Novel genetic polymorphisms associated with carcass traits in grazing Texel sheep

Improving meat production traits has increased its importance in sheep breeding. We report novel associations of SNP present in genes related to lipid metabolism and growth with several carcass traits in purebred Texel lambs. Expected progeny differences (EPD) predictions from 461 animals from the Central Progeny Testing of Texel breed in Uruguay were used for the association analysis. Live weights at different stages, ultrasound and post-mortem traits were analyzed. Markers in several genes were associated with growth, carcass and meat quality traits. Among others: PPARGC1A with valuable cuts weight, hot carcass weight and carcass fatness; DGAT1 with live weights, fat thickness, rib-eye area and shoulder weight; CAST with birth weight and fat thickness; GHR with birth weight and carcass fatness, and GHRHR with live weights and fat thickness. Genotypic effects ranged from 0.035 to 0.923 (DGAT1 vs. weaning weight) units of phenotypic SD. Most of the associations described are novel in sheep breeding, deserving further analyses.

NATURAL AND ANTHROPOGENIC EFFECTS ON THE SOIL GEOCHEMISTRY OF KAVALA AREA, NORTHERN GREECE

A total of 65 surface soils and 8 rock samples from the area surrounding the city of Kavala, Northern Greece, was collected and analyzed for their contents in 10 major and 32 trace elements. The extraction of the elements from the < 200μm soil fraction was based on the digestion of 0.1g of each sample with 2ml HNO3. The analytical methods used were ICP-OES and ICP-MS and the elements determined were Al, Ca, Cl, Fe, K, Mg, Na, P, S, Si, Ag, As, B, Ba, Cd, Ce, Co, nCr, Cs, Cu, Ga, Ge, Hg, La, Li, Mn, Mo, Ni, Pb, Rb, Sb, Se, Sn, Sr, Th, Ti, U, V, W, Y, Zn and Zr. Comparisons between the concentrations of the surface soil samples and the surrounding rock samples indicate that the majority of major, as well as, of trace elements are found in the surface soils of Kavala with such concentrations that are considered as the product of natural processes such as the weathering of parent rocks and pedogenesis. However, there are some nmajor elements (Cl, Na, S) and trace elements (Ag, As, Pb, V, Zn) that are present in the surface soils of the study area with elevated concentrations that cannot be regarded as the sole product of natural processes, but as the result of both, natural and anthropogenic activities, especially for the samples that are situated inside the industrial area of Kavala.

Beyond Return to Work: The Effect of Multimorbidity on Work Functioning Trajectories After Sick Leave due to Common Mental Disorders

Objectives Patients with common mental disorders (CMDs) often suffer from comorbidities, which may limit their functioning at work. We assessed the longitudinal impact of multimorbidity, defined as two or more co-occurring chronic health conditions, on work functioning over time among workers who had returned to work after sick leave due to CMDs. Methods Prospective cohort study of 156 workers followed for 1 year after return to work from sick leave due to CMDs. A multimorbidity score was computed by counting severity-weighted chronic health conditions measured at baseline. Work functioning was measured at baseline and at 3, 6 and 12 months follow-up with the Work Role Functioning Questionnaire. Work functioning trajectories, i.e. the course of work functioning after return to work over time, were identified through latent class growth analysis. Results A total of 44 % of workers had multimorbidity. Four work functioning trajectories were identified: one (12 % of the workers) showed increasing work functioning scores during follow-up, whereas the other trajectories showed low, medium and high scores (23, 41 and 25 %, respectively) that remained stable across time points. Although multimorbidity did not predict membership in any trajectory, within the increasing score trajectory levels of work functioning were lower among those with high baseline multimorbidity score (p < 0.001). Conclusions Over time, multimorbidity negatively impacts work functioning after return to work from sick leave due to CMDs.

Effects of county-level attributes on geographic variation in female breast cancer mortality rates across counties in United States

e13093

Background: Though studies have examined geographic disparities in breast cancer mortality among United States (U.S.) counties, county-level risk factors were not accounted for. The aim of this study is to efficiently map the spatial association between female breast cancer mortality rates & socioeconomic attributes across U.S. counties for identifying high risk geographical clusters in terms of socioeconomic attributes. Methods: County-specific age standardized breast cancer mortality rates for women ≥20 years in the U.S. were obtained for 3,109 counties in 48 contiguous states from Surveillance Epidemiology and End Results program from 1990-2012. County-level attributes such as percentages of Hispanic white, Non-Hispanic white, Non-Hispanic black, < high school education, below 200% poverty, urban, foreign born, language isolation, women aged ≥ 40 years with mammography within last 2 years, and median household income were gathered from U.S. decennial census. Factor analysis condensed county attributes into three factor covariates namely Hispanic immigrants, health care access among urban high socioeconomic population, and non-Hispanic black unemployment. Spatiotemporal analysis was carried out by structured additive regression model to incorporate spatial functions & Markov chain Monte Carlo simulation techniques. Results: Moran’s index suggested existence of spatial dependence for breast cancer mortality among U.S. counties. As mammography screening, %urban population, % with high socioeconomic status and non-Hispanic black unemployment increased in counties of the Southwest region, Rocky mountain region and those in the western border of Midwest region of U.S, risk of breast cancer mortality increased significantly above the national average. As the Hispanic immigrant culture increased, counties of Midwest region of U.S had significantly higher mortality rates compared to national average. Conclusions: These initial results describe socio-economic, cultural, and healthcare access factors for observed geographic variations in female breast cancer mortality, and in turn, could support a stronger theoretical basis for public health policy.

The effect of multimorbidity on sickness absence by specific diagnoses

BACKGROUND

As the world's population ages, the prevalence of multiple chronic and non-chronic health-related conditions is increasing. Research on multimorbidity, the co-occurrence of two or more health-related conditions, has mainly involved patient and older populations. Its effect in working populations, presumably younger and healthier, is not well known but could conceivably affect sickness absence (SA) and ability to return to work.

AIMS

To examine the effect of multimorbidity on the incidence and duration of SA episodes by frequent diagnostic groups.

METHODS

A prospective study (in 2006-2008) of workers in Spain. Information on health-related conditions was gathered with a standardized questionnaire and used to construct a sex-specific multidimensional multimorbidity score (MDMS). In order to estimate the effect of MDMS on incidence and duration of SA episodes due to cardiovascular diseases (CVD), musculoskeletal disorders (MSD) and mental health disorders (MHD), we fitted Cox models adjusted by age, occupational social class and number of prior SA episodes for both sexes.

