Joint association of physical and psychosocial working conditions with risk of long-term sickness absence: Prospective cohort study with register follow-up

Reliability and Accuracy of Standard Reference Procedures for Measurements of Trunk and Arm Postures in Ergonomics

Adequate reference procedures for obtaining the reference zero-angle position are important for precise and accurate posture measurements, but few studies have systematically investigated these. A limited number of previous studies suggest differences in accuracy between procedures, with some causing an underestimation of the true arm elevation angle when sensors are taped to the skin. The reliability of commonly used reference procedures for the measurement of the trunk posture is also not well explored, and alternative procedures may improve precision. Based on this identified gap, this study evaluated the test-retest reliability of the N-position (I-pose), i.e., the standard procedure for recording trunk postures, and compared it with two new alternative procedures. Additionally, the accuracy of the N-position for measuring arm elevation angles was compared with one alternative procedure. A total of 40 participants (22 women and 18 men) aged 26-70 years performed the reference procedures in a laboratory setting. Postures were recorded using a smart workwear system equipped with two inertial measurement units (IMUs) embedded in pockets within the workwear. For the trunk posture, the N-position showed a slight lack of test-retest reliability, while one of the alternative procedures demonstrated better test-retest reliability. For the arm posture, the N-position, which does not include lateral trunk inclination, resulted in a substantial underestimation of the arm elevation angle of approximately 15°, which is a novel finding. In contrast, the posture involving trunk inclination closely matched the targeted reference, with a difference of less than 2°. This study underscores the importance of selecting appropriate reference procedures to ensure precise and accurate posture measurements.

Work-Related Psychosocial Risk and Protective Factors Influencing Workplace Sickness Absence: A Systematic Literature Review

PURPOSE

Employee sickness absence (SA) is a significant issue facing organizations and individuals worldwide, leading to multiple negative consequences, such as increased costs, early retirement, decreased productivity, and reduced quality of work. Therefore, within the occupational health and safety (OHS) framework, it is crucial to explore the factors that help workforces stay at work sustainably. This study investigates the role of work-related psychosocial factors (WRPFs) as predictors of SA and suggests proactive measures to prevent its occurrence.

METHODS

A systematic literature review was conducted within the Job Demands-Resources Model framework. Following the PRISMA Checklist, 1087 articles from PsycINFO, Medline, and Web of Science databases were screened, and 30 longitudinal studies were included.

RESULTS

The findings describe SA as a multifaceted phenomenon influenced by risk (e.g., poor quality leadership, bullying, and violence) and protective WRPFs (e.g., developmental opportunities and social support). These factors, spanning contextual, content-related, and relational dimensions, collectively influence workers' SA over time.

CONCLUSIONS

These insights provide valuable guidance for researchers and OHS stakeholders, supporting the development of research and interventions aimed at preventing SA. This research contributes important knowledge to the field, paving the way for more targeted strategies that address the organizational causes of SA and promote healthier, more productive work environments.

Long-term sickness absence trajectories and associated occupational and lifestyle-related factors: a longitudinal study among young and early midlife Finnish employees with pain

OBJECTIVES

This study aimed to identify distinct trajectories of long-term sickness absence (LTSA, >10 consecutive working days) among young and early midlife Finnish employees who experienced pain at baseline. It also aimed to determine the pain characteristics and occupational and lifestyle factors associated with these LTSA patterns.

DESIGN

Longitudinal occupational cohort study with register linkage.

SETTING

The largest municipal employer in Finland.

PARTICIPANTS

The study population comprised 19-39-year-old Finnish municipal employees (n=1685) who reported pain in 2017.

OUTCOME MEASURES

Prospective register data on all-cause LTSA through March 2020 were obtained from the Social Insurance Institution of Finland. Group-based trajectory modelling was used to identify distinct all-cause LTSA trajectories. Multinomial logistic regression was used to examine associations of pain characteristics and work- and lifestyle-related factors with trajectory group membership.

