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The mining environment is hazardous for worker’s health. It can affect the mental health, triggering symptoms and diseases, such as anxiety, job stress, depression, sleep disorders, mental fatigue and other. The aim of this study was to describe and analyze the scientific literature about the mental health in mine workers and to summarize the findings. The method used was scoping review. The principal outcomes were the following: evidence in the last 12 years in the topic was focused in four themes 1) Psychological problems & personal factors (38.2%); 2) Psychosocial problems & health related factor (23.6%); 3) Well-being (21.1%) and 4) Physical problems & organization factors (17.1%). Several affections, symptoms, characteristics or disorders were inquired about mine worker’s mental health, such as job strain, unsafety experiences, poor quality of sleep, non-subjective well-being, job unsatisfaction, social-relations conflict, risk of accidents and injuries, musculoskeletal disorders (MSDs), substance abuse, dangerous working conditions and demanding job organization, and so on. For those factors, Mining could expose to serious mental health problems to a part of their workers. It’s necessary to deepen the elaboration of international policies and carry out more scientific research and suggestions to make programs on the topic.

Purpose Nurses’ musculoskeletal diseases (MSDs) are worldwide prevalent and are considered to be a costly occupational injury. This study aims to investigate the relationship between exposure to occupation-related psychosocial factors, physical workload, and upper body musculoskeletal diseases among hospital nurses. Methods An electronic search was implemented using nine databases with June 2019 as the latest search date. English and Chinese studies were chosen, and data were independently and separately extracted by two investigators. Pooled odds ratio (OR) and its 95% confidence interval (CI) were estimated for each subset, using the fixed or random-effects model, following heterogeneity between studies for research synthesis. The source of heterogeneity was explored through subgroup, sensitivity, and meta-analyses. Results Eighteen studies were included in the meta-analysis. Most participants were women (51.4%–100.0%), aged between 20 and 60. A correlation was found between high job demand and the prevalence of low back pain (OR = 1.41; 95% CI = 1.23-1.62). Total job strain was related to the risk of low back pain (OR = 1.71; 95% CI = 1.15-2.55), neck pain (OR = 1.67; 95% CI = 1.26-2.20), shoulder pain (OR = 1.62; 95% CI = 1.06-2.48) and back pain (OR = 1.45; 95% CI = 1.10-1.91). Furthermore, the physical workload was significantly associated with the prevalence of low back pain (OR = 1.76; 95% CI = 1.32-2.35), neck pain (OR = 1.17; 95% CI = 1.08-1.27), shoulder pain (OR = 1.59; 95% CI = 1.37-1.85) and back pain (OR = 1.66; 95% CI = 1.45-1.90). Conclusion There were significant associations between occupational strain, more physical workload and upper body MSDs, but the evidence advocating a growth risk in MSDs due to low levels of social support is quite weak.

Nurses are at risk for work-related fatigue, which can impact their health, well-being, and job readiness. The purpose of this study was to examine the levels, types, and factors associated with fatigue in registered nurses (RNs) in direct patient care (DCRNs) and in non-direct patient care (non-DCRNs) roles. A cross-sectional survey was administered to 313 RNs. Measures included: Multidimensional Fatigue Symptom Inventory, Occupational Fatigue Exhaustion Recovery, Brief COPE, PROMIS® Global Sleep Disturbance, Job Content Questionnaire. Acute fatigue levels in RNs were similar to those in diseased populations, and nearly 50% reported moderate/high levels of chronic fatigue. DCRNs reported higher levels of acute and chronic fatigue than non-DCRNs, but the differences were small and disappeared when accounting for other factors associated with fatigue including sleep disturbance, job strain, workplace support, maladaptive coping, and especially intershift recovery, which accounted for 20-41% of fatigue variability. This study suggests that it may not be only nurses providing direct patient care who are at risk for acute and chronic fatigue. Intershift recovery may be particularly important in alleviating acute and chronic fatigue in nurses. This article is protected by copyright. All rights reserved.

BACKGROUND: The complex position of a first line manager is characterized by heavy workload and contradictory demands. Little is known about how first line managers experience demand and control in their work. OBJECTIVES: The aim of this study was to explore experiences of demand and control among first line managers within psychiatric and addiction care. METHOD: In the present study, interviews with ten managers in for-profit psychiatric and addiction care in Sweden were analyzed with a phenomenographic approach. RESULTS: The managers experiences of demand and control implied varied and extensive responsibilities for a wide range of professions; regulation by organizational, economic, and political frameworks; creating balance in their work; and handling the emergence and consequences of acute crisis. These experiences of demand and control involved high and contradictory demands together with coexisting high and low levels of control. Many of their work characteristics could be described in terms of both demand and control. CONSLUSION: The first line managers experiences of demand and control are more complex than implied by the job demand control theory. Our results suggest that the organizational position and branch should be considered when identifying health hazards in the work environment of first line managers.

Objectives To assess the relationship between social factors (socio-economic status, household load and job strain) and chronic pain occurrence, and the role of gender in this relationship. Methods We used data corresponding to 8 years of follow-up of the Stockholm Public Health Cohort Study (2006–2014) to compute Adjusted Incidence Rate Ratios (IRRs) and additive interaction measures of chronic pain episodes, social factors, and sex in 16 687 subjects. Results For men, increased rates of chronic pain occurrence were observed for skilled workers (IRR = 1.27, 95% CI: 0.99, 1.61) and lower non-manual employees (IRR = 1.37, 95% CI: 1.05, 1.78), compared with unskilled workers; subjects with high household load (IRR = 1.39; 95% CI: 1.03, 1.88), compared with those with a null score; and subjects with active jobs (IRR = 1.27, 95% CI: 1.06, 1.51), compared with those with low-strain jobs. For women, we observed decreased rates of chronic pain occurrence in lower (IRR = 0.82, 95% CI: 0.68, 0.99), intermediate (IRR = 0.74, 95% CI: 0.63, 0.88) and higher non-manual employees (IRR = 0.65, 95% CI: 0.54, 0.79), compared with unskilled workers. Compared with subjects with a null score, women with low household load showed a lower rate of chronic pain occurrence (IRR = 0.85; 95% CI: 0.72, 1.00). Compared with subjects with low-strain jobs, those with passive jobs (IRR = 1.21; 95% CI: 1.02, 1.44) and high-strain jobs (IRR = 1.46; 95% CI: 1.02, 2.09) showed higher rates of chronic pain occurrence. Conclusion In general, our analysis yielded different, if not opposite, results when data were stratified by sex. Sex may then represent an effect modifier of the relationship between social factors and chronic pain.

Purpose To examine differences between genders in exposure to psychosocial and ergonomic factors at work and in work-related health, according to different work organization models. Methods The study population included a sample of 9749 (women: 37.1%) and 10,374 (women: 39.9%) employees who participated in the 2010 and 2015 European Working Conditions Surveys, respectively. Multiple Correspondence Analysis was applied to work characteristics reported by workers to estimate principal components, followed by Hierarchical Clustering on principal components to identify clusters of work organization models. Gender differences in exposure to work hazards and health outcomes were assessed through Poisson robust regression. Differences of PRs across organizational models were tested through interaction between gender and type of work organization. Results Three organizational models were identified in 2010, including lean production, Tayloristic production, and a “reflexive production” model, whereas in 2015, a “simple” or traditional model was also found. In 2010, women employed in companies adopting the Tayloristic or the lean production models were more likely than men to be exposed to unfavourable psychosocial and physical work factors, and to report musculoskeletal pain, compared to those belonging to reflexive production. In 2015, a significantly higher female/male ratio persisted in lean production for exposure to high job strain and for carrying/moving heavy loads, whereas gender differences in Tayloristic and traditional production were quite similar to those of reflexive production. Conclusions Our results suggest that employment in workplaces characterized by lower monotony, repetitiveness, and production constraints may contribute to reduce exposure to job strain among working women.