RESULTS

The study population was 372370. Men with high MDMS showed a trend towards higher incidence risk for SA due to CVD and MSD [adjusted hazard ratio (aHR) = 2.03; 95% confidence interval (CI) 1.48-2.78 and aHR = 1.20; 95% CI 1.01-1.43, respectively]. Women showed a similar trend for MSD, but MHD had the strongest association (aHR = 4.78; 95% CI 1.97-11.62) for high MDMS. In both sexes, the effect of MDMS was strongest among those without a prior SA. No consistent associations with SA duration were observed.

CONCLUSIONS

Multimorbidity increased the risk of incident musculoskeletal, mental and cardiovascular SA episodes but not their duration.

Abstract P2-07-14: Geographic variation in the female breast cancer mortality rates across counties in United States

Background: Few studies have examined geographic disparities in breast cancer mortality at smaller geographical areas in the United States (U.S,) taking into account geographical details and spatial auto-correlations. Though these have identified counties with high breast cancer mortality risk, county-level socioeconomic attributes which are proven to be risk factors for breast cancer mortality were not examined and accounted for. The aim of this study is to efficiently map the spatial variation in the female breast cancer mortality rates across the counties of U.S., and to identify the high risk geographical clusters while adjusting for the county attributes, such as ethnic distribution of the population, educational attainment, poverty, unemployment and health care access.

Methodology: County-specific age standardized rates for breast cancer mortality for women aged ≥ 20 years in the U.S. were obtained for 3,109 counties from Surveillance Epidemiology and End Results (SEER) program from 1990-2012. We gathered county attributes from American Community Survey, such as the percentages of Hispanic white, Non-Hispanic white, Non-Hispanic black, &lt; high school education, below 200% poverty, urban, foreign born, language isolation, women aged ≥ 40 years with mammography within last 2 years, and median household income. Then, we applied factor analysis to condense county attributes into three factors as covariates namely Hispanic immigrants, health care access among urban high income population, and non-Hispanic black unemployment. Spatiotemporal analysis was carried out by the structured additive regression model to incorporate spatial functions and Bayesian inference using Markov Chain Monte Carlo simulation techniques. Deviance Information Criteria was used for model comparisons and selections.

Results: Moran's index for the age standardized breast cancer mortality rate was 0.12 (p-value :&lt; 0.001) suggesting the existence of spatial dependence for the breast cancer mortality among the counties of U.S. Estimated effects [Mean (95%CI)] of spatial estimates for the factors were 0.03(0.02-0.05) for Hispanic immigrant culture, 0.06(0.04-0.09) for health care access among urban & high income groups and 0.41(0.31-0.51) for the non-Hispanic black unemployment. Counties in the Southwest region, Rocky mountain region and those in the western border of Midwest region of U.S with more Hispanic immigrants, have significantly lower mortality rates, a finding that can attributed to the lower incidence of breast cancer among Hispanics. As the mammography screening among urban and high income areas of the counties in the Mid-west region increase, the risk of breast cancer mortality increase significantly above the national average. And as the non-Hispanic black unemployment rates increase, the counties of Mid-West and those of South-West were at higher risk of mortality compared to national average. The percentage of counties with significant positive spatial function were 3.8% for the health care access factor and 6.3% for non-Hispanic black unemployment factor.

Conclusion: These initial results might explain social, cultural, and other reasons for the observed geographic variations, and in turn, could support a stronger theoretical basis for public health policy.

Citation Format: Sagiraju HKR, Chien L-C, Valerio MA, Jatoi I, Gimeno D. Geographic variation in the female breast cancer mortality rates across counties in United States [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P2-07-14.

Economic Burden of Hearing Loss for the U.S. Military: A Proposed Framework for Estimation

The goal of this multiphased research is to develop methods to comprehensively determine the economic impact of hearing impairment and noise-induced hearing injury among active duty U.S. Service Members. Several steps were undertaken to develop a framework and model for economic burden analysis: (1) a literature review identifying studies reporting the cost of health conditions and injuries in the Department of Defense, (2) consultation with a panel of subject matter experts who reviewed these cost items, and (3) discussions with DoD data stewards and review of relevant data dictionaries and databases. A Markov model was developed to represent the cumulative economic effect of events along the career span, such as retraining after hearing impairment and injury, by synthesizing inputs from various sources. The model, as developed and proposed in this study, will be a valuable decision-making tool for the DoD to identify high-risk groups, take proactive measures, and develop focused education, customized equipping, and return-to-duty and reintegration programs, thereby maximizing the retention of skilled, experienced, and mission-ready Service Members.

[Basic questionnaire and methodological criteria for Surveys on Working Conditions, Employment, and Health in Latin America and the Caribbean]

This article aimed to present a basic questionnaire and minimum methodological criteria for consideration in future Surveys on Working Conditions, Employment, and Health in Latin America and the Caribbean. A virtual and face-to-face consensus process was conducted with participation by a group of international experts who used the surveys available up until 2013 as the point of departure for defining the proposal. The final questionnaire included 77 questions grouped in six dimensions: socio-demographic characteristics of workers and companies; employment conditions; working conditions; health status; resources and preventive activities; and family characteristics. The minimum methodological criteria feature the interviewee's home as the place for the interview and aspects related to the quality of the fieldwork. These results can help improve the comparability of future surveys in Latin America and the Caribbean, which would in turn help improve information on workers' heath in the region.

Descriptive Epidemiology of Somatising Tendency: Findings from the CUPID Study

Somatising tendency, defined as a predisposition to worry about common somatic symptoms, is importantly associated with various aspects of health and health-related behaviour, including musculoskeletal pain and associated disability. To explore its epidemiological characteristics, and how it can be specified most efficiently, we analysed data from an international longitudinal study. A baseline questionnaire, which included questions from the Brief Symptom Inventory about seven common symptoms, was completed by 12,072 participants aged 20-59 from 46 occupational groups in 18 countries (response rate 70%). The seven symptoms were all mutually associated (odds ratios for pairwise associations 3.4 to 9.3), and each contributed to a measure of somatising tendency that exhibited an exposure-response relationship both with multi-site pain (prevalence rate ratios up to six), and also with sickness absence for non-musculoskeletal reasons. In most participants, the level of somatising tendency was little changed when reassessed after a mean interval of 14 months (75% having a change of 0 or 1 in their symptom count), although the specific symptoms reported at follow-up often differed from those at baseline. Somatising tendency was more common in women than men, especially at older ages, and varied markedly across the 46 occupational groups studied, with higher rates in South and Central America. It was weakly associated with smoking, but not with level of education. Our study supports the use of questions from the Brief Symptom Inventory as a method for measuring somatising tendency, and suggests that in adults of working age, it is a fairly stable trait.

