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Knutsen RH, Nielsen MB, Lunde LK, Skare Ø, Johannessen HA. Impact of psychosocial work factors on risk of medically certified sick leave due to common mental disorders: a nationwide prospective cohort study of Norwegian home care workers. BMC Public Health 2024; 24:773. [PMID: 38475747 DOI: 10.1186/s12889-024-18299-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 03/06/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND The Norwegian home care services experience a high level of sick leave, a large proportion of which is due to common mental disorders. A substantial number of such cases can be attributed to psychosocial factors at work, but more knowledge about occupation-specific risk factors is needed to develop targeted preventive measures to reduce sick leave levels. The aim of this study is to identify the most prominent psychosocial work factors influencing the risk of sick leave spells due to common mental disorders. METHODS Employees from a random sample of 130 Norwegian home care services (N = 1.819) completed a baseline survey on 15 psychosocial work factors. Participants were subsequently followed up for 26 months using registry data on sick leave. The outcome measure was the number of medically certified sick leave spells due to common mental disorders during follow-up in the Norwegian social insurance database. Incidence risk ratios (IRR) and 95% confidence intervals (CIs) were calculated using negative binomial regression with robust standard errors. RESULTS Emotional dissonance (IRR 1.30, 95% CI 1.05-1.60) and emotional demands (IRR 1.35, 95% CI 1.14-1.58) were associated with an excess risk of sick leave, while control over work pacing (IRR 0.78, 95% CI 0.62-0.98) was associated with a reduced risk. An estimated 30% (95% CI 8.73-48.82) of sick leave cases were attributable to emotional dissonance and 27% (95% CI 4.80-46.33) were attributable to emotional demands. Control over work pacing was estimated to have prevented 20% (95% CI 1.32-37.78) of the sick leave cases. CONCLUSIONS This study found that emotional dissonance and emotional demands were robust risk factors for sick leave due to common mental disorders, and that control of work pacing constituted a robust protective factor against sick leave.
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Affiliation(s)
- Rigmor Harang Knutsen
- Research Group for Work Psychology and Physiology, National Institute for Occupational Health, Oslo, Norway.
- Department of Psychology, University of Oslo, Oslo, Norway.
| | - Morten Birkeland Nielsen
- Research Group for Work Psychology and Physiology, National Institute for Occupational Health, Oslo, Norway
| | - Lars-Kristian Lunde
- Research Group for Work Psychology and Physiology, National Institute for Occupational Health, Oslo, Norway
| | - Øivind Skare
- Research Group for Occupational Medicine and Epidemiology, National Institute for Occupational Health, Oslo, Norway
| | - Håkon A Johannessen
- Research Group for Work Psychology and Physiology, National Institute for Occupational Health, Oslo, Norway
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Christensen JO, Johannessen H. Is new tech a pain in the neck? The impact of introducing new technologies in home-care on neck pain: a prospective study. BMC Public Health 2024; 24:734. [PMID: 38454440 PMCID: PMC10921650 DOI: 10.1186/s12889-024-18252-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 03/01/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Home healthcare services are increasingly utilizing novel technologies to enhance quality and efficiency of caregiving, to reduce workloads and compensate for expected labor shortages in the future due to ageing populations. However, rapid, ongoing implementation of new technologies may demand considerable adaptation for employees. The objective of this study was to prospectively examine associations of newly introduced work technologies with neck pain complaints. METHODS With a nationally representative prospective sample of home-care workers in Norway (N = 887), we estimated effects of 1) introducing new technologies and 2) the appraised quality of training during implementation on neck pain eight months after. RESULTS A majority of employees reported new technologies having been introduced the previous 12 months (73.8%). This was not by itself associated with neck pain. However, perceived high quality of training was associated with less subsequent neck pain, also after adjustment for job demands and job control. The strongest effect was seen for "very good" versus "very poor" quality training (OR 0.35, 95% CI 0.17,0.71, in the fully adjusted model). Cross-lagged path analyses ruled out potential reverse causation stemming from the influence of pain on needs for or appraisals of training. CONCLUSION The present findings suggest the introduction of new work technologies has a significant impact on home-care workers' health, depending on the quality of training during implementation. This highlights the need to include training programs in risk assessments when implementing new technologies.