Background Evidence from prospective studies has suggested that long working hours are associated with incident coronary heart disease (CHD) events. However, no previous study has examined whether long working hours are associated with an increased risk of recurrent CHD events among patients returning to work after a first myocardial infarction (MI). Objectives The purpose of this study was to examine the effect of long working hours on the risk of recurrent CHD events. Methods This is a prospective cohort study of 967 men and women age 35 to 59 years who returned to work after a first MI. Patients were recruited from 30 hospitals across the province of Quebec, Canada. The mean follow-up duration was 5.9 years. Long working hours were assessed on average 6 weeks after their return to work. Incident CHD events (fatal or nonfatal MI and unstable angina) occurring during follow-up were determined using patients’ medical files. Hazard ratios were estimated using Cox proportional hazard regression models. Splines and fractional polynomial regressions were used for flexible exposure and time modeling. Results Recurrent CHD events occurred among 205 patients. Participants working long hours (≥55 h/week) had a higher risk of recurrent CHD events after controlling for sociodemographics, lifestyle-related risk factors, clinical risk factors, work environment factors, and personality factors (hazard ratio vs. 35 to 40 h/week: 1.67; 95% confidence interval: 1.10 to 2.53). These results showed a linear risk increase after 40 h/week and a stronger effect after the first 4 years of follow-up and when long working hours are combined with job strain. Conclusions Among patients returning to work after a first MI, longer working hours per week is associated with an increased risk of recurrent CHD events. Secondary prevention interventions aiming to reduce the number of working hours among these patients may lower the risk of CHD recurrence.

Purpose To study the longitudinal relationship between interdisciplinary vocational rehabilitation (VR) with and without additional work module on work participation of patients with chronic musculoskeletal pain and sick leave from work. Methods Retrospective longitudinal data retrieved from care as usual in seven VR centers in the Netherlands was used. The VR program without work module consisted of multi-component healthcare (physical exercise, cognitive behavioral therapy, education, relaxation). The other program with additional work module (VR+) included case management and a workplace visit. Generalized estimating equations using binary logistic was applied. The dependent variable was work participation (achieved/not achieved) on discharge and 6-months follow-up. Independent variables were type of intervention, return to work expectation, sick leave duration, working status, job strain, and job dissatisfaction. Results Data from N = 470 patients were analyzed, of which 26% received VR and 74% VR+. Both programs increased work participation at 6-months follow-up (VR 86%, VR+ 87%). The crude model showed a significant longitudinal relationship between type of intervention and work participation in favor of VR+ (OR 1.8, p = 0.01). The final model showed a non-significant relationship on discharge (OR 1.3, p = 0.51) and a significant relationship on 6-months follow-up in favor of VR+ (OR 1.7, p = 0.04). RTW expectation was a significant confounder in the final model on discharge and 6-months follow up (OR 3.1, p = 0.00). Conclusions Both programs led to increased work participation. The addition of a work module to the VR program lead to a significant increase in odds of work participation at 6-months follow-up.

Musculoskeletal disorders may affect labor efficiency, cause disability, impair one’s work ability, and lower one’s quality of life. This consequently leads to a larger expenditure of medical resources. We aimed to design easy-to-open assistive devices for pneumatic tube systems to improve ergonomics and reduce musculoskeletal complaints of workers. We followed a design control process, including designs of motors, gears, sensors, and V-shaped connecting rods. Efficacy was evaluated by examining risks based on job strain index, user satisfaction, and musculoskeletal complaints of operators before and after the system’s implementation on a Nordic musculoskeletal questionnaire. We designed three assistive devices: two semiautomatic and one automatic. Each semiautomatic device costs about 300 US dollars and required space of 10 × 18 × 38 c m 3 . The automatic device costs about 3000 US dollars and required space of 28 × 38 × 50 c m 3 . The job strain index score decreased from 36 (very high risk) to 3 (low risk) with the semiautomatic devices and to 0 with the automatic device. Musculoskeletal complaints in the neck and upper limbs were reduced, with a significantly higher satisfaction rate for female operators. Our novel design of an automatic cap opening device for a pneumatic tube system was effective in improving ergonomics and reducing musculoskeletal complaints.

Objectives Epidemiological studies have explored the relationship between work-related stress and the risk of type 2 diabetes mellitus (T2DM), but it remains unclear on whether work-related stress could increase the risk of T2DM. We aimed to evaluate the association between job strain and the risk of T2DM. Methods We searched PubMed and Web of Science up to April 2019. Summary risk estimates were calculated by random-effect models. And the analysis was also conducted stratifying by gender, study location, smoking, drinking, body mass index, physical activity, family history of T2DM, education and T2DM ascertainment. Studies with binary job strain and quadrants based on the job strain model were analyzed separately. Results A total of nine studies with 210 939 participants free of T2DM were included in this analysis. High job strain (high job demands and low control) was associated with the overall risk of T2DM compared with no job strain (all other combinations) [relative risk (RR) 1.16, 95% confidence interval (CI) 1.03–1.31], and the association was more evident in women (RR 1.48, 95% CI 1.02–2.14). A statistically significant association was also observed when using high strain as a category (job strain quadrants) rather than binary variable (RR 1.62, 95% CI 1.04–2.55) in women but not men. Conclusions Our study suggests that job strain is an important risk factor for T2DM, especially among women. Appropriate preventive interventions in populations with high job strain would contribute to a reduction in T2DM risk.

OBJECTIVE The American Diabetes Association recently called for research on social and environmental determinants of diabetes to intensify primary prevention. Recent epidemiological evidence suggests that frequent and modifiable psychosocial stressors at work might contribute to the development of diabetes, but more prospective studies are needed. We evaluated the relationship between job strain and diabetes incidence in 12,896 workers followed up over a 13-year period in Ontario, Canada. We also examined the modifying effect of body mass index in this relationship. METHODS Data from Ontario respondents (35-74 years of age) to the 2000-2001, 2002, and 2003 cycles of the Canadian Community Health Survey were prospectively linked to the Ontario Health Insurance Plan database for physician services and the Canadian Institute for Health Information Discharge Abstract Database for hospital admissions. The sample consisted of actively employed participants with no previous diagnosis for diabetes. Cox proportional hazard regression models were performed to evaluate the relationship between job strain, obesity, and the incidence of diabetes. RESULTS Overall, job strain was not associated with the incidence of diabetes (hazard ratio [HR] = 1.05; 95% confidence interval [CI] = 0.83-1.34). Among women, job strain was associated with an elevated risk of diabetes, although this finding did not reach statistical significance (HR = 1.36; 95% CI = 0.94-1.96). Among men, no association was observed (HR = 0.89; 95% CI = 0.65-1.22). Also, job strain increased the risk of diabetes among women with obesity (HR = 1.88; 95% CI = 1.14-3.08), whereas these stressors reduced the risk among men with obesity (HR = 0.58; 95% CI = 0.36-0.95). CONCLUSIONS The current study suggests that lowering job strain might be an effective strategy for preventing diabetes among women, especially the high-risk group comprising women with obesity.

Background Suicide is now the 10th leading cause of death in the United States. Suicide rates for health care providers are thought to be higher than for people in other occupations because of job strain and burnout. Despite the National Academy of Medicine's Action Collaborative on Clinician Well-Being and Resilience, which focuses on reducing stress and preventing suicide, a shortage of data limits our understanding of nurse suicide. Neither employers nor professional nursing associations track suicide data. Purpose To determine the number of suicides and estimated rate of suicide among RNs, using data from the National Violent Death Reporting System (NVDRS). Methods We extracted data from the NVDRS, which is based on death certificates, coroner reports, and law enforcement reports, for the year 2015. The National Institute for Occupational Safety and Health's Industry and Occupation Computerized Coding System was used to code the data. Industry and occupation coding experts reviewed the coding for accuracy. Results Analysis of 2015 NVDRS data from 17 states showed that among civilian employed nurses ages 16 to 64 years, the estimated suicide rates for female and male nurses (11.4 and 29.3 per 100,000 nurses, respectively) were each higher than the rates for the comparable total population (8.2 and 26.1 per 100,000 people, respectively). Conclusions Our findings indicate that RNs may die by suicide at higher rates than the total employed population in the 16-to-64-year age range. Implementation of evidence-based approaches to prevent suicide are warranted.