[Musculoskeletal pain in Central American workers: results of the First Survey on Working Conditions and Health in Central America]

OBJECTIVE

Examine the prevalence of musculoskeletal pain (MSP) in the six Spanish-speaking countries of Central America using a single standardized instrument, the First Survey on Working Conditions and Health in Central America in workers from all manual and non-manual labor sectors, using social security coverage as an indicator of formal versus informal employment.

METHODS

The workers (n = 12 024) were surveyed in their homes. The age-adjusted prevalence of MSP during the previous month was calculated for pain in the back (upper, or cervical; middle, or thoracic; and lower, or lumbar) and arm joints (shoulder, elbow, and wrist). Prevalence was estimated by sex, occupation (manual or non-manual), economic sector (agriculture, industry, or services), and social security coverage. Poisson regression models were used to calculate the prevalence rates and 95% confidence intervals, with stratification by country and anatomical site.

RESULTS

By sites, the age-adjusted prevalence of cervical-dorsal MSP was the highest, especially in El Salvador (47.8%) and Nicaragua (45.9%), and lumbar MSP was less prevalent, especially in Panama (12.8%) and Guatemala (14.8%). After additional adjustments, the prevalence of MSP was higher in women and manual workers for all the sites and in all the countries. There were no differences in MSP in terms of social security coverage or sector of economic activity.

CONCLUSIONS

The high prevalence of MSP in Central America, regardless of sector of activity or social security coverage, indicates that the prevention of MSP should be a priority in occupational health programs in low- and middle-income countries, especially for women and manual workers.

The influence of market deregulation on fast food consumption and body mass index: a cross-national time series analysis

OBJECTIVE

To investigate the effect of fast food consumption on mean population body mass index (BMI) and explore the possible influence of market deregulation on fast food consumption and BMI.

METHODS

The within-country association between fast food consumption and BMI in 25 high-income member countries of the Organisation for Economic Co-operation and Development between 1999 and 2008 was explored through multivariate panel regression models, after adjustment for per capita gross domestic product, urbanization, trade openness, lifestyle indicators and other covariates. The possible mediating effect of annual per capita intake of soft drinks, animal fats and total calories on the association between fast food consumption and BMI was also analysed. Two-stage least squares regression models were conducted, using economic freedom as an instrumental variable, to study the causal effect of fast food consumption on BMI.

FINDINGS

After adjustment for covariates, each 1-unit increase in annual fast food transactions per capita was associated with an increase of 0.033 kg/m2 in age-standardized BMI (95% confidence interval, CI: 0.013-0.052). Only the intake of soft drinks--not animal fat or total calories--mediated the observed association (β: 0.030; 95% CI: 0.010-0.050). Economic freedom was an independent predictor of fast food consumption (β: 0.27; 95% CI: 0.16-0.37). When economic freedom was used as an instrumental variable, the association between fast food and BMI weakened but remained significant (β: 0.023; 95% CI: 0.001-0.045).

CONCLUSION

Fast food consumption is an independent predictor of mean BMI in high-income countries. Market deregulation policies may contribute to the obesity epidemic by facilitating the spread of fast food.

National working conditions surveys in Latin America: comparison of methodological characteristics

BACKGROUND

High-quality and comparable data to monitor working conditions and health in Latin America are not currently available. In 2007, multiple Latin American countries started implementing national working conditions surveys. However, little is known about their methodological characteristics.

OBJECTIVE

To identify commonalities and differences in the methodologies of working conditions surveys (WCSs) conducted in Latin America through 2013.

METHODS

The study critically examined WCSs in Latin America between 2007 and 2013. Sampling design, data collection, and questionnaire content were compared.

RESULTS

Two types of surveys were identified: (1) surveys covering the entire working population and administered at the respondent's home and (2) surveys administered at the workplace. There was considerable overlap in the topics covered by the dimensions of employment and working conditions measured, but less overlap in terms of health outcomes, prevention resources, and activities.

CONCLUSIONS

Although WCSs from Latin America are similar, there was heterogeneity across surveyed populations and location of the interview. Reducing differences in surveys between countries will increase comparability and allow for a more comprehensive understanding of occupational health in the region.

Cleaning products and short-term respiratory effects among female cleaners with asthma

OBJECTIVE

We evaluated the short-term effects of exposure to cleaning products on lung function and respiratory symptoms among professional cleaning women.

METHODS

Twenty-one women with current asthma and employed as professional cleaners participated in a 15-day panel study. During 312 person-days of data collection, participants self-reported their use of cleaning products and respiratory symptoms in daily diaries and recorded their forced expiratory volume in 1 s (FEV1) and peak expiratory flow (PEF) three times per day using a handheld spirometer. We evaluated associations of cleaning product use with upper and lower respiratory tract symptoms using Poisson mixed regression models and with changes in FEV1 and PEF using linear mixed regression analyses.

RESULTS

Participants reported using an average of 2.4 cleaning products per day, with exposure to at least one strong irritant (eg, ammonia, bleach, hydrochloric acid) on 56% of person-days. Among participants without atopy, lower respiratory tract symptoms were associated with the use of hydrochloric acid and detergents. Measurements of FEV1 and PEF taken in the evening were 174 mL (95% CI 34 to 314) and 37 L/min (CI 4 to 70), respectively, lower on days when three or more sprays were used. Evening and next morning FEV1 were both lower following the use of hydrochloric acid (-616 and -526 mL, respectively) and solvents (-751 and -1059 mL, respectively). Diurnal variation in FEV1 and PEF increased on days when ammonia and lime-scale removers were used.

CONCLUSIONS

The use of specific cleaning products at work, mainly irritants and sprays, may exacerbate asthma.

Assessment of the magnitude of geographical variations in the duration of non-work-related sickness absence by individual and contextual factors

OBJECTIVE

To examine variation in the duration of non-work-related sickness absence (NWRSA) across geographical areas and the degree to which this variation can be explained by individual and/or contextual factors.

METHODS

All first NWRSA episodes ending in 2007 and 2010 were analyzed. Individual (diagnosis, age, sex) and contextual factors (healthcare resources, socioeconomic factors) were analyzed to assess how much of the geographical variation was explained by these factors. Median NWRSA durations in quartiles were mapped by counties in Catalonia. Multilevel Cox proportional hazard regression models with episodes nested within counties were fitted to quantify the magnitude of this variation. The proportional change in variance (PCV), median hazard ratios (MHR) and interquartile hazard ratios (IHR) were calculated.