RESULTS

Three distinct LTSA-trajectory groups were identified: no LTSA (74%), decreasing (18%) and increasing (8%). The decreasing trajectory group had a higher prevalence of chronic or multisite pain, smoking (average marginal effects (AME) 6% points, 95% CI 2 to 11), obesity (AME 8% points, 95% CI 2 to 13), manual or routine non-manual occupation (AME 9% points, 95% CI 4 to 13) and high physical workload, after adjusting for age and gender. No predictor was identified for the increasing trajectory.

CONCLUSION

A majority of young and early midlife employees with pain had no LTSA during follow-up; however, chronic and multisite pain, smoking, overweight or obesity, lower occupational class and higher physical workload were associated with the decreasing LTSA trajectory. Interventions at workplaces and in occupational healthcare to prevent LTSA should aim at supporting employees who work with pain and have these risk factors.

Effectiveness of Sensors-Based Augmented Feedback in Ergonomics to Reduce Adverse Biomechanical Exposure in Work-Related Manual Handling-A Rapid Review of the Evidence

Manual handling is a major risk factor for work-related musculoskeletal disorders and one of the leading causes of disability-adjusted life years globally, necessitating multifaceted risk reduction measures. One potential intervention for manual handling tasks is work technique training assisted by augmented feedback on biomechanical exposures. However, there is a research gap regarding its effectiveness specifically for manual handling tasks in both real work environments and controlled settings, as well as its ability to induce retained reductions in biomechanical exposure. The gap was investigated using a rapid review comprising a literature search using two databases and 11 reviews/overviews to identify studies from the past 20 years, up to studies published by 1 June 2024. Sixteen studies were identified, with 14 of them being of high or moderate methodological quality and were included. Three studies were conducted in real work environments and eleven in controlled settings. Most studies (n = 9) used auditory feedback, followed by vibration feedback (n = 6). In real work environments, the evidence for the effectiveness of sensor-based augmented feedback in reducing biomechanical exposure during administration was considered to be inconsistent and very limited directly after administration. For longer periods after administration, ranging from one week to more than six months, there is currently no evidence demonstrating the effectiveness of the feedback. In controlled settings, there was strong evidence for its effectiveness during and immediately after administration, and limited evidence for effectiveness up to six months post-administration when considering the tasks included in the training. Future research needs are discussed.

Effects of job demands, job resources, personal resources on night-shift alertness of ICU shift nurses: a cross‑sectional survey study based on the job demands-resources model

BACKGROUND

A positive work environment can enhance nursing safety and patient satisfaction while alleviating nurse stress. Conversely, a poor work environment can harm nurses' physical and mental health and compromise the quality of care, particularly in the high-intensity and shift-based setting of the ICU.

OBJECTIVES

Based on the Job demands-resources (JD-R) model, this study examined the effects of job demands and job resources in the work environment, as well as personal resources, on the night-shift alertness of ICU shift nurses.

METHODS

This cross-sectional correlational exploratory study, conducted from July to September 2022, recruited 291 ICU shift nurses from a hospital in Beijing, China. The Copenhagen Psychosocial Questionnaire (COPSOQ), the Self-resilience scale, the General Self-Efficacy Scale (GSES), and the Psychomotor Vigilance Task (PVT) were used to subjectively and objectively measure the job demands, job resources, personal resources, and night-shift alertness. SPSS 26.0 and Mplus 8.3 were used to analyze the data and construct the structural equation model.

RESULTS

The night-shift reaction time was 251.0 ms (Median), indicating a relatively high level of alertness. Job demands were negatively correlated with both job resources (r=-0.570, P < 0.001) and personal resources (r=-0.462, P < 0.001), while a positive correlation existed between job resources and personal resources (r = 0.554, P < 0.001). The results show that increased job demands can lead to higher levels of nurse strain (β = 0.955, P < 0.001), whereas job resources were found that it can decrease strain (β=-0.477, P = 0.047). Adequate job resources can enhance motivation directly (β = 0.874, P < 0.001), subsequently reducing reaction time (β=-0.148, P = 0.044) and improving night-shift alertness among ICU shift nurses.