Objective Given that job strain can be a risk factor for health, the researchers looked at the meta-analysis in which consequences of musculoskeletal pain in job strain is reviewed. Study design Systematic review and meta-analysis. Methods After searching in databases based on keywords, studies were retrieved until January 2019. The extracted studies were combined altogether and the risk ratio was calculated. In addition, additional analysis was conducted at the end. Results The results showed that job strain as a risk factor for musculoskeletal pain was 1.62. The risk ratio is equal to 1.38 in men and 1.28 in women. Begg (P = 0.629) and Egger (P = 0.251) tests were not significant but trim-and-fill method imputed 9 missing studies. Conclusions Job strain was a risk factor for physical health and increased the risk of musculoskeletal pain. Therefore, it seems psychologically healthy work environment is essential for the prevention of health problems.

Previous studies on the effect of long working hours on blood pressure have shown inconsistent results. Mixed findings could be attributable to limitations related to blood pressure measurement and the lack of consideration of masked hypertension. The objective was to determine whether individuals who work long hours have a higher prevalence of masked and sustained hypertension. Data were collected at 3-time points over 5 years from 3547 white-collar workers. Long working hours were self-reported, and blood pressure was measured using Spacelabs 90207. Workplace clinic blood pressure was defined as the mean of the first 3readings taken at rest at the workplace. Ambulatory blood pressure was defined as the mean of the next readings recorded every 15 minutes during daytime working hours. Masked hypertension was defined as clinic blood pressure < 140/90 mm Hg and ambulatory blood pressure ≥135/85 mm Hg. Sustained hypertension was defined as clinic blood pressure ≥140/90 mm Hg and ambulatory blood pressure ≥135/85 mm Hg or being treated hypertension. Long working hours were associated with the prevalence of masked hypertension (prevalence ratio 49+ =1.70 [95% CI, 1.09–2.64]), after adjustment for sociodemographics, lifestyle-related risk factors, diabetes mellitus, family history of cardiovascular disease, and job strain. The association with sustained hypertension was of a comparable magnitude (prevalence ratio 49+ =1.66 [95% CI, 1.15–2.50]). Results suggest that long working hours are an independent risk factor for masked and sustained hypertension. Workplace strategies targeting long working hours could be effective in reducing the clinical and public health burden of hypertension.

Introduction. The mining and metallurgical industries form the basis of the economy of the Murmansk Region. Working conditions at industrial enterprises, combined with extreme climatic conditions of the Arctic, pose an increased risk of occupational diseases. The purpose of the study was to investigate working conditions and occupational disease rates among industrial workers of the Murmansk Region in 2007–2017. Materials and methods. We studies socio-hygienic monitoring data on working conditions and occupational diseases in the population of the Murmansk Region in 2007-2017 provided by the Federal Center for Hygiene and Epidemiology of the Federal Service for Supervision of Consumer Rights Protection and Human Welfare, Moscow. Results. In 2008-2017, the most common occupational risk factors in the Murmansk Region included noise (25.8%), job strain (17.8%), and chemical factor (12.6%) while 39.2% of workers were exposed to a combination of occupational hazards. Over 10 years, the absolute number of workers exposed to dangerous and hazardous industrial factors decreased by 1.8 times. In the Murmansk Region, 84.3% of occupational disease cases were registered among workers of mining and metallurgical enterprises. In 2007-2017, the region experienced a significant decrease in occupational disease incidence mainly related to job cuts. The role of other factors (improvement of working conditions, health promotion) needs to be clarified; yet, it is possible to predict their positive influence on occupational morbidity in the next few years. Conclusion. To achieve a substantial decrease in occupational disease incidence rates, it is essential to keep improving comprehensive measures aimed at preserving workers’ health in the Murmansk Region.

We aimed to examine the association between exposure to work stress and chronic disease incidence and loss of chronic disease-free life years in the Danish workforce. The study population included 1,592,491 employees, aged 30 to 59 in 2000 and without prevalent chronic diseases. We assessed work stress as the combination of job strain and effort-reward imbalance using job exposure matrices. We used Cox regressions to estimate risk of incident hospital-diagnoses or death of chronic diseases (i.e., type 2 diabetes, coronary heart disease, stroke, cancer, asthma, chronic obstructive pulmonary disease, heart failure, and dementia) during 18 years of follow-up and calculated corresponding chronic disease-free life expectancy from age 30 to age 75. Individuals working in occupations with high prevalence of work stress had a higher risk of incident chronic disease compared to those in occupations with low prevalence of work stress (women: HR 1.04 (95% CI 1.02 to 1.05), men: HR 1.12 (95% CI 1.11 to 1.14)). The corresponding loss in chronic disease-free life expectancy was 0.25 (95% CI -0.10 to 0.60) and 0.84 (95% CI 0.56 to 1.11) years in women and men, respectively. Additional adjustment for health behaviours attenuated these associations among men. We conclude that men working in high-stress occupations have a small loss of years lived without chronic disease compared to men working in low-stress occupations. This finding appeared to be partially attributable to harmful health behaviours. In women, high work stress indicated a very small and statistically non-significant loss of years lived without chronic disease.

Background Sedentary behaviour (SB) and low levels of physical activity (PA) are predictors of morbidity and mortality. Tertiary employees spend a considerable amount of their daily time seated and new efficient strategies to both reduce sedentary time and increase physical activity are needed. In that context, the REMOVE study aims at evaluating the health effects of a 24-week cycling desk intervention among office workers. Methods A prospective, open-label, multicentre, two-arm parallel, randomized controlled trial (RCT) will be conducted in office-sitting desk workers. Office workers (N = 80) who have 0.8 full time equivalent hours (FTE) and 75% of this time in a sitting position will be recruited from tertiary worksites in Clermont-Ferrand, France. Subjects will be randomly assigned to one of the two following interventions: (i) PPM6: performance of two 30 min of cycling desk (using portable pedal exercise machine—PPM) per working day for 6 months or (ii) CTL_PPM3: 3 months with no intervention (control) followed by 3 months during which workers will be asked to complete two 30 min of PPM per working day. At baseline (T0), at 3 months (T1) and at 6 months (T2) after the start of the interventions, primary outcomes; 7-day PA and SB (3D-accelerometers), secondary outcomes; body composition (bioelectrical impedance), physical fitness (aerobic fitness, upper and lower limb strength), metabolic outcomes (fasting blood samples), self-perceived stress, anxiety, quality of life at work and job strain (questionnaires), tertiary outcomes; resting metabolic rate and cycling energy expenditure (indirect calorimetry) and eating behaviours (questionnaires) will be measured. An ergonomic approach based on observations and individual interviews will be used to identify parameters that could determine adherence. Discussion The REMOVE study will be the first RCT to assess the effects of cycling workstations on objectively measured PA and SB during working and non-working hours and on key physiological and psychological health outcomes. This study will provide important information regarding the implementation of such cycling workstations in office workers and on the associated potential health benefits. Trial registration ClinicalTrials.govNCT04153214. Registered on November 2019, version 1

Introduction On psychiatric wards, aggressive behaviour displayed by patients is common and problematic. Understanding factors associated with the development of aggression offers possibilities for prevention and targeted interventions. This review discusses factors that contribute to the development of aggression on psychiatric wards. Method In Pubmed and Embase, a search was performed aimed at: prevalence data, ward characteristics, patient and staff factors that are associated with aggressive behaviour and from this search 146 studies were included. Results The prevalence of aggressive behaviour on psychiatric wards varied (8–76%). Explanatory factors of aggressive behaviour were subdivided into patient, staff and ward factors. Patient risk factors were diagnosis of psychotic disorder or bipolar disorder, substance abuse, a history of aggression, younger age. Staff risk factors included male gender, unqualified or temporary staff, job strain, dissatisfaction with the job or management, burn-out and quality of the interaction between patients and staff. Staff protective factors were a good functioning team, good leadership and being involved in treatment decisions. Significant ward risk factors were a higher bed occupancy, busy places on the ward, walking rounds, an unsafe environment, a restrictive environment, lack of structure in the day, smoking and lack of privacy. Conclusion Despite a lack of prospective quantitative data, results did show that aggression arises from a combination of patient factors, staff factors and ward factors. Patient factors were studied most often, however, besides treatment, offering the least possibilities in prevention of aggression development. Future studies should focus more on the earlier stages of aggression such as agitation and on factors that are better suited for preventing aggression such as ward and staff factors. Management and clinicians could adapt staffing and ward in line with these results.

