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Aim In 1993, a study of 1000 automotive workers in Sweden and France looked into national differences of cardiovascular disease. Here, we evaluate the proportion of the Swedish cohort that suffered a stroke or died over a 25-year period and associated risk factors. Subject and methods Data from 1993 included a life-style questionnaire, a health examination and laboratory data. Figures on stroke and survival status up until the end of 2018 were collected from national registers. Survival analysis was used for both univariable and multivariable analyses to study associations between potential risk factors and stroke and death, respectively. Results By the end of 2018, 65 individuals had suffered a stroke and 160 had died. In the univariable analysis, we found age, systolic blood pressure, Framingham risk index and diabetes at baseline to be significantly associated with stroke during follow-up. For death, most of the traditional risk factors were significantly associated with the outcome, as was blue-collar work and living alone. In the multivariable analysis, age and diabetes at baseline remained significantly associated with stroke, whereas eight factors (age, blue-collar work, living alone, systolic blood pressure, waist–hip ratio, smoking habits, diabetes and hypertension at baseline) were significantly associated with death during follow-up. Conclusion Few of the traditional risk factors were significantly associated with stroke possibly explained by low power and/or different pathogenetic mechanism than for myocardial infarction. Partly because death occurred more often, we did find a number of potential risk factors to be significantly associated with this outcome.

Aim The study aim was to further clarify the relationship between psychological factors and myocardial infarction (MI) by simultaneously examining anger, depression, and anxiety as risk factors for incident MI in a healthy working sample. Subject and method Baseline measurements of psychological variables were assessed through a self-reported questionnaire in a healthy cohort of 968 middle-aged men working at the Volvo Corporation. Single-item questions assessed depression and anxiety. Anger was assessed by the Trait Anger subscale of the Spielberger State-Trait Anger Expression Inventory. The endpoint was incident MI verified by national registers or medical records with follow up after 22 years. The main outcome was computed through logistic regression, reported as odds ratios. Additional correlation analyses were performed between psychological variables and coronary risk factors. Results None of the psychological variables was significantly associated with the outcome; thus, the results failed to show an association between anger, depression, or anxiety and incident MI in this sample. There were some significant, but weak, correlations between psychological factors and negative health behaviors. Other components of traditional risk scoring instruments did not correlate with the psychological factors. Conclusion A cohort restricted to middle-age healthy men limits applicability. However, our failure to replicate earlier results of population samples suggests a need for further research on associations between psychological factors and MI in healthy samples.

Background In 1993, 1000 randomly selected employed Swedish men aged 45–50 years were invited to a nurse-led health examination with a survey on life style, fasting lab tests, and a 12-lead ECG. A repeat examination was offered in 1998. The ECGs were classified according to the Minnesota Code. Upon ethical approval, endpoints in terms of MI and death over 25 years were collected from Swedish national registers with the purpose of analyzing the independent association of ECG abnormalities as risk factors for myocardial infarction and death. Results Seventy-nine of 977 participants had at least one ECG abnormality 1993 or 1998. One hundred participants had a first MI over the 25 years. Odds ratio for having an MI in the group that had one or more ECG abnormality compared with the group with two normal ECGs was estimated to 3.16. 95%CI (1.74; 5.73), p value 0.0001. One hundred fifty-seven participants had died before 2019. For death, similarly no statistically significant difference was shown, OR 1.52, 95%CI (0.83; 2.76). Conclusions Our study suggests that presence of ST- and R-wave changes is associated with an independent 3–4-fold increased risk of MI after 25 years follow-up, but not of death. A 12-lead resting ECG should be included in any MI risk calculation on an individual level.

Aim This study was performed within an international organization (IO), headquartered in Washington, D.C. The employees are facing great risks during their missions abroad, where developing countries are the most common travel destination. The IO conducted a staff road safety survey in 2008 and based a road safety policy on the results of this survey. In 2017, a follow-up survey investigated the impact of the policy implementation. The aim of this study was to investigate the effect of that policy. Subjects and methods This study is based on two cross-sectional road safety surveys conducted by the IO’s Staff Road Safety Task Force. The study population consisted of both regular employees and consultants based at country offices (CO) worldwide. The number of reported road traffic crashes and near-crashes (nearly had a crash), as well as road safety behavior, was compared between these two surveys. The analysis was performed from a gender perspective. High-risk countries were identified based on the number of reported road traffic crashes and near-crashes. Results Over a period of nine years, the incidence rates had dropped from 1.6 to 0.7 road traffic crashes per 1000 travel days and from 14 to 8.9 near-crashes per 1000 travel days. Seat belt usage had increased from 70% to 80%. There were no major differences between male and female respondents. Developing countries had the highest travel adjusted event rates. Conclusion The findings of this study suggest that the policy had a positive impact on road safety among CO staff within the IO.