CONCLUSION

Enhancing ICU shift nurses' work motivation through bolstering job resources can boost night-shift alertness. However, it is noteworthy that, in this study, neither strain nor individual resources significantly influenced nurses' night-shift alertness. This may be attributed to the complexity of the ICU environment and individual differences. Future research should explore the relationship between these factors and nurses' work alertness.

A Rapid Review on the Effectiveness and Use of Wearable Biofeedback Motion Capture Systems in Ergonomics to Mitigate Adverse Postures and Movements of the Upper Body

Work-related diseases and disorders remain a significant global health concern, necessitating multifaceted measures for mitigation. One potential measure is work technique training utilizing augmented feedback through wearable motion capture systems. However, there exists a research gap regarding its current effectiveness in both real work environments and controlled settings, as well as its ability to reduce postural exposure and retention effects over short, medium, and long durations. A rapid review was conducted, utilizing two databases and three previous literature reviews to identify relevant studies published within the last twenty years, including recent literature up to the end of 2023. Sixteen studies met the inclusion criteria, of which 14 were of high or moderate quality. These studies were summarized descriptively, and the strength of evidence was assessed. Among the included studies, six were rated as high quality, while eight were considered moderate quality. Notably, the reporting of participation rates, blinding of assessors, and a-priori power calculations were infrequently performed. Four studies were conducted in real work environments, while ten were conducted in controlled settings. Vibration feedback was the most common feedback type utilized (n = 9), followed by auditory (n = 7) and visual feedback (n = 1). All studies employed corrective feedback initiated by the system. In controlled environments, evidence regarding the effectiveness of augmented feedback from wearable motion capture systems to reduce postural exposure ranged from strong evidence to no evidence, depending on the time elapsed after feedback administration. Conversely, for studies conducted in real work environments, the evidence ranged from very limited evidence to no evidence. Future reach needs are identified and discussed.

Comprehensive evaluation of the impact of workplace exposures on physician-certified sick leave in the general working population

BACKGROUND

Our objective was to quantify the prospective associations between work factors across chemical, physical, mechanical, and psychosocial domains and the onset of medically certified sick leave.

METHODS

Eligible respondents were interviewed in 2009, 2013, or 2016 and were registered in the national sick leave register with an employee relationship lasting more than 50 working days during the year of the survey interviews and the following year (n = 15,294 observations). To focus on the onset of high-level sick leave (HLSL; >16 days a year), we excluded individuals with HLSL during the survey year (baseline). We then used mixed-effect logistic regression models to assess prospective associations between self-reported work conditions and the occurrence of doctor-certified HLSL in the following year.

RESULTS

The average occurrence of HLSL was 13.1%. After adjusting for sex, age, level of education, chronic health problems, and smoking, we observed an exposure-response relationship between cumulative exposure to work factors within all domains and the occurrence of HLSL. When evaluating the impact of combined exposures, predicted odds ratios (OR) for employees exposed to 1, 2, and 3 or more work factors within all domains were 1.60 (95%CI 1.32 - 1.94), 2.56 (95%CI 1.73 - 3.74) and 4.09 (95%CI 2.28 - 7.25), compared to those not exposed.

CONCLUSIONS

The results support the notion that exposure to multiple work factors in various domains, including psychosocial, mechanical, chemical, and physical work conditions, is associated with an increased risk of high-level sick leave. Employers and occupational health professionals should consider the joint impact of these domains when designing interventions.

Effects of consecutive workdays and days off on low back pain, fatigue and stress: prospective cohort study among warehouse and construction workers

OBJECTIVES

Limited knowledge exists about day-to-day changes in physical and mental symptoms in warehouse and construction workers. This study investigated the associations between consecutive workdays and days off with low back pain (LBP) intensity, bodily fatigue and mental stress.