Background Many resident physicians suffer from distress, which endangers their individual health and the quality of care. Objective To examine the impact of a tailored mindfulness-based program (MBP) for resident physicians on distress and the quality of care. Methods A single-centre, two-armed, longitudinal randomised controlled trial. The intervention group took part in an eight-week, tailored MBP that included a course book. The MBP was followed by a four-month maintenance phase. The active control group received the course book for self-study. Assessments were at baseline (t0, 0 months), after the intervention (t1, 2 months), after the maintenance phase (t2, 6 months), and at follow-up (t3, 12 months). The primary outcome was change in burnout at t2. Secondary outcomes included perceived stress, mental distress, perceived job strain, depression, anxiety, hair cortisol secretion, self-reported medical errors, and third-party ratings by patients, supervisors, and colleagues. Results Seventy-six participants were randomised to the intervention- and seventy-one to the control group. The intervention group showed greater improvements in the primary outcome (burnout at t2, d = 0.32, p = .046), in perceived stress (d = 0.31, p = .046) and perceived job strain (d = 0.33, p = .026) at t1, and in supervisor rated empathy (d = 0.71, p = .037) and colleague rated attentiveness (d = 0.85, p = .006) at t2. There was no difference between groups in the other outcomes. Conclusion A tailored MBP for resident physicians improved burnout and might have improved other aspects of distress and the quality of care. This article is protected by copyright. All rights reserved.

Background Studies assessing sex differences in the associations of psychosocial strain with depression have shown mixed and inconsistent results. Our objective was to examine prospective associations of job strain and family strain with risk of major depressive episode (MDE) among United States workers, as well as assess potential effect modification by sex. Methods Using data from the nationally representative and population-based Mid-life in the United States (MIDUS) study with a prospective cohort design and a 9-year follow-up period, the effects of job strain and family strain at baseline on risk of MDE within the 12 months prior to the follow-up assessment were examined in 1581 workers (805 men, 776 women) who were free from MDE within the 12 months prior to the baseline survey, by multivariate Poisson regression analysis. Results After adjustment for relevant covariates, there was evidence for effect modification by sex for the association between job strain and MDE but not for the association between family strain and MDE. Indeed, high job strain was prospectively associated with the risk of MDE (RR and 95% CI = 2.14 [1.14, 4.03]) in men but not in women. Moreover, high family strain was prospectively associated with a higher risk of MDE (RR and 95% CI = 1.57 [1.05, 2.37]) in the whole sample. Conclusion Family strain was associated with risk of MDE regardless of the sex of a person. In contrast, high job strain may involve an increased risk of developing MDE only in men but not in women.

Purpose: This study examined the interactions between the job strain and social support in the workplace on the development of work-related neck pain in office workers. Methods: The participants included 62 office workers without neck pain over the last twelve months. A battery of measures evaluating the potential workplace risk factors in office settings were conducted at the baseline, and at the 12 month incidence of work-related neck pain was reported via monthly questionnaires. Survival analysis evaluated the interaction effect between job strain and social sup port on the development of work-related neck pain. Results: The incidence of work-related neck pain was 1.91 (95% CI: 1.06 - 3.45) per 100 person months. The interaction effect between job strain and social support found that job strain may increase the risk of developing new work-related neck pain when lower social support existed in the workplace. On the other hand, the adverse effects of job strain on the development of neck pain were not signifi cant when workers had higher social support from their colleagues and supervisors. Conclusion: An investigation of the moderating effects of risk factors on neck pain might reveal the unexplained relationship between the risk factors for the development of neck pain in office workers. Therefore, the interest in prevention plans and treatments should in volve a comprehensive understanding of the risk factors at workplace.

Introduction Taxi drivers experience frequent hassles that may contribute to mental exertion and depression symptoms. Aim Mental exertion and depression symptoms in taxi drivers are explored in association with hassles, effort-reward imbalance, job strain, and iso-strain. Methods Personal interviews were conducted with 130 drivers in San Francisco. Results Mental exertion averaged 4.5 (±2.68) and physical exertion averaged 3.71 (±2.1) on 0 to 10 Borg scales. Based on the Center for Epidemiological Studies-Depression scale, 38% had depression symptoms. Mental exertion and depression symptoms correlated with job strain, iso-strain and effort-reward imbalance in anticipated directions, lending construct validity to the Borg mental exertion scale. Physical exertion, night shift, stressful personal events, and being uninsured for healthcare predicted mental exertion. Lack of respect by dispatchers and stressful personal events predicted depression symptoms. Conclusion Selected hassles may be remedied by communication trainings, emphasizing mutual respect. Recognition and treatment of depression in taxi drivers are important.

Aims The aim of this study was to investigate the independent associations of occupational (OPA) and sport physical activity (SpPA) and job strain on the incidence of coronary heart disease (CHD) events, and to explore their interplay. Methods The study sample included 3310 25–64-year-old employed men, free of CHD at baseline, recruited in three population-based and one factory-based cohorts. OPA and SpPA, and job strain were assessed by the Baecke and the Job Content Questionnaires, respectively. We estimated the associations between different domains of physical activity and job strain with CHD, adjusting for major risk factors using Cox models. Results During follow-up (median=14 years), 120 CHD events, fatal and non-fatal, occurred. In the entire sample, a higher CHD risk was found for high job strain (hazard ratio=1.55, 95% confidence interval: 1.05–2.31). The joint effect of low OPA and high job strain was estimated as a hazard ratio of 2.53 (1.29–4.97; reference intermediate OPA with non-high strain). With respect to intermediate OPA workers, in stratified analysis when SpPA is none, low OPA workers had a hazard ratio of 2.13 (95% confidence interval: 1.19–3.81), increased to 3.95 (1.79–8.78) by the presence of high job strain. Low OPA–high job strain workers take great advantage from SpPA, reducing their risk up to 90%. In contrast, the protective effect of SpPA on CHD in other OPA–job strain categories was modest or even absent, in particular when OPA is high. Conclusions Our study shows a protective effect of recommended and intermediate SpPA levels on CHD risk among sedentary male workers. When workers are jointly exposed to high job strain and sedentary work their risk further increases, but this group benefits most from regular sport physical activity.

BackgroundThere is good evidence that job stressors are prospectively related to mental health problems, particularly depressive symptoms. This review aimed to examine whether job stressors were also related to use of psychotropic medications.MethodsUsing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach, we examined seven electronic databases that indexed literature from a wide range of disciplines. Inclusion criteria were (1) the study included a job stressor or psychosocial working condition as an exposure, and (2) psychotropic medication was an outcome. All effect-size estimates were considered but needed to present either a SE or 95% CIs to be included in meta-analyses. Data were pooled between studies using the relative risk (RR) or odds ratio (OR) and 95% CIs.ResultsThere were 18 unique studies with non-overlapping exposures eligible for inclusion in the quantitative meta-analysis. High job demands were associated with a statistically significant increased risk of psychotropic medication use (RR 1.16, 95% CI 1.02 to 1.31). There was also an elevated RR in relation to work–family conflict (RR 1.26, 95% CI 1.03 to 1.48). In studies reporting OR, high job demands were associated with an OR of 1.39 (95% CI 1.06 to 1.71).ConclusionsThe findings of this review highlight the need for policy and programme attention to reduce harmful exposure to psychosocial job stressors. Health-service use measures should be considered as outcomes and may represent more severe mental health conditions.