Objective: Does proactive ergonomics program enhance office worker health and productivity? Method: The investigation was conducted in connection with the move of 1500 office staff to a building with improved ergonomics. It was focused on associations between workstation features, working postures, musculoskeletal pain symptoms, and eye strain before and 18 months after implementation of a proactive ergonomic program. The outcomes were compared between the intervention and a similar reference group. Results: Associations between improvement of postures and less musculoskeletal pain and eye strain were confirmed. A cross association between several features and postures and improved symptoms was noted, along with improved productivity. Conclusion: The study suggests that a proactive program adhering to the OSHA recommendations needs to include an individual workstation assessment to be effective in reducing symptoms and increasing productivity.

AIMS: To analyse the relationship between life events, social support, psychological well-being and cardiovascular risk factors in blue- and white-collar Swedish automotive workers. METHODS: Baseline questionnaire regarding life events, social support, depressed mood and mental strain and smoking habits. Follow-up questionnaire after 5 years included the Psychological General Well-being Inventory to assess various health variables. At baseline and follow-up, anthropometric data were obtained. Blood pressure, blood glucose and serum lipids were measured and smoking habits were surveyed. RESULTS: The blue-collar workers showed a profile indicating increased cardiovascular risk with a higher proportion of smokers, a higher waist to hip ratio and higher triglycerides. They also reported themselves to have worse general health and less emotional self-control, but were less anxious than the white-collar workers. Negative life events, especially those related to work seemed to affect the well-being of the blue-collar workers more adversely than the white-collar workers. Being nervous and depressed at baseline increased the risk of poor psychological well-being at the follow-up. Social support within this 5-year perspective was a factor which predicted psychological well-being in both worker categories. Increase in cholesterol/high-density lipoprotein-cholesterol (HDL-C) ratio was the only cardiovascular risk factor associated with the strain of life events but not with work-related events. CONCLUSION: Over a 5-year period, men who experienced negative, strongly stressful and work-related life events displayed poorer psychological well-being at follow-up regardless of worker category. Social support was protective. Language: en

Background: Deep venous thrombosis (DVT) is commonly seen among bedridden and postoperative patients. Its association with travel may also make DVT an occupational health risk to otherwise healthy business travelers. We estimated the incidence of and risk factors for DVT among 8,189 World Bank employees and a subset of 4,951 international business travelers. Methods: Occurrence of DVT between 1995 and 1998 was determined using 1) medical insurance claims; 2) Workers’ Compensation claims; and 3) intra-office E-mail solicitation followed by interview. For each insurance claim case, 10 controls were randomly selected from among World Bank employees insured during the same month and year as the case's claim was filed, and case-control analyses were performed to identify potential predictors or risk factors for DVT. Results: Thirty individuals filed claims for DVT of the legs (annual incidence rate: 0.9 per 1,000 employees); three of these claims were filed within 30 days after a travel mission. Two employees reported DVT as a Workers’ Compensation injury, and five staff with verified DVT participated in interviews. After controlling for age and gender, no association with any travel-related covariate was seen. Results of analyses considering all thrombophlebitis and thromboembolism followed the same pattern. The average annual incidence of DVT occurring within 30 days of mission among traveling staff ranged from 0.10 per 1,000 to 0.25 per 1,000 travelers, depending on the case-finding method. Conclusion: No association between DVT and travel was observed after adjustment for gender and age. These results, however, are preliminary, and due to the rarity of DVT, based on small numbers.

Business travel is often a positive experience —offering close collaborations with distant colleagues and clients,the stimulation of different environments,and a change of routine. But it is also a source of a variety of stresses,often overlooked or denied by both organizations and travelers themselves.The World Bank,studying its own travelers,discovered that both their physical and mental health-care claims were significantly greater than those of nontravelers.And so the bank recently sponsored a symposium on the subject of business travel stress,at which more than 100 representatives of more than 50 organizations in a wide variety of industries met and agreed that travel stress,including jet lag, fatigue, family disruptions, and compromised work effectiveness were common outcomes of frequent business travel -and that responsibility for understanding and doing something about travel stress is shared among the individual employee,the manager,and the organization. © 2000 John Wiley & Sons, Inc.

