Occupational and Environmental Health

Common mental disorders through the eyes of German employees: attributed relevance of work-related causes and prevention measures assessed by a standardised survey Abstract Purpose Common mental disorders (CMDs) are becoming increasingly relevant in the working world. Numbers of risk factors have been confirmed by mostly correlative cross-sectional studies. Comprehensive and effective prevention is urgently needed. There is little knowledge about employees’ own perceptions on causes of CMDs and prevention measures. Therefore, a survey was conducted in 2016. Methods A standardised instrument was developed for an online survey in a commercial access panel, targeted employees in different job types. We assessed two outcomes: perceived relevance of (1) work-related demands to the development of CMDs, and (2) prevention approaches in the workplace and on individual and societal levels. Possible predictive aspects were analysed exploratively by multivariate linear regression analysis. Results The response rate was 75% (n = 610). Job types were categorised as “blue”, “grey” and “white-collar” workers (n = 193, 169, 248). The majority of respondents rated both outcomes consistently as “quite” or “very relevant”; societal prevention strategies were more relevant for non-white-collar workers. Perceived relevance of individual predisposition to develop a CMD was the strongest predictor for both outcomes, indicating the perception that people with higher personal vulnerability might suffer a higher strain from work-related risk factors than others. Conclusion We assume that participants in our survey judged the relevance of work-related causes of CMDs independently of their own workload. The perceived relevance of prevention measures in different areas is consistent with official guidelines. A possible selection bias due to characteristics of access panel collectives and own direct or indirect experiences with CMD should be critically questioned.

Short rest between shifts (quick returns) and night work is associated with work-related accidents Abstract Purpose The aim of this study was to examine whether less than 11 h between shifts (i.e., quick returns, QRs) and night shifts is associated with self-reported work-related accidents, near accidents or dozing off at work in a sample of nurses. Methods The study was based on cross-sectional data from 1784 nurses (response rate = 60%; mean age = 40.1 years, SD = 8.4; 91% female). Negative binomial regression analyses were conducted to investigate the association between the shift exposures, and eight different self-reported work-related items on accidents, near accidents and dozing off at work, controlling for demographics and work factors. Results The number of QRs during a year was positively associated with seven of the eight items on work-related accidents, near-accidents and dozing off at work, and number of night shifts was positively associated with five items. Some of the key findings were that QRs were associated with nurses causing harm to themselves (incidence rate ratio [IRR] = 1.009; 95% CI = 1.005–1.013), causing harm to patients/others (IRR = 1.006; 95% CI = 1.002–1.010) and causing harm to equipment (IRR = 1.004; 95% CI = 1.001–1.007); while night shifts were associated with nurses involuntarily dozing off at work (IRR = 1.015; 95% CI = 1.013–1.018), dozing off while driving to/from work (IRR = 1.009; 95% CI = 1.006–1.011), and harming patients/others (IRR = 1.005; 95% CI = 1.001–1.009). Conclusion QRs and night shifts were both associated with the self-reported work-related accidents, near-accidents and dozing off at work. Studies that can establish the causal relationship between QRs and accidents are called for.

Development of perceived job insecurity among young workers: a latent class growth analysis Abstract Purpose Individual differences in the development of perceived job insecurity among young workers may be influenced by characteristics of the first job (contract type and sector) and individual background (education and previous unemployment), and can have implications for subsequent health and well-being. The aim of this study was to investigate the development of perceived job insecurity during the early career, as well as associations between different patterns of development (i.e., trajectories), predictors and outcomes. Methods We conducted a latent class growth analysis to identify trajectories of perceived job insecurity and investigated their respective associations with predictors and outcomes across 6 years in a sample of 1711 German labor market entrants. Results Six trajectories were identified: three showed stable job insecurity perceptions (stable moderate, 36%; stable low, 32%; stable high, 5%), two showed decrease (moderate to low, 12%; high to moderate, 3%), and one showed increasing job insecurity perceptions (low to moderate, 13%). Temporary contracts and previous unemployment predicted trajectories characterized by increasing, higher initial or higher overall levels of perceived job insecurity. In contrast, public sector employees and university graduates were less likely to experience persisting or increasing job insecurity. The trajectories differed in their overall levels of self-rated health and job satisfaction, but not with respect to change in these outcomes. Instead, increasing perceived job insecurity was associated with decreasing life satisfaction. Conclusions The findings suggest that an insecure career start and individual risk factors may predispose young workers to an unfavorable development of both job insecurity perceptions and levels of well-being.