RESULTS

We found a geographical pattern in the duration of NWRSA, with longer duration in northwestern Catalonia. There was a small, but statistically significant, geographical variation in the duration of NWRSA, which mostly decreased after adjustment for individual factors in both women (PCV=34.98%, MHR=1.09, IHR=1.13 in 2007; PCV=34.68%, MHR=1.11, IHR=1.28 in 2010) and men (PCV=39.88%, MHR=1.10, IHR=1.27 in 2007; PCV=45.93%, MHR=1.10, IHR=1.25 in 2010); only in the case of women in 2010 was there a reduction in county-level variance due to contextual covariates (PCV=16.18%, MHR=1.12, IHR=1.32).

CONCLUSIONS

County-level variation in the duration of NWRSA was small and was explained more by individual than by contextual variables. Knowledge of geographic differences in NWRSA duration is needed to plan specific programs and interventions to minimize these differences.

Labour market trajectories and early retirement due to permanent disability: a study based on 14 972 new cases in Spain

BACKGROUND

To analyse the impact of labour market trajectory indicators on early retirement, measured by age at onset of permanent disability (PD).

METHODS

Four labour market trajectory indicators were reconstructed in 14 972 new cases of PD recognized between 2004 and 2010: (1) number of employment contracts, (2) number of unemployment periods, (3) number of periods without social security affiliation and (4) percentage of time spent in inactivity. The outcome was measured as the age at onset of PD. Median differences and 95% confidence intervals (95%CI) were compared using a median regression. Analyses were stratified by sex and adjusted for occupational category and total time elapsed between the beginning of working life and the age at onset of PD: separately for each labour market indicator, and adjusted for each other.

RESULTS

In men, the age at the onset of PD for workers with 15 or more employment contracts decreased by 4.8 years; and for workers with five or more periods without affiliation it decreased by 4.6 years. In women, the corresponding decreases were 5.8 years for 15 or more contracts and 7.2 years for five or more unaffiliated periods. The results for four indicators slightly changed when they were mutually adjusted.

CONCLUSIONS

Poor employment conditions, such as having a high number of periods without affiliation, a high number of contracts (in men) and a higher percentage of inactive time (in women) are associated with early retirement due to PD.

Cross-national comparisons of sickness absence systems and statistics: towards common indicators

We aimed to identify common elements in work sickness absence (SA) in Spain, Sweden and The Netherlands. We estimated basic statistics on benefits eligibility, SA incidence and duration and distribution by major diagnostics. The three countries offer SA benefits for at least 12 months and wage replacement, differing in who and when the payer assumes responsibility; the national health systems provide health care with participation from occupational health services. Episodes per 1000 salaried workers and episode duration varied by country; their distribution by diagnostic was similar. Basic and useful SA indicators can be constructed to facilitate cross-country comparisons.

Prevalence of work-related musculoskeletal symptoms among US large-herd dairy parlor workers

BACKGROUND

Dairy production in the US is moving towards large-herd milking operations resulting in an increase in task specialization and work demands.

METHODS

A modified version of the Standardized Nordic Questionnaire was administered to assess MSS prevalence among 452 US large-herd parlor workers. Worker demographics and MSS prevalences were assessed, and differences based on parlor configuration (i.e., herringbone, parallel, rotary) were computed.

RESULTS

Three-fourths (76.4%) of parlor workers reported work-related MSS in at least one body part. Highest prevalences were reported in the upper extremity (55%). Herringbone workers reported a higher prevalence of MSS in the wrist/hand, and rotary workers reported higher prevalences of MSS in the neck, upper back, and shoulders.

CONCLUSIONS

Our findings draw attention to higher work-related MSS in the upper extremity among dairy parlor workers. As the trend toward larger herd sizes on US dairy farms continues, the need for further health and safety research will increase.

Disabling musculoskeletal pain in working populations: is it the job, the person, or the culture?

To compare the prevalence of disabling low back pain (DLBP) and disabling wrist/hand pain (DWHP) among groups of workers carrying out similar physical activities in different cultural environments, and to explore explanations for observed differences, we conducted a cross-sectional survey in 18 countries. Standardised questionnaires were used to ascertain pain that interfered with everyday activities and exposure to possible risk factors in 12,426 participants from 47 occupational groups (mostly nurses and office workers). Associations with risk factors were assessed by Poisson regression. The 1-month prevalence of DLBP in nurses varied from 9.6% to 42.6%, and that of DWHP in office workers from 2.2% to 31.6%. Rates of disabling pain at the 2 anatomical sites covaried (r = 0.76), but DLBP tended to be relatively more common in nurses and DWHP in office workers. Established risk factors such as occupational physical activities, psychosocial aspects of work, and tendency to somatise were confirmed, and associations were found also with adverse health beliefs and group awareness of people outside work with musculoskeletal pain. However, after allowance for these risk factors, an up-to 8-fold difference in prevalence remained. Systems of compensation for work-related illness and financial support for health-related incapacity for work appeared to have little influence on the occurrence of symptoms. Our findings indicate large international variation in the prevalence of disabling forearm and back pain among occupational groups carrying out similar tasks, which is only partially explained by the personal and socioeconomic risk factors that were analysed.

Heterogeneity and event dependence in the analysis of sickness absence

BACKGROUND

Sickness absence (SA) is an important social, economic and public health issue. Identifying and understanding the determinants, whether biological, regulatory or, health services-related, of variability in SA duration is essential for better management of SA. The conditional frailty model (CFM) is useful when repeated SA events occur within the same individual, as it allows simultaneous analysis of event dependence and heterogeneity due to unknown, unmeasured, or unmeasurable factors. However, its use may encounter computational limitations when applied to very large data sets, as may frequently occur in the analysis of SA duration.

METHODS

To overcome the computational issue, we propose a Poisson-based conditional frailty model (CFPM) for repeated SA events that accounts for both event dependence and heterogeneity. To demonstrate the usefulness of the model proposed in the SA duration context, we used data from all non-work-related SA episodes that occurred in Catalonia (Spain) in 2007, initiated by either a diagnosis of neoplasm or mental and behavioral disorders.

RESULTS

As expected, the CFPM results were very similar to those of the CFM for both diagnosis groups. The CPU time for the CFPM was substantially shorter than the CFM.