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Finnanger Garshol B, Knardahl S, Emberland JS, Skare Ø, Johannessen HA. Effects of the Labor Inspection Authority's regulatory tools on physician-certified sick leave and employee health in Norwegian home-care services - a cluster randomized controlled trial. Scand J Work Environ Health 2024; 50:28-38. [PMID: 37903341 PMCID: PMC10924761 DOI: 10.5271/sjweh.4126] [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: 06/02/2023] [Indexed: 11/01/2023] Open
Abstract
OBJECTIVE This study aimed to determine the effects of the Labor Inspection Authority's regulatory tools on physician-certified sick leave and self-reported health outcomes among employees in municipal home-care services in Norway. METHODS We conducted a cluster-randomized controlled trial in the home-care service sector, and 96 eligible municipalities were randomly assigned to one of three groups: (i) labor inspection visits, based on the Labor Inspection Authority's standard inspections; (ii) guidance-through-workshops, where participants from home-care services met with labor inspectors to receive information and discuss relevant topics; and (iii) the control group. Data on employee self-reported health (N=1669) were collected at baseline and 6 and 12 months after the interventions. Additionally, registry data (N=1202) on diagnosis specific physician-certified sick leave were collected for 18 months after the interventions. RESULTS We found no statistically significant effects of either intervention on self-reported health outcomes. There was, for both interventions, a pattern of decrease in days and periods of physician-certified sick leave due to musculoskeletal diagnoses and increase in days and periods of physician-certified sick leave due to psychological diagnoses, but these were not statistically significant. CONCLUSION Labor inspections and guidance-through-workshops had no statistically significant effect on self-reported health and physician-certified sick leave. The results should be interpreted with caution given the low response rate and subsequent attrition, and in the context of the COVID-19 pandemic. Future studies, in various industries, should further elucidate whether regulatory tools influence employee health and sick leave due to musculoskeletal and mental disorders.
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Affiliation(s)
- Bjørnar Finnanger Garshol
- Department of Work Psychology and Physiology, National Institute of Occupational Health, Oslo, Norway.
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Cannings-John R, Schoenbuchner S, Jones H, Lugg-Widger FV, Akbari A, Brookes-Howell L, Hood K, John A, Thomas DR, Prout H, Robling M. Impact of the COVID-19 pandemic on domiciliary care workers in Wales, UK: a data linkage cohort study using the SAIL Databank. BMJ Open 2023; 13:e070637. [PMID: 37263685 DOI: 10.1136/bmjopen-2022-070637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVES To quantify population health risks for domiciliary care workers (DCWs) in Wales, UK, working during the COVID-19 pandemic. DESIGN A population-level retrospective study linking occupational registration data to anonymised electronic health records maintained by the Secure Anonymised Information Linkage Databank in a privacy-protecting trusted research environment. SETTING Registered DCW population in Wales. PARTICIPANTS Records for all linked DCWs from 1 March 2020 to 30 November 2021. PRIMARY AND SECONDARY OUTCOME MEASURES Our primary outcome was confirmed COVID-19 infection; secondary outcomes included contacts for suspected COVID-19, mental health including self-harm, fit notes, respiratory infections not necessarily recorded as COVID-19, deaths involving COVID-19 and all-cause mortality. RESULTS Confirmed and suspected COVID-19 infection rates increased over the study period to 24% by 30 November 2021. Confirmed COVID-19 varied by sex (males: 19% vs females: 24%) and age (>55 years: 19% vs <35 years: 26%) and were higher for care workers employed by local authority social services departments compared with the private sector (27% and 23%, respectively). 34% of DCWs required support for a mental health condition, with mental health-related prescribing increasing in frequency when compared with the prepandemic period. Events for self-harm increased from 0.2% to 0.4% over the study period as did the issuing of fit notes. There was no evidence to suggest a miscoding of COVID-19 infection with non-COVID-19 respiratory conditions. COVID-19-related and all-cause mortality were no greater than for the general population aged 15-64 years in Wales (0.1% and 0.034%, respectively). A comparable DCW workforce in Scotland and England would result in a comparable rate of COVID-19 infection, while the younger workforce in Northern Ireland may result in a greater infection rate. CONCLUSIONS While initial concerns about excess mortality are alleviated, the substantial pre-existing and increased mental health burden for DCWs will require investment to provide long-term support to the sector's workforce.
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Affiliation(s)
| | | | - Hywel Jones
- Division of Population Medicine, Cardiff University, Cardiff, UK
| | | | - Ashley Akbari
- Faculty of Medicine, Health & Life Science, Swansea University Medical School, Swansea, UK
| | | | - Kerenza Hood
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Ann John
- Health Data Research UK | Administrative Data Research Wales, Swansea University, Swansea, UK
- DECIPHer-Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement, Cardiff University, Cardiff, UK
| | - Daniel Rh Thomas
- Communicable Disease Surveillance Centre, Public Health Wales, Cardiff, UK
- Cardiff Metropolitan University, Cardiff, UK
| | - Hayley Prout
- Centre for Trials Research, Cardiff University, Cardiff, UK
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Johannessen HA, Knardahl S, Emberland JS, Skare Ø, Finnanger Garshol B. Do regulatory tools instigate measures to prevent work-related psychosocial and ergonomic risk factors? A process evaluation of a Labour inspection authority trial in the Norwegian home-care services. BMC Res Notes 2022; 15:349. [PMID: 36401320 PMCID: PMC9673432 DOI: 10.1186/s13104-022-06244-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 11/02/2022] [Indexed: 11/19/2022] Open
Abstract
Objective There is a research gap regarding the way managers and employee representatives respond to Labour Authority interventions targeting work-related psychosocial and ergonomic risk factors. The present study aimed to determine if (I) labour inspections and (II) guidance-through-workshops led by inspectors were perceived by the target audience as equally useful and educational; and to determine if utility and enhanced knowledge were associated with the implementation of measures to prevent work-related risk factors. Finally, it aimed to determine if the managers in the intervention groups to a greater extent than the controls reported implementing such measures. Results Managers and employee representatives in both intervention groups reported a high level of perceived utility as well as a high level of enhanced knowledge. Both utility (p < 0.05) and enhanced knowledge (p < 0.05) were significantly associated with the implementation of, or plans to soon implement, measures to improve working conditions. When compared to controls, implemented measures, or plans to implement measures, were reported significantly more frequently by managers in the inspection group (p < 0.05). Trial Registration ClinicalTrials.gov ID: NCT03855163 Registered on February 26, 2019. Supplementary Information The online version contains supplementary material available at 10.1186/s13104-022-06244-4.
