Separate and joint associations of chronic pain, multisite pain and mental health with sickness absence among younger employees: a register based longitudinal study

Plant food consumption and emotional well-being: the Helsinki Health Study among 19-39-year-old employees

BACKGROUND AND OBJECTIVES

Associations between fruit and vegetable consumption and mental health have been observed, but studies comparing different types of plant foods are sparse. This study among Finnish municipal employees examined associations of the consumption of a range of different plant foods with emotional well-being (EWB).

DATA AND METHODS

We used survey data from the Helsinki Health Study conducted in 2017 among 19-39-year-old employees of the City of Helsinki, Finland (N = 5898, response rate 51.5%, 80% women). Consumption of plant foods, including fruit, berries, fresh and cooked vegetables and wholegrain bread, was measured by a food frequency questionnaire and dichotomised into daily/non-daily consumption. The EWB scale of the RAND-36 questionnaire was dichotomised, with the lowest quartile indicating 'poor EWB' and the three higher quartiles indicating 'good EWB'. We used logistic regression for analysing the associations between plant food consumption and EWB. Analyses were sex-stratified and age, socioeconomic circumstances and psychosocial working conditions were adjusted for.

RESULTS

Prevalence of daily consumption of plant foods varied from 25% for berries and cooked vegetables to 70% for fresh vegetables. Daily consumption was associated with good EWB among both women and men. The strongest age-adjusted association was found for fresh vegetables, with women (OR 1.48, 95% CI 1.27-1.74) and men (OR 1.86, CI 1.37-2.52) with daily consumption having clearly higher odds of good EWB compared to non-daily consumers. Associations slightly attenuated but mostly remained after adjusting for socioeconomic circumstances and working conditions.

CONCLUSIONS

More frequent plant food consumption was associated with good EWB. Thus, the results support the need for interventions that investigate whether the promotion of plant food consumption could show potential mental health benefits among employees.

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.

Sickness absence trajectories among young and early midlife employees with psychological distress: the contributions of social and health-related factors in a longitudinal register linkage study

PURPOSE

Psychological distress has been associated with sickness absence (SA), but less is known about whether there are distinct patterns in the development of SA among people with psychological distress. We examined trajectories of short- and long-term SA among employees with psychological distress and how social and health-related factors are associated with them.

METHODS

We used the employer's register data on all-cause short- (≤ 10 working days) and long-term (> 10 working days) SA with a two-year follow-up. We prospectively linked the Helsinki Health Study survey data on 19-39-year-old employees of the City of Helsinki, Finland, in 2017, to the SA data. We included 1060 participants (81% women) who reported experiencing psychological distress, measured by the emotional wellbeing scale of RAND-36. Survey responses of age; gender; education; marital status; social support, procedural and interactional organisational justice, and bullying at work; physical activity; diet; tobacco and alcohol use; prior SA; and the level of psychological distress were included as exposures. Group-based trajectory modelling and multinomial logistic regression were used for the analyses.

RESULTS

We identified four short-term SA trajectories: 'low' (n = 379, 36% of participants), 'descending' (n = 212, 20%), 'intermediate' (n = 312, 29%), and 'high' (n = 157, 15%); and two long-term SA trajectories: 'low' (n = 973, 92%) and 'high' (n = 87, 8%). A higher education, fewer prior SA, and lower levels of psychological distress were associated with the 'low' short- and long-term SA trajectories.

CONCLUSION

SA trajectories differ among employees with psychological distress. Early intervention and support are needed among employees with mental health symptoms to prevent future SA.