
- Ambulance Service, Skaraborg Hospital, Skövde, Sweden
- Skaraborg Hospital, Skövde, Sweden
| | - Anders R. Jonsson
- School of Health Sciences, Borås University, Borås, Sweden
- Swedish Armed Forces, Centre for Defence Medicine, Västra Frölunda, Sweden
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Hewko SJ, Cooper SL, Huynh H, Spiwek TL, Carleton HL, Reid S, Cummings GG. Invisible no more: a scoping review of the health care aide workforce literature. BMC Nurs 2015; 14:38. [PMID: 26203297 PMCID: PMC4511030 DOI: 10.1186/s12912-015-0090-x] [Citation(s) in RCA: 116] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 07/14/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Healthcare aides (HCAs) are the primary caregivers for vulnerable older persons. They have many titles and are largely unregulated, which contributes to their relative invisibility. The objective of this scoping review was to evaluate the breadth and depth of the HCA workforce literature. METHODS We conducted a search of seven online bibliographic databases. Studies were included if published since 1995 in English, peer-reviewed journals. Results were iteratively synthesized within and across the following five categories: education, supply, use, demand and injury and illness. RESULTS Of 5,045 citations screened, 82 studies met inclusion criteria. Few examined HCA education; particularly trainee characteristics, program location, length and content. Results in supply indicated that the average HCA was female, 36-45 years and had an education level of high school or less. Home health HCAs were, on average, older and were more likely to be immigrants than those working in other settings. The review of studies exploring HCA use revealed that their role was unclear - variation in duties, level of autonomy and work setting make describing "the" role of an HCA near impossible. Projected increased demand for HCAs and high rates of turnover, both at the profession and facility-level, elicit predictions of future HCA shortages. Home health HCAs experienced comparatively lower job stability, earned less, worked the fewest hours and were less likely to have fringe benefits than HCAs employed in hospitals and nursing homes. The review of studies related to HCA illness and injury revealed that they were at comparatively higher risk of injury than registered nurses and licensed practical nurses. CONCLUSIONS This is the largest, most comprehensive scoping review of HCA workforce literature to date. Our results indicate that the HCA workforce is both invisible and ubiquitous; as long as this is the case, governments and healthcare organizations will be limited in their ability to develop and implement feasible, effective HCA workforce plans. The continued undervaluation of HCAs adversely impacts care providers, the institutions they work for and those who depend on their care. Future workforce planning and research necessitates national HCA registries, or at minimum, directories.
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Affiliation(s)
- Sarah J. Hewko
- CLEAR Outcomes Research Program, Faculty of Nursing, University of Alberta, Level 3, Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB T6G 1C9 Canada
| | - Sarah L. Cooper
- CLEAR Outcomes Research Program, Faculty of Nursing, University of Alberta, Level 3, Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB T6G 1C9 Canada
| | - Hanhmi Huynh
- CLEAR Outcomes Research Program, Faculty of Nursing, University of Alberta, Level 3, Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB T6G 1C9 Canada
| | - Trish L. Spiwek
- CLEAR Outcomes Research Program, Faculty of Nursing, University of Alberta, Level 3, Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB T6G 1C9 Canada
| | - Heather L. Carleton
- CLEAR Outcomes Research Program, Faculty of Nursing, University of Alberta, Level 3, Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB T6G 1C9 Canada
| | - Shawna Reid
- CLEAR Outcomes Research Program, Faculty of Nursing, University of Alberta, Level 3, Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB T6G 1C9 Canada
| | - Greta G. Cummings
- CLEAR Outcomes Research Program, Faculty of Nursing, University of Alberta, Level 3, Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB T6G 1C9 Canada
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Nexo MA, Borg V, Sejbaek CS, Carneiro IG, Hjarsbech PU, Rugulies R. Depressive symptoms and early retirement intentions among Danish eldercare workers: Cross-sectional and longitudinal analyses. BMC Public Health 2015; 15:677. [PMID: 26184519 PMCID: PMC4504417 DOI: 10.1186/s12889-015-1973-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 06/25/2015] [Indexed: 11/29/2022] Open