Workplace violence and development of burnout symptoms: a prospective cohort study on 1823 social educators Abstract Purpose Burnout and workplace violence (WPV) have been associated in cross-sectional studies, but longitudinal studies with solid methods and adequate sample sizes are lacking. This study investigates whether WPV increases burnout symptoms during a 12-month period. Methods Questionnaire data were collected on 1823 social educators at baseline and 12-month follow-up, coupled with additionally 12 monthly text-message surveys on exposure to WPV. Using general linear modelling for repeated measures, we estimated change over time in burnout symptoms in three WPV exposure groups (none, low, high). Results A time by exposure to WPV interaction existed for development of burnout; F(2) = 7.2, p = 0.001 η2 = 0.011. Burnout increased significantly within the group of low exposure; F(1) = 6.8, p = 0.01 and high exposure; F(1) = 6.7 p = 0.001, but not within the non-exposed F(1) = 2.1 p = 0.15. At follow-up, both the low exposed and high exposed had significantly higher levels of burnout compared to the non-exposed. Conclusion Exposure to WPV increases level of burnout within a 12-month period. We propose that assessment of burnout in future studies should utilize instruments capable of detecting small changes. We further propose that prevention against employee burnout could be improved using monitoring targeted at employees exposed to WPV.

Burnout symptomatology and social support at work independent of the private sphere: a population-based study of French teachers Abstract Purpose To investigate the relationship between social support at work and burnout among teachers, independent of the teachers’ private social and environmental context. Methods In the 2013 “Teachers’ Quality of Life” population-based study (France, n = 2653), burnout symptomatology was assessed using the Maslach Burnout Inventory. The score for each dimension (emotional exhaustion, depersonalization and personal accomplishment) was dichotomized using extreme tertiles. Global score for social support at work, and subscores by source and type were derived from the Karasek Job Content Questionnaire and were categorized into tertiles (low, medium, and high). The private context was appraised through the “social relationships” and “environment” subscales of the short version of the World Health Organization Quality of Life Questionnaire. Associations between social support at work and burnout indicators were evaluated among 2473 teachers with complete data, using logistic regression models adjusted for the private context plus sociodemographic and work-related characteristics. Results Eight percent of the teachers showed simultaneously high emotional exhaustion, high depersonalization and low personal accomplishment symptoms and were considered as burnout cases. After controlling for the private context, teachers who reported high social support at work were significantly less likely to report burnout [odds ratio (95% confidence interval) high vs. low = 0.62 (0.40, 0.98)]. When distinguishing the source of social support at work, only high social support from supervisors remained significantly associated with a lower risk of burnout [0.43 (0.27, 0.71)]. Conclusions Improving social support at work, especially from a hierarchical point of view, may be an effective target to promote teacher’s well-being.

Shift work and mental health: a systematic review and meta-analysis Abstract Background Shift work is common. However, research findings are mixed regarding the impact of shift work on mental health. This systematic review sought to provide a comprehensive summary of existing research examining the association between different types of shift work and mental health. The review included large-scale, non-occupation-specific research. Methods Four electronic databases PubMed, PsycINFO, Web of Science and SCOPUS were searched to identify studies that reported on the statistical association between shift work and mental health and that used population-based samples. Two reviewers extracted information about study characteristics and data on the association between shift work and mental health. A meta-analysis was performed for longitudinal studies adopting a ‘broad binary’ measure of shift work. Results Thirty-three studies were included in the final review—10 cross-sectional studies, 22 longitudinal studies, and 1 study that included both. Findings were grouped based on whether the measure of shift work focussed on: (1) night/evening work, (2) weekend work, (3) irregular/unpredictable work schedule, or (4) a broad binary measure. There was a reasonable level of evidence that overall, when a broad binary measure was adopted, shift work was associated with poorer mental health—this finding was supported by the meta-analysis results. There was also some evidence that irregular/unpredictable work was associated with poorer mental health. There was less evidence for night/evening and minimal evidence for weekend work. Inconsistencies in study methodology, limited contrasting and combining the results. Conclusions The association between shift work and mental health is different across types of shift work. The evidence is strongest for a broad binary, general measure of shift work and for irregular or unpredictable shift work. There is a need for continued research that adopts consistent and clear measures of shift work.

Physical workload and obesity have a synergistic effect on work ability among construction workers Abstract Purpose Obesity and high physical workload are both associated with poor work ability, but the interaction between obesity and high physical workload on work ability is not yet fully understood. Obesity and high physical workload may share a common mechanical pathway, possibly leading to a synergistic negative effect on work ability. The purpose of this study was to investigate the effect of obesity on work ability in workers with high versus low physical work load. Methods A longitudinal study was conducted among 36,435 Dutch construction workers who participated in at least two periodic medical examinations during the years 2008–2015. Logistic regression analyses were used to investigate the effect of manual material handling and strenuous work postures in sports on the association between obesity and work ability. Work ability was measured using the self-reported Work Ability Index consisting of seven dimensions. Confounding effects were tested for age, educational level, smoking, vigorous physical activity, psychosocial work demands, and working hours. Additive interaction between obesity and physical workload on work ability was tested using the relative excess risk due to interaction (RERI). Results Construction workers with overweight (OR = 1.09; 95% CI 1.02–1.16) or obesity (OR = 1.27; 95% CI 1.17–1.38) had an increased risk of poor/moderate work ability. Exposure to manual material handling (OR = 1.58; 95% CI 1.49–1.68) or strenuous work postures (OR = 1.80; 95% CI 1.70–1.90) also increased the risk of poor/moderate work ability. The effect of the combination of obesity with high physical workload was greater than the sum of the individual effects (strenuous work postures: RERI = 0.39; 95% CI 0.10–0.67; manual material handling: RERI = 0.26; 95% CI 0.02–0.51). Conclusions Obesity and high physical workload were associated with poor work ability and had a synergistic, negative effect on work ability. Interventions that prevent obesity and high physical workload might have a beneficial effect on work ability.