CONCLUSIONS

The CFPM is an suitable alternative to the CFM in survival analysis with recurrent events, especially with large databases.

Associations between change in sleep duration and inflammation: findings on C-reactive protein and interleukin 6 in the Whitehall II Study

Cross-sectional evidence suggests associations between sleep duration and levels of the inflammatory markers, C-reactive protein and interleukin-6. This longitudinal study uses data from the London-based Whitehall II study to examine whether changes in sleep duration are associated with average levels of inflammation from 2 measures 5 years apart. Sleep duration (≤5, 6, 7, 8, ≥9 hours on an average week night) was assessed in 5,003 middle-aged women and men in 1991/1994 and 1997/1999. Fasting levels of C-reactive protein and interleukin-6 were measured in 1997/1999 and 2002/2004. Cross-sectional analyses indicated that shorter sleep is associated with higher levels of inflammatory markers. Longitudinal analyses showed that each hour per night decrease in sleep duration between 1991/1994 and 1997/1999 was associated with higher levels of C-reactive protein (8.1%) and interleukin-6 (4.5%) averaged across measures in 1997/1999 and 2002/2004. Adjustment for longstanding illness and major cardiometabolic risk factors indicated that disease processes may partially underlie these associations. An increase in sleep duration was not associated with average levels of inflammatory markers. These results suggest that both short sleep and reductions in sleep are associated with average levels of inflammation over a 5-year period.

Safety climate and verbal abuse among public hospital-based workers in Costa Rica

OBJECTIVE

Low levels of safety climate and training have been associated with higher occurrence of occupational-related health outcomes; workplace violence and verbal abuse could be considered an early indicator of escalating psychological workplace violence. We examined whether low level of safety factors were associated with a higher prevalence of verbal abuse at the workplace.

METHODS

We used data from a cross-sectional survey administered among a stratified random sample of 1,000 employees from 10 of the 29 public hospitals in Costa Rica. Odds ratios (OR) and 95% confidence intervals (95%CI) were calculated using survey logistic regression models to estimate the association between safety factors and verbal abuse from the following sources: administrators, supervisors, patients, patients' relatives and coworkers.

RESULTS

There was a high prevalence of verbal abuse among the healthcare workforce from both external (i.e., patients and patients' relatives) and internal workplace sources (i.e., coworkers, supervisors and administrators). A low level of safety climate was associated with verbal abuse from all sources with associations ranging from verbal abuse from administrators (OR=6.07; 95%CI: 2.05-17.92) to verbal abuse from patients (OR=2.24; 95%CI: 1.23-4.09).

CONCLUSION

These results highlight the need to address organizational characteristics of the workplace that may increase the risk of verbal abuse for the future development of prevention interventions in this setting.

The CUPID (Cultural and Psychosocial Influences on Disability) study: methods of data collection and characteristics of study sample

Background

The CUPID (Cultural and Psychosocial Influences on Disability) study was established to explore the hypothesis that common musculoskeletal disorders (MSDs) and associated disability are importantly influenced by culturally determined health beliefs and expectations. This paper describes the methods of data collection and various characteristics of the study sample.

Methods/Principal Findings

A standardised questionnaire covering musculoskeletal symptoms, disability and potential risk factors, was used to collect information from 47 samples of nurses, office workers, and other (mostly manual) workers in 18 countries from six continents. In addition, local investigators provided data on economic aspects of employment for each occupational group. Participation exceeded 80% in 33 of the 47 occupational groups, and after pre-specified exclusions, analysis was based on 12,426 subjects (92 to 1018 per occupational group). As expected, there was high usage of computer keyboards by office workers, while nurses had the highest prevalence of heavy manual lifting in all but one country. There was substantial heterogeneity between occupational groups in economic and psychosocial aspects of work; three- to five-fold variation in awareness of someone outside work with musculoskeletal pain; and more than ten-fold variation in the prevalence of adverse health beliefs about back and arm pain, and in awareness of terms such as “repetitive strain injury” (RSI).

Conclusions/Significance

The large differences in psychosocial risk factors (including knowledge and beliefs about MSDs) between occupational groups should allow the study hypothesis to be addressed effectively.

Contribution of volcanic ashes to the regional geochemical balance: the 2008 eruption of Chaitén volcano, Southern Chile

The environmental geochemical behaviour of the rhyolitic ashes from the 2008 eruption of Chaitén volcano, Southern Chile, has been studied. After the bulk characterisation, the potential contribution to the regional geochemical fluxes was examined using: i) single batch leaching tests to provide a rapid screening of the implied major and trace elements; and ii) column experiments to evaluate the temporal mobility of leached elements. The environmental concerns of these ashes are related to the fine grained component present in each sample (independent of distance from the source), in particular the presence of cristobalite, and the geochemical hazards posed by ash-water interaction. Leaching experiments show the fast dissolution of surface salts and aerosols, which dominate over glass dissolution during the first steps of the ash-water interaction. Chaitén ashes could transfer to the environment more than 1×10(10)g or 10,000 metric tonnes (mt) of Cl, S, Ca, Na, Si, and K; between 1000 and 10,000 mt of F, Mg, and Al; between 100 and 1000 mt of As, Pb, P, Fe, Sr, Zn, Mn, and Br; between 10 and 100 mt of Ba, Li, Ti, Ni, Nb, Cu, Rb, Zr, V, Mo, Co, and Sc; and less than 10 mt of Cr, Sb, Ce, Ga, Cs, and Y. These results show the fertilising potential of the ashes (e.g., providing Ca and Fe) but also the input of potentially toxic trace elements (e.g., F and As) in the regional geochemical mass balance. The Chaitén results evidence lower potentials for poisoning and fertilising than low silica ashes due to the lower contents released of practically all elements.

Return to work expectations of workers on long-term non-work-related sick leave

INTRODUCTION

Despite suggestions that worker perception might be the best predictor of return to work (RTW), there still is limited research on time to RTW in workers with lengthy non-work-related sick leave.

METHODS

Prospective cohort study of 663 workers with a current long-term non-work-related sick leave episode recruited during the first medical visit in a mutua (Spanish health insurance company) and followed until their sick leave episode ended. Workers completed a baseline questionnaire regarding their perceptions of sick leave episode and expectations of RTW (i.e., health status, work ability, expectations and time required to RTW, self-efficacy and self-perceived connection between health and job). Time to RTW was established based on the mutua's register. Cox regression models were used to examine the associations of worker perception and expectation of RTW with time to RTW within the study population as a whole as well as in three diagnostic subgroups (i.e., musculoskeletal disorders, mental disorders and other physical conditions).