METHODS

Participants (n=224) received daily questions for 21 days about LBP, fatigue, stress (outcome, 0-10 scales), and workdays and days off (exposure). We tested associations between 1-3 workdays (n=148) and 1-2 days off (n=158) with LBP intensity, bodily fatigue and mental stress after work and the following morning using linear mixed models with repeated measures controlling for relevant confounders.

RESULTS

Consecutive workdays led to progressively increased LBP intensity, with three workdays increasing LBP intensity by 1.76 (95% CI 1.48 to 2.03) points. Bodily fatigue and mental stress increased after one workday (2.06 (95% CI 1.80 to 2.32) and 0.97 (95% CI 0.77 to 1.17) points, respectively) and remained stable for three workdays. After 1 day off, bodily fatigue and mental stress decreased -1.82 (95% CI -2.03 to -1.61) and -0.88 (95% CI -1.05 to -0.71) points, respectively, without decreasing further. In contrast, LBP intensity decreased progressively -1.09 (95% CI -1.27 to -0.91) and -1.45 (95% CI -1.67 to -1.24) points after 1 and 2 days off, respectively.

CONCLUSIONS

Workdays and days off affected the outcome variables differently. LBP intensity progressively increased with consecutive workdays, while workers needed 2 days off to recover. This study provides valuable knowledge about how to organise the workweek to prevent LBP, fatigue and stress, potentially reducing labour market withdrawal.

Combined exposure to heavy physical workload and low job control and the risk of disability pension: A cohort study of employed men and women in Sweden

OBJECTIVE

To investigate the separate and combined effects of overall heavy physical workload (PWL) and low decision authority on all-cause disability pension (DP) or musculoskeletal DP.

METHODS

This study uses a sample of 1,804,242 Swedish workers aged 44-63 at the 2009 baseline. Job Exposure Matrices (JEMs) estimated exposure to PWL and decision authority. Mean JEM values were linked to occupational codes, then split into tertiles and combined. DP cases were taken from register data from 2010 to 2019. Cox regression models estimated sex-specific Hazard Ratios (HR) with 95% confidence intervals (95% CI). The Synergy Index (SI) estimated interaction effects.

RESULTS

Heavy physical workload and low decision authority were associated with an increased risk of DP. Workers with combined exposure to heavy PWL and low decision authority often had greater risks of all-cause DP or musculoskeletal DP than when adding the effects of the single exposures. The results for the SI were above 1 for all-cause DP (men: SI 1.35 95%CI 1.18-1.55, women: SI 1.19 95%CI 1.05-1.35) and musculoskeletal disorder DP (men: SI 1.35 95%CI 1.08-1.69, women: 1.13 95%CI 0.85-1.49). After adjustment, the estimates for SI remained above 1 but were not statistically significant.

CONCLUSION

Heavy physical workload and low decision authority were separately associated with DP. The combination of heavy PWL and low decision authority was often associated with higher risks of DP than would be expected from adding the effects of the single exposures. Increasing decision authority among workers with heavy PWL could help reduce the risk of DP.

Working conditions and mental health functioning among young public sector employees

Background: The associations between adverse working conditions and mental disorders are well established. However, associations between adverse working conditions and poor mental health functioning is a less explored area. This study examines these associations among younger public sector employees of the City of Helsinki, Finland. Methods: We use data from the Young Helsinki Health Study with a representative sample of the employees of the City of Helsinki, aged 19-39 years (n=4 217). Mental health functioning was measured with mental composite summary of the Short Form 36. Working conditions included factors related to both the psychosocial (job control and job demands) and the physical work environment (physical workload). To examine the associations, we used logistic regression models with adjustments for socio-demographics, other working conditions and health-related covariates. Results: After adjustment for sociodemographic characteristics, poor health, health behaviours and other occupational exposures, high job demands (OR=1.69; 95% CI=1.45-1.97) and low job control (OR=1.65; 95% CI=1.40-1.94) were associated with poor mental health functioning. High physical workload was not associated with the outcome (OR=0.87; 95% CI=0.72-1.05) after the adjustments. Conclusions: Adverse psychosocial working conditions were associated with mental health functioning, whereas physical working conditions were not. As impaired functioning is likely to cause health-related lost productivity and can lead to work disability, further research and interventions with a balanced approach focusing on both psychosocial working conditions and mental health functioning are recommended.