Snap-fit assembly and upper limb functional limitations in automotive production workers: a nested case–control study Abstract Objectives The use of snap-fits in car-part assembling has developed into an industrial standard. Cross-sectional evidence indicates, however, that this assembling process might adversely affect workers’ upper limb function. The objective of this study was to analyze incident cases of upper limb functional limitations (ULFL) in relation to exposure to snap-fit assembly. Methods We performed a nested case–control study within a population of 5139 blue-collar automotive production workers. Cases with ULFL detected during follow-up were matched with controls based on employment duration and investigated on their exposure to snap-fit assembly. By conditional logistic regression, we modeled the risk for ULFL according to person-years of exposure to snap-fit assembly, adjusted for gender and baseline BMI. Results Overall, 64 ULFL cases were detected during a follow-up of 20610.8 person-years (3.1 cases per 1000 person-years). Cases, matched with an average of 4 controls, had significantly longer exposure duration to snap-fit assembly compared with controls (M = 1.15 person-years, SD = 1.68 person-years vs. M = 0.41 person-years, SD = 1.25 person-years). One person-year of exposure to snap-fit assembly was associated with an approximate 20% risk increase of developing ULFLs (OR 1.23, 95% CI 1.08–1.39). Conclusions We confirm an association between accumulated exposure to snap-fits in car-part assembling and upper limb musculoskeletal disorders. Company physicians should thus be vigilant to symptoms of musculoskeletal disorders of the upper limbs in snap-fit assembly and support the development of threshold values for snap-fit insertion forces.

Cold water immersion test (10 °C, 10 min) for diagnosing vibration-induced white finger among a group of polishers in a subtropical environment Abstract Objective This study aimed to investigate whether the finger skin temperature (FST) after cold provocation (10 °C, 10 min) is as a useful indicator for assisting in the diagnosis of vibration-induced white finger (VWF) in a group of polishers in a subtropical environment. Method Ninety male vibration-exposed metal polishers (30 patients and 60 controls) from the Guangdong Province in Southern China were recruited. The FSTs at 30, 20, 10, and 0 min before cold water immersion (FSTpre-30, FSTpre-20, FSTpre-10, and FSTbaseline) and 0, 5, 10, 15, 20, 25, and 30 min after immersion (FST0, FST5, FST10, FST15, FST20, FST25, and FST30) were measured on the index, middle, and ring fingers of both hands. Results During the first 20-min adaptation period, there was a significant increase in FST in three fingers on both hands in the two groups. In contrast, there were no significant differences between FSTpre-10 and FSTbaseline. Furthermore, FSTpre-30, FSTpre-20, FSTpre-10, and FSTbaseline of the three fingers in both hands did not differ significantly. During recovery, the indicators FST5–0, FST10–0, R5, and R10 for the index finger of the left hand in patients were lower than for the controls. Among the various indicators, the absolute recovery rate, FST5–0, at 5 min after immersion was identified as the best diagnosis indicator with a sensitivity of 76.7% and specificity of 70.0% when applied to the index finger of the left hand. Conclusion The cold water immersion test as applied in a subtropical environment can have a fair discriminating ability for diagnosing VWF.

The association of vertical and horizontal workplace social capital with employees’ job satisfaction, exhaustion and sleep disturbances: a prospective study Abstract Purpose Workplace social capital (WSC) may be beneficial for employees’ health and well-being; however, most studies have analyzed WSC on the individual and not the workplace level. We test whether higher compared to lower levels of vertical WSC (WSC between employees and superiors) and horizontal WSC (WSC between employees), measured at the workplace level, is prospectively associated with higher levels of employees’ well-being. Methods Using data from an intervention study, we analyzed associations between workplace aggregated vertical and horizontal WSC at baseline with job satisfaction, exhaustion and sleep disturbances at 24-months follow-up. The sample included 606 municipal pre-school employees (71 workplaces). We adjusted for individual and workplace characteristics, baseline scores of outcomes, intervention status, and the interaction of exposure with intervention status. We used the Genmod procedure in SAS with a repeated statement to account for correlation of individuals within workplaces. We repeated analyses using individual-level WSC measurements. Results Higher levels of vertical and horizontal WSC at baseline predicted a higher level of job satisfaction (0.20, p = 0.01 and 0.24, p = 0.01, respectively) and a lower level of exhaustion (− 0.33, p = 0.04 and − 0.43, p = 0.04) at follow-up in the most adjusted model. Analyses with individual-level measures yielded similar results and further showed an association of a higher level of horizontal WSC with a lower level of sleep disturbances. Conclusions Higher levels of vertical and horizontal WSC were prospectively associated with better well-being of employees in municipal pre-schools. Workplaces may thus consider focusing on improving WSC as a means for ensuring or improving employees’ well-being.