RESULTS

As a whole, time to RTW was longer for workers reporting poor health [hazard ratio (HR) = 0.71, 95%CI 0.59-0.85], extremely reduced work ability (HR = 0.69, 95%CI 0.53-0.88), a longer period of time required to RTW (HR = 0.36, 95%CI 0.25-0.52) and lack of expectation of returning to the same job (HR = 0.13, 95%CI 0.06-0.31). Workers with musculoskeletal and other physical conditions showed a similar pattern to whole study population, while workers with mental disorders did not.

CONCLUSION

Self-required time and RTW expectations are important prognostic factors in sick listed workers by all types of health conditions certified as non-work-related. Questioning the workers on their perceptions and expectations of RTW during medical visits could help health care professionals to identify individuals at risk of long-term sickness absence and facilitate triage and management of the patient.

Mechanical systems versus smoking bans for secondhand smoke control

INTRODUCTION

Despite international efforts to implement smoking bans, several national legislations still allow smoking and recommend mechanical systems, such as ventilation and air extraction, to eliminate secondhand smoke (SHS) health-related risks. We aimed to quantify the relative contribution of mechanical systems and smoking bans to SHS elimination.

METHODS

A cross-sectional study was conducted in randomly selected establishments from 4 Mexican cities (3 with no ban). SHS exposure was assessed using nicotine passive monitors. Establishment characteristics, presence of mechanical systems, and enforcement of smoking policies were obtained through direct observation and self-report. Multilevel models were used to assess relative contributions to SHS reduction.

RESULTS

Compared with Mexico City, nicotine concentrations were 3.8 times higher in Colima, 5.4 in Cuernavaca, and 6.4 in Toluca. Mechanical systems were not associated with reduced nicotine concentrations. Concentration differences between cities were largely explained by the presence of smoking bans (69.1% difference reduction) but not by mechanical systems (-5.7% difference reduction).

CONCLUSIONS

Smoking bans represent the only effective approach to reduce SHS. Tobacco control regulations should stop considering mechanical systems as advisable means for SHS reduction and opt for complete smoking bans in public places.

Effect of working conditions on non-work-related sickness absence

BACKGROUND

There is limited evidence of the role of working conditions as prognostic factors for non-work-related sickness absence (i.e. absence due to injuries or diseases of non-occupational origin).

AIMS

To analyse the association between working conditions and time to return to work (RTW) in workers with long-term (>15 days) non-work-related sickness absence.

METHODS

We followed up a total of 655 workers, who completed a baseline questionnaire including physical and psychosocial work factors, until their non-work-related long-term sickness absence ended. Time to RTW was determined based on the health insurance company register. Cox proportional hazard models were constructed to evaluate the associations between working conditions and time to RTW.

RESULTS

A self-perceived high level of physical activity at work and work with back twisted or bent were related to longer duration of sickness absence. We did not find any strong evidence of associations between psychosocial work factors and time to RTW, although higher job insecurity and low reward showed marginal statistical significance.

CONCLUSIONS

Hazardous physical working conditions are associated with longer duration of non-work-related sickness absence. Workplace ergonomic interventions could conceivably shorten the length of sickness absence that has not originated at work.

Natural course of recurrent psychological distress in adulthood

BACKGROUND

The course of major depressive disorder is often characterized by progressing chronicity, but whether this applies to the course of self-reported psychological distress remains unclear. We examined whether the risk of self-reported psychological distress becomes progressively higher the longer the history of distress and whether prolonged history of distress modifies associations between risk markers and future distress.

METHODS

Participants were British civil servants from the prospective Whitehall II cohort study (n=7934; 31.5% women, mean age 44.5 years at baseline) followed from 1985 to 2006 with repeat data collected in 7 study phases. Psychological distress was assessed with the 30-item General Health Questionnaire (GHQ). Sex, socioeconomic status, marital status, ethnicity, physical activity, alcohol consumption, smoking, and obesity were assessed as risk markers.

RESULTS

Recurrent history of psychological distress was associated with a progressively increasing risk of future distress in a dose-response manner. Common risk markers, such as low socioeconomic status, non-White ethnicity, being single, and alcohol abstinence, were stronger predictors of subsequent distress in participants with a longer history of psychological distress. Sex differences in psychological distress attenuated with prolonged distress history.

LIMITATIONS

The participants were already adults in the beginning of the study, so we could not assess the progressive chronicity of psychological distress from adolescence onwards.

CONCLUSIONS

These data suggest that self-reported psychological distress becomes more persistent over time and that a longer prior exposure to psychological distress increases sensitivity to the stressful effects of certain risk markers.

Association of CRP and IL-6 with lung function in a middle-aged population initially free from self-reported respiratory problems: the Whitehall II study

To assess whether two inflammatory markers, C-reactive protein (CRP) and interleukin-6 (IL-6), and change in their concentrations over 12 years, are associated with lung function (FVC and FEV(1)) 12 years after baseline. Data are from over 1,500 participants free from self-reported respiratory problems in a large-scale prospective cohort study of white-collar male and female civil servants. CRP and IL-6 measured at baseline (1991-1993) and follow-up (2002-2004) and FVC and FEV(1), measured at follow-up. Results adjusted for sociodemographic and anthropometric characteristics, health behaviours, biological factors, chronic conditions and medications, and corrected for short-term variability in CRP and IL-6 concentrations. Higher baseline levels of CRP and IL-6 were strongly associated with lower FVC and FEV(1), independent of potential confounders. A 10% increase serum CRP from baseline to follow-up was associated with lower values of FVC and FEV(1) at follow-up, 4.7 and 3.0 ml, respectively. The corresponding values for a 10% increase in IL-6 were 12.6 ml for FVC and 7.3 ml for FEV(1). Systemic low-grade inflammation is associated with only slightly poorer pulmonary function in a population free from self-reported respiratory problems 12 years earlier. These data provide evidence linking inflammation to adverse outcomes beyond cardiovascular disease. Interventions targeting inflammation may prevent lung function impairment.

[Tobacco smoke exposure in public places in Mexico City, Guadalajara and Monterrey]

OBJECTIVE

To quantify environmental tobacco smoke exposure in public places in Mexico to promote policies of 100% smoke-free environments.

MATERIALS AND METHODS

In hospitals, schools and public offices of Monterrey, Guadalajara and Mexico City 20% of inner areas were monitored. Median nicotine concentrations were estimated by city, type of public space and type of inner area.