Musculoskeletal Health Climate Is a Prognostic Determinant of Sickness Absence Among Female Eldercare Workers: A Prospective Cohort Study

OBJECTIVES

The present study investigated the association between musculoskeletal health climate, that is, the shared perceptions among workers concerning musculoskeletal health, and sickness absence.

METHODS

Questionnaire data on two domains of musculoskeletal health climate, perceived management priority (PMP) and pain acceptance at work (PAW), were collected at baseline. Data on sickness absence were extracted at 1-year follow-up. Data were analyzed using negative binomial multivariable regression.

RESULTS

The final study population comprised 390 female eldercare workers. Compared with participants with low PMP scores, participants with high PMP scores had lower risk of sickness absence (incidence rate ratio, 0.6; 95% confidence interval, 0.4-0.9). Participants with high PAW scores had higher risk of sickness absence than participants with low PAW scores (incidence rate ratio, 1.4; 95% confidence interval, 0.9-2.2).

CONCLUSIONS

The results showed an association between the musculoskeletal health climate and sickness absence.

The Interplay between Multimorbidity, Physical Work Demands and Work Ability: Cross-Sectional Study among 12,879 Senior Workers

Background: Aging increases the risk of chronic diseases, which can challenge the ability to work and thereby push senior workers out of the labour market. This study investigates the association between non-communicable diseases (NCDs) and work ability among workers ≥50 years (senior workers) with physically demanding and sedentary work, respectively. Methods: In the SeniorWorkingLife study, 12,879 senior workers replied to a questionnaire survey on work and health in 2018. Associations between the type and number of NCD and work ability (scale 0−10) were modelled using a general linear model adjusting for potential confounders and combined with model-assisted weights from national registers. Results: A higher number of NCD (multimorbidity) was progressively associated with a lower work ability (trend test, p-value < 0.001). Physical work influenced the association between the number of NCDs and work ability. For specific diseases, mental disorders, including burn-out syndrome (least square mean difference (LSMD): −1.46, 95% CI: −1.61 to −1.32) and stress ( LSMD: −1.18, 95% CI: −1.29 to −1.07), demonstrated a stronger association with a lower work ability compared with somatic diseases, such as back diseases (LSMD: −0.72, 95% CI: −0.80 to −0.64). Conclusions: Multimorbidity was progressively associated with a lower work ability in senior workers, especially among those with physical work.

Role of job and personal resources in the appraisal of job demands as challenges and hindrances

Previous research has shown that challenge and hindrance job demands show different effects on employees' wellbeing and performance. Moreover, it has been demonstrated that employees' subjective appraisal of job demands as challenges and hindrances may vary: they can be appraised as challenges or hindrances or both. Subjective appraisal of job demands was found to be also related to employees' wellbeing and productivity. However, little is known about predictors of the appraisals of job demands made by employees. The aim of the study was to identify predictors of such appraisals among job and individual resources. Cross-sectional research was carried out among 426 IT, healthcare and public transport employees. COPSOQ II scales were used to measure job demands (emotional, quantitative, cognitive demands, work pace and role conflicts) and job resources (influence at work, possibilities for development, vertical and horizontal trust), single questions were used to measure employees' subjective appraisals of job demands as hindrances and challenges, and PCQ was used to measure psychological capital. Multiple hierarchical regression analyses showed that only horizontal trust predicted the appraisal of job demands as challenges, and vertical trust predicted the appraisal of job demands as hindrances among four analysed job resources. Individual resource-psychological capital-predicted only the appraisal of job demands as challenges. Control variables-occupation, age and job demands also played a significant role in predicting the appraisal of job demands. Implications and future directions are discussed.