The quality of workers’ dietary intake could be influenced by their working conditions. This review aimed to summarize the published literature examining the association between work-related factors, such as work hours, shift work, physical strain, mental strain, job strain, support, and diet quality. The literature search, conducted in PubMed, was limited to articles published from 2000 to 2017, written in English, available online, and among workers employed in high-income countries. The search resulted in 16 articles that met the criteria. Although there was some evidence of unhealthy diet among shift workers, data on the diet quality in association with other work-related factors, such as number of hours worked, physical, mental, and job strain, and worksite support were scarce. Further studies are need for purposes better defining the association between work-related factors and quality of workers’ diet.

Objective To examine the effect of work-related stress and road noise exposure on self-rated sleep and potential additive interaction effects. Methods Sleep and predictor variables were surveyed within two subsamples with 2191 and 1764 working women in a cross-sectional study. Sleep was assessed using a single question on general sleep quality and four questions on specific sleep problems and subsequently dichotomized (poor sleep vs. no poor sleep). Work-related stress was operationalized by job strain and effort-reward imbalance. Nocturnal exposure to road traffic noise was assessed as (a) the orientation of the bedroom window to a quiet façade vs. a low-, medium- or high-trafficked street and (b) energy-equivalent sound pressure levels for night-time modelled at the most exposed façade (Lnight). We distinguished between low ( 50 dB(A)). Results Poor sleep was associated with job strain and effort-reward imbalance. The prevalence of poor sleep did not increase with increasing Lnight, but bedroom window orientation showed a non-significant trend. A quiet façade had a protective effect on sleep in each Lnight category. We found a non-significant trend for an additive interaction between bedroom window orientation and job strain. Conclusion Noise levels modelled for the most exposed façade likely overestimate the actual exposure and thus may not be a precise predictor of poor sleep. Bedroom window orientation seems more relevant. Potential additive interaction effects between bedroom window orientation and job strain should be considered when interpreting epidemiological study results on noise-induced sleep disturbances.

Objective Occupational stress represents a significant precipitating factor in different diseases but its role in Irritable Bowel Syndrome (IBS) needs to be clarified. The present cross-sectional study aimed at investigating the prevalence of IBS diagnosis in a sample of health workers and exploring the potential relationships between IBS, work-related stress levels and work ability. Methods 653 health workers undergoing periodical occupational health surveillance at the Occupational and Preventive Medicine Unit of a major University Hospital in central Italy, were consecutively recruited and screened for IBS diagnosis, according to ROMA IV criteria. The rating scales IBS Severity Scoring System (IBS-SSS), Demand–Control–Support Questionnaire (DCSQ) and Work Ability Index (WAI) were used to assess respectively IBS severity, occupational stress and work ability levels. Results IBS prevalence in the sample was 16.8%. Participants suffering from IBS were characterized by a higher prevalence of psychiatric diagnosis and sleep disturbances, higher levels of job strain and isostrain as well as by lower levels of work ability compared to non affected subjects. Moreover, the severity of IBS correlated positively with occupational stress and both were negatively associated with work ability. Conclusions The present results suggest the need for preventive, organizational and management strategies at workplace aimed at protecting the health and well-being but also productivity of the worker with IBS.

Background: Stress is a significant public health concern that can be self-evaluated using the job control demands model from Karasek. Emergency health care workers are particularly exposed to stress because of the intrinsic characteristics associated with the job (i.e., life-threatening emergencies, overcrowding, lack of bed spaces). However, these attributes have never been studied using the Karasek model. Methods: An observational, prospective, multicentric study in French Emergency Departments will be conducted using a cohort of emergency health care workers. Four questionnaires before a control day and after a nightshift will be assessed every 5 years in the same emergency departments. Also, the Karasek questionnaire, a sociodemographic questionnaire, the Maslach Burnout Inventory scale, the Hospital Anxiety, Depression Scale, and a food intake questionnaire will be evaluated. Salivary biomarkers (cortisol, immunoglobulin A, lysozyme) will be collected from every emergency health care worker who consents to participating in the study. Conclusion: This study will provide a point of care for the emergency health care workers’ stress situation every 5 years. Ethics: This protocol was registered in Clinical Trials under the identification NCT02401607 after the French Ethics Committee’s approval.

Background The association between psychosocial stress and coronary heart disease (CHD) may be stronger in women than men and may differ across types of stressors. In this study, we assessed associations of psychosocial stressors, including job strain, stressful life events, and social strain with the incidence of CHD in women. Methods and Results We used longitudinal data from 80 825 WHI‐OS (Women's Health Initiative Observational Study) participants with a mean age of 63.4 years (7.3 years) at baseline. Job strain was assessed through linkage of Standard Occupational Classification codes to the Occupational Information Network. Stressful life events and social strain were assessed via validated self‐reported questionnaires. Cox proportional hazard models were used to evaluate associations of each stressor with CHD separately and jointly. A total of 3841 (4.8%) women developed CHD during an average of 14.7 years of follow‐up. After adjustment for age, other stressors, job tenure, and socioeconomic factors, high stressful life events score was associated with a 12% increased CHD risk, and high social strain was associated with a 9% increased CHD risk. Job strain was not independently associated with CHD risk, but we observed a statistically significant interaction between job strain and social strain (P=0.04), such that among women with high social strain, passive job strain was associated with a 21% increased CHD risk. Conclusions High stressful life events and social strain were each associated with higher CHD risk. Job strain and social strain work synergistically to increase CHD risk.

Background Work related upper limb disorders (WRULDs) are a major occupational health concern. The health field, with its various occupational categories, is a conducive environment for the emergence of these conditions. Midwives are particularly at risk for WRULDs. Objective To determine the prevalence of WRULDs among midwives exersing at a Tunisian academic maternity and identify its associated factors. Methods This is a cross-sectional descriptive study conducted among midwives working at the maternity Departement of the Farhat Hached Teaching Hospital in the central region of Tunisia, during the period from March to May 2016. This study was based on a self-administered questionnaire including socio-professional characteristics, the “Nordic” questionnaire for the assessment of WRULDs in the last 12 months and the last 7 days, and the job content questionnaire for the evaluation of the psychosocial environment at work. Results A total of 54 midwives participated to our study with a response rate of 84.3%. The mean age was 46.1 + 8.7 years. In the last week before the study, the median number of deliveries performed by midwives per day was 3. Job strain was noted in 33.3% of cases. During the last 12 months, the prevalence of WRULDs was 90.7%. The complaints were located at the neck in 72.7% of cases. For the last seven days, this prevalence was 53.7%. Obesity and upper limb trauma history were significantly associated with WRULDs over the last 7 days. No social-occupational risk factors were associated with WRULDs in midwives in the last 12 months. Conclusion Our study found a high prevalence of WRULDs in midwives, emphasizing the need of adequate prevention in order to reduce the importance of this occupational disease and its harmful consequences.

Objective To analyze the factors associated with mental distress among health workers who cared for patients with a suspected or confirmed diagnosis of coronavirus disease 2019 (COVID-19). Methods A cross-sectional analytical study of national scope, carried out between in the second quarter of 2020. A total of 437 health professionals, who filled out an electronic form about sociodemographic data, occupational aspects, psychosocial characteristics of work and mental distress. Multiple logistic regression was performed to analyze the covariables associated with mental distress. Results There was a predominance of workers on the nursing team (65.0%), female (71.0%), from Southeastern region of the country (68.6%) and with no morbidities (36.2%). The prevalence of mental distress was 61.6%. Job strain was reported by 24% of participants, and the perception of low support from coworkers was described by 52.9%. The final multiple regression model showed that mental distress was associated with females (odds ratio - OR: 1.93; 95%CI: 1.22-3.07), age up to 40 years (OR: 1.64; 95%CI: 1.07-2.52), weekly working hours equal or over 60 hours (OR: 1.87; 95%CI: 1.15-3.11), job strain (OR: 2.45; 95%CI: 1.41-4.40) and low support from co-workers (OR: 3.47; 95%CI: 2.26-5.38). Conclusion Six out of ten participants presented mental distress, which was associated to both individual characteristics and factors related to the work carried out during the pandemic. There is an urgent need to map services that have such characteristics, to outline actions to promote mental health and prevent emotional distress at different levels of health care.