Abstract
Background Depression increases the risk of disability pension and represents a health related strain that pushes people out of the labour market. Although early voluntary retirement is an important alternative to disability pension, few studies have examined whether depressive symptoms incur early voluntary retirement. This study examined whether depressive symptoms and changes in depressive symptoms over time were associated with early retirement intentions. Methods We used a cross-sectional (n = 4041) and a prospective (n = 2444) population from a longitudinal study on employees of the Danish eldercare sector. Depressive symptoms were measured by the Major Depression Inventory and the impact of different levels of depressive symptoms (severe, moderately severe, moderate, mild and none) and changes in depressive symptoms (worsened, improved, unaffected) on early retirement intentions were analysed with multinomial logistic regression. Results In the cross-sectional analysis all levels of depressive symptoms were significantly associated with retirement intentions before the age of 62 years. Similar associations were found prospectively. Depressive symptoms and worsened depressive symptoms in the two year period from baseline to follow-up were also significantly associated with early retirement intentions before age 62. The prospective associations lost statistical significance when controlling for early retirement intentions at baseline. Conclusions The whole spectrum of depressive symptoms represents a health related strain that can incur intentions to retire early by early voluntary retirement. In order to change the intentions to retire early, the work related consequences of depressive symptoms should be addressed as early in the treatment process as possible.
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Affiliation(s)
- Mette Andersen Nexo
- The National Research Centre for the Working Environment, Lersoe Parkallé 105, DK-2100, Copenhagen, Denmark.
| | - Vilhelm Borg
- The National Research Centre for the Working Environment, Lersoe Parkallé 105, DK-2100, Copenhagen, Denmark.
| | - Camilla Sandal Sejbaek
- Department of Public Health, University of Copenhagen, Oester Farimagsgade 5, Post box 2099, DK-1014, Copenhagen K, Denmark.
| | - Isabella Gomes Carneiro
- The National Research Centre for the Working Environment, Lersoe Parkallé 105, DK-2100, Copenhagen, Denmark. .,Cancer Research UK partnership with the National Cancer Intelligence Network, Wellington House, 133-55 Waterloo Road, London, SE1 8UG, U. K.
| | - Pernille U Hjarsbech
- Danish Institute for Local and Regional Government Research. Koebmagergade 22, DK-1150, Copenhagen K, Denmark.
| | - Reiner Rugulies
- The National Research Centre for the Working Environment, Lersoe Parkallé 105, DK-2100, Copenhagen, Denmark. .,Department of Public Health, University of Copenhagen, Oester Farimagsgade 5, Post box 2099, DK-1014, Copenhagen K, Denmark. .,Department of Psychology, Copenhagen University, Oester Farigmagsgade 2A, DK-1353, Copenhagen, Denmark.
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Abstract
Changing demographics mean that many patients with soft tissue rheumatism, osteoarthritis, inflammatory arthritis, large joint prostheses and age-related co-morbidities are seeking to work beyond the traditional retirement age. In this chapter, we review the evidence on musculoskeletal health and work at older ages. We conclude that musculoskeletal problems are common in older workers and have a substantial impact on their work capacity. Factors that influence their job retention are described, together with approaches that may extend working life. Many gaps in evidence were found, notably on the health risks and benefits of continued work in affected patients and on which interventions work best. The roles of physicians and managers are also considered.
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Affiliation(s)
- Keith T Palmer
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK; ARUK-MRC Centre for Musculoskeletal Health and Work, UK.
| | - Nicola Goodson
- ARUK-MRC Centre for Musculoskeletal Health and Work, UK; Department of Musculoskeletal Biology 1, Institute of Aging and Chronic Diseases, University of Liverpool, University Hospital Aintree, Liverpool L9 7AL, UK.