RESULTS

Median concentration in areas where nicotine was detected was 0.06 µg/m³ (P₂₅=0.03, P₇₅=0.12 µg/m³). Higher concentrations were found in Mexico City and in public offices. Nicotine was not detected in 75% of monitored areas.

CONCLUSIONS

Monitoring environmental nicotine is a useful tool to evaluate compliance of public places with the smoke-free environments legislation, and could constitute an important source of information to strengthen implementation efforts.

[Perception over smoke-free policies amongst bar and restaurant representatives in central Mexico]

OBJECTIVE

To analyze the perceptions and appreciations over smoke-free environments of restaurant and bar managers from four cities in central Mexico.

MATERIAL AND METHODS

Managers from 219 restaurants and bars from Mexico City, Colima, Cuernavaca and Toluca were surveyed about smoke-free environments opinions and implementation. Simultaneously, environmental nicotine was monitored.

RESULTS

The majority of surveyed managers considered public places should be smoke-free, although more than half were concerned with potential economic loses. Implementation of smoke-free environments was more frequent in Mexico City (85.4%) than in the other cities (15.3% overall), with consequently lower environmental nicotine concentrations.

CONCLUSION

Managers acknowledge the need to create smoke-free environments. Concerns over economic negative effects derived from the prohibition could explain, at least partially, the rejection of this sector towards the implementation of this type of policy.

Organisational justice and cognitive function in middle-aged employees: the Whitehall II study

BACKGROUND

Little is known about the role that work-related factors play in the decline of cognitive function. This study examined the association between perceived organisational justice and cognitive function among middle-aged men and women.

METHODS

Perceived organisational justice was measured at phases 1 (1985-8) and 2 (1989-90) of the Whitehall II study when the participants were 35-55 years old. Assessment of cognitive function at the screening clinic at phases 5 (1997-9) and 7 (2003-4) included the following tests in the screening clinic: memory, inductive reasoning (Alice Heim 4), vocabulary (Mill Hill), and verbal fluency (phonemic and semantic). Mean exposure to lower organisational justice at phases 1 and 2 in relation to cognitive function at phases 5 and 7 were analysed using linear regression analyses. The final sample included 4531 men and women.

RESULTS

Lower mean levels of justice at phases 1 and 2 were associated with worse cognitive function in terms of memory, inductive reasoning, vocabulary and verbal fluency at both phases 5 and 7. These associations were independent of covariates, such as age, occupational grade, behavioural risks, depression, hypertension and job strain.

CONCLUSIONS

This study suggests an association between perceived organisational justice and cognitive function. Further studies are needed to examine whether interventions designed to improve organisational justice would affect employees' cognition function favourably.

Environmental geochemistry of ancient volcanic ashes

Volcanic ashes from the Puna and surrounding Andean areas in northern Argentina show that sometimes volcanic ash deposits are very well preserved (up to several million years) and can remain a potential hazard for the environment in a similar way as current deposits. Eight ashes have been characterized by SEM-EDX and DRX, and their potential released geochemical fluxes were examined by using water and nitric acid batches, which are analyzed by ICP-OES, ICP-MS and ISE (F). Results demonstrate that water batch system is better medium than nitric acid for this study. The high and fast reactivity of these ancient ashes is mainly associated with their high content in glass. The order of magnitude of released contents of implied elements is consistent among the samples, i.e., Al>B>Fe>Zn>F>P>Mn>Ba>Sr>Li>Ti>Rb>Cu>Ni>Sb>Pb>As>Cr>V. Ash-water interaction, although infrequent in arid regions such as the Puna Region in northern Argentina, introduces rapid changes in the geochemical fluxes of elements and pH and may constitute a potential hazard for the environment. In fact, many of these elements are included in the drinking water guidelines due to their potential toxicity and may constitute potential hazards for the environment and human health.

Occupational safety and health interventions to reduce musculoskeletal symptoms in the health care sector

INTRODUCTION

Health care work is dangerous and multiple interventions have been tested to reduce the occupational hazards.

METHODS

A systematic review of the literature used a best evidence synthesis approach to address the general question "Do occupational safety and health interventions in health care settings have an effect on musculoskeletal health status?" This was followed by an evaluation of the effectiveness of specific interventions.

RESULTS

The initial search identified 8,465 articles, for the period 1980-2006, which were reduced to 16 studies based on content and quality. A moderate level of evidence was observed for the general question. Moderate evidence was observed for: (1) exercise interventions and (2) multi-component patient handling interventions. An updated search for the period 2006-2009 added three studies and a moderate level of evidence now indicates: (1) patient handling training alone and (2) cognitive behavior training alone have no effect on musculoskeletal health. Few high quality studies were found that examined the effects of interventions in health care settings on musculoskeletal health.

CONCLUSIONS

The findings here echo previous systematic reviews supporting exercise as providing positive health benefits and training alone as not being effective. Given the moderate level of evidence, exercise interventions and multi-component patient handling interventions (MCPHI) were recommended as practices to consider. A multi-component intervention includes a policy that defines an organizational commitment to reducing injuries associated with patient handling, purchase of appropriate lift or transfer equipment to reduce biomechanical hazards and a broad-based ergonomics training program that includes safe patient handling and/or equipment usage. The review demonstrates MCPHI can be evaluated if the term multi-component is clearly defined and consistently applied.

The association of cognitive performance with mental health and physical functioning strengthens with age: the Whitehall II cohort study

BACKGROUND

Cognitive performance has been associated with mental and physical health, but it is unknown whether the strength of these associations changes with ageing and with age-related social transitions, such as retirement. We examined whether cognitive performance predicted mental and physical health from midlife to early old age.

METHOD

Participants were 5414 men and 2278 women from the Whitehall II cohort study followed for 15 years between 1991 and 2006. The age range included over the follow-up was from 40 to 75 years. Mental health and physical functioning were measured six times using SF-36 subscales. Cognitive performance was assessed three times using five cognitive tests assessing verbal and numerical reasoning, verbal memory, and phonemic and semantic fluency. Socio-economic status (SES) and retirement were included as covariates.

RESULTS

High cognitive performance was associated with better mental health and physical functioning. Mental health differences associated with cognitive performance widened with age from 39 to 76 years of age, whereas physical functioning differences widened only between 39 and 60 years and not after 60 years of age. SES explained part of the widening differences in mental health and physical functioning before age 60. Cognitive performance was more strongly associated with mental health in retired than non-retired participants, which contributed to the widening differences after 60 years of age.