Objective: To investigate possible gender differences in psychosocial job strain (PSYJS) and single and multi-site musculoskeletal pain (MSP) in cabin crew. Background: In recent years the proportion of male cabin crew has increased, still few studies have investigated gender differences in PSYJS and MSP in this occupational group. Methods: In this cross-sectional study, a questionnaire concerning work-related psychosocial demands, control, social support, and MSP was answered by 107 male and 329 female cabin crew members from the three major airline companies in Norway. Binary logistic regression models were used for the analysis. Results: There were no gender differences in PSYJS, but female cabin crew reported higher levels of social support from colleagues (p = .001) and nearest supervisor (p = .006). Multi-site MSP was reported by 70%. No gender differences in prevalence of single-site or multi-site MSP were found, except from a higher prevalence of pain in feet in female cabin crew (p = .020). Both a high strain (33%) and a passive (17%) work situation were associated with significantly higher risks of most single and multi-site MSP. Conclusion: Even though few gender differences were found, both male and female cabin crew reported high prevalence of MSP and high PSYJS. Attention should be given to create a healthier psychosocial work environment for this occupational group, with a special emphasis on support at work for male cabin crew.

Objectives To examine the association between cognitively stimulating work and subsequent risk of dementia and to identify protein pathways for this association. Design Multicohort study with three sets of analyses. Setting United Kingdom, Europe, and the United States. Participants Three associations were examined: cognitive stimulation and dementia risk in 107 896 participants from seven population based prospective cohort studies from the IPD-Work consortium (individual participant data meta-analysis in working populations); cognitive stimulation and proteins in a random sample of 2261 participants from one cohort study; and proteins and dementia risk in 13 656 participants from two cohort studies. Main outcome measures Cognitive stimulation was measured at baseline using standard questionnaire instruments on active versus passive jobs and at baseline and over time using a job exposure matrix indicator. 4953 proteins in plasma samples were scanned. Follow-up of incident dementia varied between 13.7 to 30.1 years depending on the cohort. People with dementia were identified through linked electronic health records and repeated clinical examinations. Results During 1.8 million person years at risk, 1143 people with dementia were recorded. The risk of dementia was found to be lower for participants with high compared with low cognitive stimulation at work (crude incidence of dementia per 10 000 person years 4.8 in the high stimulation group and 7.3 in the low stimulation group, age and sex adjusted hazard ratio 0.77, 95% confidence interval 0.65 to 0.92, heterogeneity in cohort specific estimates I 2 =0%, P=0.99). This association was robust to additional adjustment for education, risk factors for dementia in adulthood (smoking, heavy alcohol consumption, physical inactivity, job strain, obesity, hypertension, and prevalent diabetes at baseline), and cardiometabolic diseases (diabetes, coronary heart disease, stroke) before dementia diagnosis (fully adjusted hazard ratio 0.82, 95% confidence interval 0.68 to 0.98). The risk of dementia was also observed during the first 10 years of follow-up (hazard ratio 0.60, 95% confidence interval 0.37 to 0.95) and from year 10 onwards (0.79, 0.66 to 0.95) and replicated using a repeated job exposure matrix indicator of cognitive stimulation (hazard ratio per 1 standard deviation increase 0.77, 95% confidence interval 0.69 to 0.86). In analysis controlling for multiple testing, higher cognitive stimulation at work was associated with lower levels of proteins that inhibit central nervous system axonogenesis and synaptogenesis: slit homologue 2 (SLIT2, fully adjusted β −0.34, P Conclusions The risk of dementia in old age was found to be lower in people with cognitively stimulating jobs than in those with non-stimulating jobs. The findings that cognitive stimulation is associated with lower levels of plasma proteins that potentially inhibit axonogenesis and synaptogenesis and increase the risk of dementia might provide clues to underlying biological mechanisms.

Background: Mental health disorders are a major public health issue (1) accounting for 10% of the global burden of disease (2), and are the single largest contributor to global disability (3). An important social determinant of worker mental health is the corporate climate for psychological health (i.e., Psychosocial Safety Climate, PSC). This study aimed to develop PSC-4 risk levels for predicting job strain and mental ill-health and determine the population attributable risk (PAR) of these criteria to PSC. Methods: Australian Workplace Barometer survey interviews were used yielding cross-sectional (Time 1, n=2970; Time 2, n=4140) and longitudinal (n=1476) databases. PSC-4 risk levels were determined by comparative mean level and ROC analyses. Logistic regression assessed the predictive validity of PSC-4 risk on criteria controlling for baselines and PAR was estimated. Findings: Workers reported high job strain (jobs combining high demands and low control) (20%), mild/moderate to severe symptoms of psychological distress (16%), and depression (8%). PSC-4 risk levels were estimated as > 13 low risk and < 12 high risk for job strain and worker mental ill-health. The PAR revealed that eliminating high risk PSC could reduce 22% of the Australian worker population burden of psychological distress, 32% of depressive symptoms, and 12% of job strain. Interpretation: This easy-to-use one minute tool could help shift clinical medical thinking to social determinants of mental health, such as the corporate climate. PAR results show large scope for job strain and mental ill-health prevention by improving PSC. Advocacy by public health, psychiatrists, and physicians could bolster social protection for worker mental health. Funding Statement: Australian Research Council, WorkSafe Victoria WorkWell program, Safe Work Australia, SafeWork SA. Declaration of Interests: There are no known conflicts of interest. Ethics Approval Statement: Ethics for the study was obtained by the University of South Australia Human Research Ethics committee, protocol number 0000033122.

Aims Due to the stressful nature of policing, police employees are at risk of mental health problems and problematic alcohol use. We aim to determine the prevalence of hazardous and harmful alcohol use in the UK Police Service, and to explore the associations with job strain and mental health problems. Methods Cross-sectional data from the Airwave Health Monitoring Study (N = 40 986) included measures of alcohol consumption (total units in past week), mental health (depression, anxiety and post-traumatic stress disorder [PTSD]) and job strain. The associations between mental health and job strain with alcohol consumption (i.e. abstinence, low-risk [14 to 35 units for women, >14 to 50 units for men], harmful [>35 units for women, >50 units for men]), were analysed using multinomial logistic regressions, adjusting for potential confounders (i.e. age, gender, ethnicity, marital status, children under 18, income and smoking status). Results A total of 32.6% of police employees reported hazardous drinking, with 3.0% drinking at harmful levels. Compared to those without a mental health problem, police employees with depression, anxiety or PTSD were twice as likely to be harmful drinkers and were also 1.3 times more likely to report abstinence. Those reporting low strain (reference group) were more likely to drink hazardously compared to those reporting high strain, which was statistically moderated by mental health. When the sample was stratified by mental health status, the association between low strain (compared to all other categories) and hazardous drinking, was significant only in those without a mental health problem. Conclusions These findings indicate that police employees may be an occupational group at risk of alcohol harm, with one-third drinking hazardously. The J-shaped relationship between mental health and alcohol use highlights a need for an integration of mental health and alcohol services, tailored for the UK Police Service.