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Finnanger Garshol B, Knardahl S, Emberland JS, Skare Ø, Johannessen HA. Effects of the Labour Inspectorate Authority's regulatory tools on psychosocial and biomechanical work factors in Norwegian home care services: a cluster randomised controlled trial. Occup Environ Med 2022; 79:807-815. [PMID: 36167785 DOI: 10.1136/oemed-2022-108470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 09/06/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES This study aimed to determine the effects of the Labour Inspectorate Authority's (LIA's) regulatory tools on psychosocial and biomechanical work factors in the Norwegian municipal home care services. METHODS A cluster-randomised controlled trial conducted in the home care services with employee questionnaire data on work factors at baseline, and 6 and 12 months after the interventions. In total, 96 eligible municipalities were randomly assigned to either the control group or one of two interventions: (1) labour inspection visits, based on the LIA's standard inspections; and (2) guidance-through-workshops, where the participating services highlighted issues and trained labour inspectors provided guidance based on existing labour laws and regulations. RESULTS No favourable intervention effect was observed for the inspection intervention. No effects were observed for most of the variables in the guidance intervention, although an effect was observed for the following psychosocial factors: decision control, control over work intensity and empowering leadership. However, after adjusting for multiple testing, none of the observed effects were statistically significant. CONCLUSION Labour inspections did not affect psychosocial and biomechanical work factors in the home care services. A favourable effect of the guidance intervention on psychosocial work factors was observed. However, this was not evident after adjusting for multiple testing. Further research is needed to elaborate on how labour inspections and other regulatory tools can impact psychosocial and biomechanical work factors. TRIAL REGISTRATION NUMBER NCT03855163.
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Affiliation(s)
- Bjørnar Finnanger Garshol
- Department of Work Psychology and Physiology, National Institute of Occupational Health, Oslo, Norway
| | - Stein Knardahl
- Research Director, National Institute of Occupational Health, Oslo, Norway
| | - Jan Shahid Emberland
- Department of Work Psychology and Physiology, National Institute of Occupational Health, Oslo, Norway
| | - Øivind Skare
- Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Oslo, Norway
| | - Håkon A Johannessen
- Department of Work Psychology and Physiology, National Institute of Occupational Health, Oslo, Norway
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Suleiman AM, Said IA. Design, development, and utility validation of TIPA: a tool for inspection performance assessment. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2022:1-8. [PMID: 35930255 DOI: 10.1080/10803548.2022.2110359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
BACKGROUND Workplace inspection supports improving working environment and workers' conditions. Changes in workplaces following inspections are construed as the inspection's outcome. Inspectors need to be flexible, which affects their performance. This study aimed to design and develop a tool for inspection performance assessment based on identified inspection prerequisites and evaluate the tool's appropriateness for performance assessment. METHODS Occupational safety and health experts were tasked to rank identified prerequisite for effective inspection performance, based on their experiences and perception of importance of the prerequisites. The outcome of the ranking exercise formed the basis for weighting and assignment of values to the prerequisites subgoals. A code was written creating an inspection performance assessment tool interface, which inspectors can assess their workplace inspection performance.Inspectors from different national authorities tested and evaluated the tool, providing feedback appropriateness for measuring inspection performance. RESULTS Statistical analysis of the data collected showed much agreement between the subject matter experts. A five-level performance consideration depending on the inspection performance index attained was implemented. On testing and evaluation of the tool, high average rating for the test criteria were obtained, with data from inspectors from different authorities showing higher interrater consistency, and thus reliability. CONCLUSION TIPA provides a systematic inspection performance quantification supporting inspectors' self-actualisation, improving performance. Furthermore, the tool's generality allows for use irrespective of the inspection area without affecting inspection areas specificity adjustments. In addition, the ease of use adds to its utility, and with agreement on the tool's appropriateness for inspection performance assessment.
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