CONCLUSIONS

The strength of cognitive performance in predicting mental and physical health may increase from midlife to early old age, and these changes may be related to SES and age-related transitions, such as retirement.

Work disability following major organisational change: the Whitehall II study

BACKGROUND

Privatisation and private sector practices have been increasingly applied to the public sector in many industrialised countries. Over the same period, long-term work disability has risen substantially. We examined whether a major organisational change--the transfer of public sector work to executive agencies run on private sector lines--was associated with an increased risk of work disability.

METHODS

The study uses self-reported data from the prospective Whitehall II cohort study. Associations between transfer to an executive agency assessed at baseline (1991-1994) and work disability ascertained over a period of approximately 8 years at three follow-up surveys (1995-1996, 1997-1999 and 2001) were examined using Cox proportional hazard models.

RESULTS

In age- and sex-adjusted models, risk of work disability was higher among the 1263 employees who were transferred to an executive agency (HR 1.90, 95% CI 1.46 to 2.48) compared with the 3419 employees whose job was not transferred. These findings were robust to additional adjustment for physical and mental health and health behaviours at baseline.

CONCLUSIONS

Increased work disability was observed among employees exposed to the transfer of public sector work to executive agencies run on private sector lines. This may highlight an unintentional cost for employees, employers and society.

Physical and cognitive function in midlife: reciprocal effects? A 5-year follow-up of the Whitehall II study

BACKGROUND

Cognitive and physical functions are closely linked in old age, but less is known about this association in midlife. Whether cognitive function predicts physical function and whether physical function predicts cognitive function were assessed in middle-aged men and women.

METHODS

Data were from Whitehall II, an ongoing large-scale, prospective occupational cohort study of employees from 20 London-based white-collar Civil Service departments. The participants, 3446 men and 1274 women aged 45-68 years at baseline (1995-1997), had complete data on cognitive performance and physical function at both baseline and follow-up (2002-2004). A composite cognitive score was compiled from the following tests: verbal memory, inductive reasoning (Alice Heim 4-I), verbal meaning (Mill Hill), phonemic and semantic fluency. Physical function was measured using the physical composite score of the short form (SF-36) scale. Average follow-up was 5.4 years.

RESULTS

Poor baseline cognitive performance predicted poor physical function at follow-up (beta = 0.08, p<0.001), while baseline physical function did not predict cognitive performance (beta = 0.01, p = 0.67). After full adjustment for sociodemographic, behavioural and biological risk factors, baseline cognitive performance (beta = 0.04 p = 0.009) remained predictive of physical function.

CONCLUSION

Despite previous work indicating that the association between physical and cognitive performance may be bidirectional, these findings suggest that, in middle age, the direction of the association is predominantly from poor cognition to poor physical function.

Justice at work and metabolic syndrome: the Whitehall II study

OBJECTIVES

Growing evidence shows that high levels of justice are beneficial for employee health, although biological mechanisms underlying this association are yet to be clarified. We aim to test whether high justice at work protects against metabolic syndrome.

METHODS

A prospective cohort study of 20 civil service departments in London (the Whitehall II study) including 6123 male and female British civil servants aged 35-55 years without prevalent coronary heart disease at baseline (1985-1990). Perceived justice at work was determined by means of questionnaire on two occasions between 1985 and 1990. Follow-up for metabolic syndrome and its components occurring from 1990 to 2004 was based on clinical assessments on three occasions over more than 18 years.

RESULTS

Cox proportional hazard models adjusted for age, ethnicity and employment grade showed that men who experienced a high level of justice at work had a lower risk of incident metabolic syndrome than employees with a low level of justice (HR 0.75; 95% CI 0.63 to 0.89). There was little evidence of an association between organisational justice and metabolic syndrome or its components in women (HR 0.88; 95% CI 0.67 to 1.17).

CONCLUSIONS

Our prospective findings provide evidence of an association between high levels of justice at work and the development of metabolic syndrome in men.

Do pre-employment influences explain the association between psychosocial factors at work and coronary heart disease? The Whitehall II study

OBJECTIVES

To examine whether the association between psychosocial factors at work and incident coronary heart disease (CHD) is explained by pre-employment factors, such as family history of CHD, education, paternal education and social class, number of siblings and height.

METHODS

A prospective cohort study of 6435 British men aged 35-55 years at phase 1 (1985-1988) and free from prevalent CHD at phase 2 (1989-1990) was conducted. Psychosocial factors at work were assessed at phases 1 and 2 and mean scores across the two phases were used to determine long-term exposure. Selected pre-employment factors were assessed at phase 1. Follow-up for coronary death, first non-fatal myocardial infarction or definite angina between phase 2 and 1999 was based on clinical records (250 events, follow-up 8.7 years).

RESULTS

The selected pre-employment factors were associated with risk for CHD: HRs (95% CI) were 1.33 (1.03 to 1.73) for family history of CHD, 1.18 (1.05 to 1.32) for each quartile decrease in height and 1.16 (0.99 to 1.35) for each category increase in number of siblings. Psychosocial work factors also predicted CHD: 1.72 (1.08 to 2.74) for low job control and 1.72 (1.10 to 2.67) for low organisational justice. Adjustment for pre-employment factors changed these associations by 4.1% or less.

CONCLUSIONS

In this occupational cohort of British men, the association between psychosocial factors at work and CHD was largely independent of family history of CHD, education, paternal educational attainment and social class, number of siblings and height.

Organisational justice and markers of inflammation: the Whitehall II study

OBJECTIVES

Low organisational justice has been shown to be associated with increased risk of various health problems, but the underlying mechanisms remain unclear. We tested whether organisational injustice contributes to chronic inflammation in a population of middle-aged men and women.

METHODS

This prospective cohort study uses data from 3205 men and 1204 women aged 35-55 years at entry into the Whitehall II study (phase 1, 1985-1988). Organisational justice perceptions were assessed at phase 1 and phase 2 (1989-1990) and circulating inflammatory markers C-reactive protein (CRP) and interleukin (IL)-6 at phase 3 (1991-1993) and phase 7 (2003-2004).

RESULTS

In men, low organisational justice was associated with increased CRP levels at both follow-ups (phase 3 and 7) and increased IL-6 at the second follow-up (phase 7). The long term (phase 7) associations were largely independent of covariates, such as age, employment grade, body mass index and depressive symptoms. In women, no relationship was found between organisational justice and CRP or IL-6.

CONCLUSIONS

This study suggests that organisational injustice is associated with increased long-term levels of inflammatory markers among men.