Background As an increasing number of deaths occur in the intensive care unit (ICU), studies have sought to describe, understand, and improve end-of-life care in this setting. Most of these studies are centered on the patient’s and/or the relatives’ experience. Our study aimed to develop an instrument designed to assess the experience of physicians and nurses of patients who died in the ICU, using a mixed methodology and validated in a prospective multicenter study. Methods Physicians and nurses of patients who died in 41 ICUs completed the job strain and the CAESAR questionnaire within 24 h after the death. The psychometric validation was conducted using two datasets: a learning and a reliability cohort. Results Among the 475 patients included in the main cohort, 398 nurse and 417 physician scores were analyzed. The global score was high for both nurses [62/75 (59; 66)] and physicians [64/75 (61; 68)]. Factors associated with higher CAESAR-Nurse scores were absence of conflict with physicians, pain control handled with physicians, death disclosed to the family at the bedside, and invasive care not performed. As assessed by the job strain instrument, low decision control was associated with lower CAESAR score (61 (58; 65) versus 63 (60; 67), p = 0.002). Factors associated with higher CAESAR-Physician scores were room dedicated to family information, information delivered together by nurse and physician, families systematically informed of the EOL decision, involvement of the nurse during implementation of the EOL decision, and open visitation. They were also higher when a decision to withdraw or withhold treatment was made, no cardiopulmonary resuscitation was performed, and the death was disclosed to the family at the bedside. Conclusion We described and validated a new instrument for assessing the experience of physicians and nurses involved in EOL in the ICU. This study shows important areas for improving practices.

Although health care professionals' increased job demands and strain have generated much public debate in recent years, the way in which occupational therapists' job strain has developed remains unknown.To examine how Finnish occupational therapists working in municipalities experienced job demands and control in 2014-2018 compared with physiotherapists and registered nurses.Occupational therapists (OT,More OTs had lower job demands and higher job control than PTs and RNs in each year of study. These differences were statistically significant. Most OTs had low job strain. The changes in job control and job demands of participants in different years were not statistically significant.The OTs consistently experienced low job strain as compared to the PTs and RNs. Developing good practices in OT's work may be beneficial for improving employee health and well-being and high-quality client care.

The purpose of this study was to evaluate family physicians’ job strain during the Covid-19 pandemic and determine the effective factors. The study was carried out between 01 May 2020 and 01 June 2020 by applying an online questionnaire to family physicians who worked in primary care in Istanbul and could be reached by telephone application. The survey created by us included socio-demographic information and the Job Strain Scale Short Form. P value was accepted as 0.05, and SPSS 20 package program was used in statistical analysis. 448 Family Physicians participated in the study. Anxiety levels of the participants increased after the pandemic (p

BackgroundSelf-rated health (SRH) - one of the most common health indicators used to verify health conditions - can be influenced by several types of socioeconomic conditions, thereby reflecting health inequalities. This study aimed to evaluate the participant profiles regarding the association between self-rated health and social and occupational characteristics of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).MethodsCross-sectional design, including 11,305 individuals. Self-rated health was categorized as good, fair, and poor. The relationship between socio-demographic, psychosocial work environment, health-related variables, and self-rated health was analyzed by multiple correspondence analysis (stratified by age: up to 49 years old and 50 years old or more).ResultsFor both age strata, group composition was influenced by socioeconomic conditions. Poor SRH was related to lower socioeconomic conditions, being women, black self-declared race/ethnicity, being non-married/non-united, low decision authority, low skill discretion, and obesity.ConclusionTo promote health, interventions should focus on reducing existing socioeconomic, race, and gender inequalities in Brazil.

Workplace stress and depression are positively related with inflammation, and each other. Low-grade inflammation and concurrent high levels of workplace stress or depression has been related with future morbidity. The potential pathway between constructs however, remains elusive. For the first time, this study explored the concurrent relationship between workplace stress, depressive symptomology and low-grade inflammation, and considered the role of gender in these relationships. Data from the Whitehall II cohort study (N ​= ​2528, Mage ​= ​57.01, 23.7% females) provided measures of workplace stress (job demand-control; JDC), depressive symptomology (Centre for Epidemiological Studies Depression scale; CES-D) and circulating inflammatory markers, interleukin-6 (IL-6) and C-reactive protein (CRP) collected on the same day from a single time point. Females had higher workplace stress, depressive symptoms and lower serum IL-6 concentrations. For males, higher workplace stress was associated with higher depressive symptoms. For females, higher depressive symptoms were related with elevated IL-6 levels, and both higher workplace stress and IL-6 levels were associated with higher depressive symptoms. Higher depressive symptoms were related with higher CRP levels in men only. Higher depressive symptoms statistically mediated the relationship between higher workplace stress and IL-6 levels in females only, b ​= ​0.016, CI [0.002, 0.039]. Females in this large cohort had higher levels of job strain, depression and lower IL-6 concentrations than males. In females, higher depressive symptoms were associated with higher serum IL-6 levels and workplace stress was not. Considered together, these findings suggest that low job control may be more apparent in females than males, but it is primarily negative affect that drives the positive relationship between work stress and serum IL-6 concentrations in females. Replicating the current design with a suitably proximal follow-up is required to determine if the associations identified are causal., Highlights • Females had higher workplace stress, depressive symptoms and lower IL-6. • Association between stress, depression and inflammation was stronger in women. • Among females, depressive symptoms and not stress associated with serum IL-6. .

ObjectivesTo explore the association between working conditions during first trimester and total preterm birth (PTB), and subtypes: spontaneous PTB and iatrogenic PTB, additionally to explore the role of hypertension.MethodsPregnant women from the Amsterdam Born Children and their Development study, filled out a questionnaire between January 2003 and March 2004, two weeks after first prenatal screening (singleton liveborn, n=7561). Working conditions were working hours/week, standing/walking hours/week, physical work load and job strain.ResultsProlonged standing/walking during first trimester was associated with an increased risk for total PTB (OR=1.5; 95% CI 1.0–2.3, after adjustments). Other working conditions were not related to total PTB. The separation into spontaneous and iatrogenic PTB revealed that standing/walking was associated with iatrogenic PTB only (OR=2.09; 95% CI 1.00–4.97). The highest risk was found for the combination of a long workweek with high physical work load (OR=3.42; 95% CI 1.04–8.21). Hypertension did not mediate these associations; however, stratified analysis revealed that high physical work load was only related to iatrogenic PTB when pregnancy-induced hypertension was present (OR=6.44; 95% CI 1.21–29.76).ConclusionThis study provides evidence that high physically demanding work is associated with an increased risk for iatrogenic PTB and not with spontaneous PTB. Pregnancy-induced hypertension may play a role: when present, high physical work load leads to a more severe outcome.

Occupational therapists with less than 10 years of work experience have been shown to be at higher risk of work-related stress. There is a need for further research on the level of job strain they perceive.To investigate the perceived level of job strain among Swedish occupational therapists with less than 10 years of work experience and differences between groups who have worked for 0-5 years and 6-10 years.In this cross-sectional study, a web-based survey was sent to 345 occupational therapists with less than 10 years of work experience, with 252 responding. Data was collected using the Swedish Demand-Control-Support Questionnaire and questions on job strain and sociodemographics.The participants scored 19.68 points on the control scale and 20.01 points on the support scale, indicating high levels of control and support, and 13.33 points on the demand scale (high demand ≤ 14 points). Twelve percent worked in high strain jobs. Most (75%) worked in low strain and active jobs.The participants reported low levels of job strain. However, to prevent mental health problems, employers need to identify those in active jobs to ensure that they have time to exercise control over their work situation.

This paper examines the impact of raising the State Pension age on women's health. Exploiting a UK pension reform that increased women's State Pension age for up to 6 years since 2010, we show that raising the State Pension age leads to an increase of up to 12 percentage points in the probability of depressive symptoms, alongside an increase in self-reported medically diagnosed depression among women in a lower occupational grade. Our results suggest that these effects are driven by prolonged exposure to high-strain jobs characterised by high demands and low control. Effects are consistent across multiple subcomponents of the General Health Question and Short-Form-12 (SF-12) scores, and robust to alternative empirical specifications, including “placebo” analyses for women who never worked and for men.