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Zetterström K, Voss M, Alexanderson K, Ivert T, Pehrsson K, Hammar N, Vaez M. Prevalence of all-cause and diagnosis-specific disability pension at the time of first coronary revascularisation: a population-based Swedish cross-sectional study. PLoS One 2015; 10:e0115540. [PMID: 25629517 PMCID: PMC4309573 DOI: 10.1371/journal.pone.0115540] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2014] [Accepted: 11/25/2014] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Although coronary revascularisation by coronary artery bypass graft surgery (CABG) and percutaneous coronary intervention (PCI) is well documented, scientific knowledge on disability pension (DP) at the time of revascularisation is lacking. The aim was to investigate the prevalence of all-cause and diagnosis-specific DP at the time of a first coronary revascularisation, accounting for socio-demographic and medical factors. MATERIALS AND METHODS A population-based cross-sectional study using Swedish registers was conducted including all 65,676 patients (80% men) who when aged 30-63 years, within 1994-2006, had a first CABG (n = 22,959) or PCI (n = 42,717) and did not have old-age pension. Associations between socio-demographic and medical factors and the probability of DP were estimated by odds ratios (OR) with 95% confidence intervals (CI) using logistic regression analyses. FINDINGS The prevalence of DP at time of revascularisation was 24%, mainly due to musculoskeletal diagnoses. Sixty-two percent had had DP for at least four years before the revascularisation. In the multivariable analyses, DP was more common in women (OR: 2.40; 95% CI: 2.29-2.50), older patients (50-63 years); especially men aged 60-63 years with CABG (OR: 4.91; 95% CI: 4.27-5.66), lower educational level; especially men with PCI (OR: 2.96; 95% CI: 2.69-3.26), patients born outside Sweden; especially men with PCI (OR: 2.11; 95% CI: 1.96-2.27), and in women with an indication of other diagnoses than acute coronary syndrome (ACS) or stable angina pectoris for PCI (OR: 1.72; 95% CI: 1.31-2.24). CONCLUSION About a quarter had DP at the time of revascularisation, often due to musculoskeletal diagnoses. More than half had had DP for at least four years before the intervention. DP was associated with female gender, older age, lower educational level, and being born outside Sweden.
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Affiliation(s)
- Katharina Zetterström
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Margaretha Voss
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Analysis and Forecasts, Swedish Social Insurance Agency, Stockholm, Sweden
| | - Kristina Alexanderson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Torbjörn Ivert
- Department of Cardiothoracic Surgery and Anesthesiology, Karolinska University Hospital and Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Kenneth Pehrsson
- Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Niklas Hammar
- AstraZeneca R&D, Mölndal, Sweden
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Marjan Vaez
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
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van Rijn RM, Robroek SJW, Brouwer S, Burdorf A. Influence of poor health on exit from paid employment: a systematic review. Occup Environ Med 2013; 71:295-301. [PMID: 24169931 DOI: 10.1136/oemed-2013-101591] [Citation(s) in RCA: 260] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The objective was to provide a systematic literature review on associations between poor health and exit from paid employment through disability pension, unemployment and early retirement, and to estimate the magnitude of these associations using meta-analyses. Medline and Embase databases were searched for longitudinal studies on the relationship between health measures and exit from paid employment. Random-effects models were used to estimate the pooled effects. In total, 29 studies were included. Self-perceived poor health was a risk factor for transition into disability pension (relative risk (RR) 3.61; 95% CI 2.44 to 5.35), unemployment (RR 1.44; 95% CI 1.26 to 1.65) and early retirement (RR 1.27; 95% CI 1.17 to 1.38). Workers with mental health problems had an increased likelihood for transition into disability pension (RR 1.80; 95% CI 1.41 to 2.31) or unemployment (RR 1.61; 95% CI 1.29 to 2.01). Chronic disease was a risk factor for transition into disability pension (RR 2.11; 95% CI 1.90 to 2.33) or unemployment (RR 1.31; 95% CI 1.14 to 1.50), but not for early retirement. This meta-analysis showed that poor health, particularly self-perceived health, is a risk factor for exit from paid employment through disability pension, unemployment and, to a lesser extent, early retirement. To increase sustained employability it should be considered to implement workplace interventions that promote good health.
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Affiliation(s)
- Rogier M van Rijn
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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