Maternal psychosocial stress may impact child neurodevelopment, but little is known regarding psychosocial job strain. We hypothesized high psychosocial job strain during pregnancy was associated with behavioural problems in the 11-year-old children. Mothers in the Danish National Birth Cohort (1996-2002) were included if they worked, provided information on job strain [Karasek's model: high job strain (often job demand/seldom job control) and passive (seldom or sometimes job demands/seldom job control)] during early pregnancy. At the 11-year follow-up, children (N = 30,592), mothers (N = 30,993), and teachers (N = 12,810) responded to the Strength and Difficulties Questionnaire (SDQ), a screening tool for child behaviour. Scores for hyperactivity, conduct, emotional and peer problems were dichotomised [80% (no) vs. 20% (yes)] according to Danish norms (yes/no). Maternal job strain was not associated with behavioural problems with teachers as informants. When assessed by child or mother, high maternal job strain increased risk of child behavioural problems, but risks were more pronounced for mothers in passive jobs [maternal assessment of total difficulties/odds ratio (95% confidence interval): high strain-girls: 1.16 (0.97-1.40); boys: 1.24 (1.02-1.50). Passive girls: 1.43 (1.21-1.68); boys: 1.25 (1.05-1.49)]. This is one of the first studies on this topic. The different types of maternal job strain were partly associated with child behavioural problems at 11 years; more so if mothers worked in passive rather than the hypothesized high strain jobs. Findings showing dependency on informant could not only indicate unmeasured confounding or rater's bias, but also selection in the smaller numbers of teacher informants or different environments of interaction with the children.

ObjectivesPsychological stress may influence both susceptibility and severity of infections. Although work-related stress is a widespread concern among many employees, few studies have been conducted with the focus on work stressors and infections. We therefore aimed to investigate this association in a prospective cohort study.MethodsOur study included 25 029 employed individuals who filled-out a questionnaire in September 1997 and were followed through record linkages until retirement or December 2016. Work stress was assessed at baseline using a Swedish version of the Demand-Control Questionnaire, whereas hospital contacts related to infections were identified from the National Patient Register. We fitted extensions of the standard Cox model to account for recurrent infections.ResultsIn total, we observed 8257 infections. Individuals in the third tertile of job demand had a 13% higher hazard of infections (HR=1.13; 95% CI=1.03 to 1.24) compared with individuals in the first tertile, specifically an increased incidence of upper respiratory tract infections (HR=1.15; 95% CI=1.00 to 1.33) and urinary tract infections (HR=1.31; 95% CI=1.09 to 1.57) was found. Employees with the highest job control (third tertile) had no lower risk of infections than individuals in the lowest tertile (HR=1.02; 95% CI=0.92 to 1.13). When combining the demand and control dimensions into job strain scale, no association between high job strain and infections was observed (HR=1.08; 95% CI=0.97 to 1.21).ConclusionHigh job demand, but not low job control, is associated with an increased occurrence of infections. No difference was observed in workers with high strain jobs compared with those with low strain jobs.

To test whether gas and oil field work is accompanied by stress and altered immune function, the perception of workplace stress, levels of salivary cortisol, plasma levels, and mononuclear cell production of cytokines were examined in 80 healthy workers recruited among a population of operators on gas and oilfields. Specific questionnaires for determining the perception of anxiety, occupational stress, and subjective symptoms were administered. Salivary cortisol and cytokines plasma levels were evaluated by Elisa and to investigate immune function, both spontaneous and PHA- or LPS-induced expression and production of cytokines were assessed by qRT-PCR. Workers showed medium stress levels at work, with growth and increased motivation for work, and based on salivary cortisol concentrations, were divided into two groups of &le, 10 ng/mL (n = 31) or &gt, 10 ng/mL (n = 49). Statistically significant higher plasma levels of IL-6, while lower TNF&alpha, were detected in workers with cortisol &gt, 10 ng/mL. Also, BMI, DL, JD and Job strain were significantly higher in workers with cortisol &gt, 10 ng/mL. Thus, even modest variations of cortisol might have a role in the modulation of immune response and worker&rsquo, s vulnerability to health imbalance.Thus, the evaluation of immune status, in addition to cortisol levels, could be useful to prevent illnesses, exacerbation of pre-existing conditions, morbidity, and consequent absences from work, with economic repercussions.

ObjectiveThis scoping review aimed to explore and describe the research on associations between person-centred care (PCC) and healthcare provider outcomes, for example, job satisfaction and work-related health.DesignScoping review.Eligibility criteriaStudies were included if they were empirical studies that analysed associations between PCC measurement tools and healthcare providers outcomes.Search strategySearches in PubMed, CINAHL, Psychinfo and SCOPUS databases were conducted to identify relevant studies published between 2001 and 2019. Two authors independently screened studies for inclusion.ResultsEighteen studies fulfilled the inclusion criteria. Twelve studies were cross-sectional, four quasi-experimental, one longitudinal and one randomised controlled trial. The studies were carried out in Sweden, The Netherlands, the USA, Australia, Norway and Germany in residential care, nursing homes, safety net clinics, a hospital and community care. The healthcare provider outcomes consisted of job satisfaction, burnout, stress of conscience, psychosocial work environment, job strain and intent to leave. The cross-sectional studies found significant associations, whereas the longitudinal studies revealed no significant effects of PCC on healthcare provider outcomes over time.ConclusionMost studies established a positive association between PCC and healthcare provider outcomes. However, due to the methodological variation, a robust conclusion could not be generated. Further research is required to establish the viability of implementing PCC for the improvement of job satisfaction and work-related health outcomes through rigorous and consistent research.

This cohort study examines disease-free life-years in participants with varying combinations of lifestyle risk factors. Question Are different combinations of lifestyle factors associated with years lived without chronic diseases? Findings In a multicohort study of 116 & x202f;043 participants, a statistically significant association between overall healthy lifestyle score and an increased number of disease-free life-years was noted. Of 16 different lifestyle profiles studied, the 4 that were associated with the greatest disease-free life years included body mass index lower than 25 and at least 2 of 3 factors: never smoking, physical activity, and moderate alcohol consumption. Meaning Various healthy lifestyle profiles appear to be associated with extended gains in life lived without type 2 diabetes, cardiovascular and respiratory diseases, and cancer. Importance It is well established that selected lifestyle factors are individually associated with lower risk of chronic diseases, but how combinations of these factors are associated with disease-free life-years is unknown. Objective To estimate the association between healthy lifestyle and the number of disease-free life-years. Design, Setting, and Participants A prospective multicohort study, including 12 European studies as part of the Individual-Participant-Data Meta-analysis in Working Populations Consortium, was performed. Participants included 116 & x202f;043 people free of major noncommunicable disease at baseline from August 7, 1991, to May 31, 2006. Data analysis was conducted from May 22, 2018, to January 21, 2020. Exposures Four baseline lifestyle factors (smoking, body mass index, physical activity, and alcohol consumption) were each allocated a score based on risk status: optimal (2 points), intermediate (1 point), or poor (0 points) resulting in an aggregated lifestyle score ranging from 0 (worst) to 8 (best). Sixteen lifestyle profiles were constructed from combinations of these risk factors. Main Outcomes and Measures The number of years between ages 40 and 75 years without chronic disease, including type 2 diabetes, coronary heart disease, stroke, cancer, asthma, and chronic obstructive pulmonary disease. Results Of the 116 & x202f;043 people included in the analysis, the mean (SD) age was 43.7 (10.1) years and 70 & x202f;911 were women (61.1%). During 1.45 million person-years at risk (mean follow-up, 12.5 years; range, 4.9-18.6 years), 17 & x202f;383 participants developed at least 1 chronic disease. There was a linear association between overall healthy lifestyle score and the number of disease-free years, such that a 1-point improvement in the score was associated with an increase of 0.96 (95% CI, 0.83-1.08) disease-free years in men and 0.89 (95% CI, 0.75-1.02) years in women. Comparing the best lifestyle score with the worst lifestyle score was associated with 9.9 (95% CI 6.7-13.1) additional years without chronic diseases in men and 9.4 (95% CI 5.4-13.3) additional years in women (P