The associations between life events, mood, mental strain and cardiovascular risk factors were investigated in the Renault/Volvo Coeur Study. About 1,000 men, blue-collar and white-collar workers, were asked by means of interview-administered questionnaires about life events experienced during the year preceding the screening, about mood and mental strain and about smoking, alcohol consumption and exercise habits. Blood pressure, concentration of serum lipids and blood glucose, and anthropometric measures were determined in a screening procedure. Negative life events, especially work-related, were associated with depressed mood and mental strain but not with elevation of biological risk factors such as elevated blood pressure and serum lipids. Depressed mood and mental strain were related to increased tobacco consumption in blue-collar workers and increased alcohol consumption in white-collar workers.

Background. Globally, more than 1.2 million people die on the roads every year, and unfortunately so do one or two operational travelers for the World Bank Group (WBG). Methods. To investigate potentially preventable factors and improve the institution's road safety policies and practices, an electronic survey was designed in 2008 targeting about 16,000 WBG staff worldwide to inquire about road crashes and near crashes over the 3-year period. Also, questions were asked pertaining to contributing circumstances. Staff was encouraged to provide comments on prevention. A combined index based on the number of reported crashes and near crashes divided by person-days spent on mission in each country was used to rank the countries. Results. A total of 3,760 responses were collected. There were 341 road crashes reported, about 1 in 175 missions. Seventy percent took place in taxis, and 40% of crash victims reported that seatbelts were not used. Contributing factors included driver's decision error, speeding, or road/weather conditions. On the basis of a combined index, a list of 36 high-risk countries is presented. A high correlation between crashes and near crashes (r = 0.89) justifies the method. Conclusions. Improved corporate policies will need to be developed to address preventable risk factors identified in the study. Language: en

In an attempt to increase the impact of smoking cessation activities, some recent studies have examined the use of contests and competitions. The study reported here evaluates a year-long multiple-lottery quit-smoking contest at Volvo Flygmotor, the Volvo aircraft engine manufacturing company in Trollhattan, Sweden. Lotteries were held at 1, 6, and 12 months after the contest began. By quitting for at least 1 month, enrollees were eligible to win cash prizes. Maintaining nonsmoking status from a previous lottery automatically qualified enrollees for the next one. Smoking status was established by self-report, expired carbon monoxide, and saliva cotinine. Seventy-three employees, representing approximately 10% of the company's smokers, entered the contest during the initial 2-week enrollment period. Point prevalence 1-month and 6-month cessation rates were 64.4 and 49.3%, respectively. Continuous abstinence 6-month and 1-year rates were 45.2 and 32.8% respectively. Psychological, home, work and smoking history variables generally were not related to cessation or relapse.

Objectives: Following up on two earlier publications showing increased psychological stress and psychosocial effects of travel on the business travellers this study investigated the health of spouses of business travellers. Methods: Medical claims of spouses of Washington DC World Bank staff participating in the medical insurance programme in 1997–8 were reviewed. Only the first of each diagnosis with the ninth revision of the international classification of diseases (ICD-9) recorded for each person was included in this analysis. The claims were grouped into 28 diagnostic categories and subcategories. Results: There were almost twice as many women as men among the 4630 identified spouses. Overall, male and female spouses of travellers filed claims for medical treatment at about a 16% higher rate than spouses of non-travellers. As hypothesised, a higher rate for psychological treatment was found in the spouses of international business travellers compared with non-travellers (men standardised rate ratios (RR)=1.55; women RR=1.37). For stress related psychological disorders the rates tripled for both female and male spouses of frequent travellers (≥ four missions/year) compared with those of non-travelling employees. An increased rate of claims among spouses of travellers versus non-travellers was also found for treatment for certain other diagnostic groups. Of these, diseases of the skin (men RR=2.93; women RR=1.41) and intestinal diseases (men RR=1.31; women RR=1.47) may have some association with the spouses9 travel, whereas others, such as malignant neoplasms (men RR=1.97; women RR=0.79) are less likely to have such a relation. Conclusion: The previously identified pattern of increased psychological disorders among business travellers is mirrored among their spouses. This finding underscores the permeable boundary between family relations and working life which earlier studies suggested, and it emphasises the need for concern within institutions and strategies for prevention.

Office work-related upper extremity symptoms and disorders have been associated with static work posture, repetition, and inadequate recovery in the anatomic structures of the neck and upper extremities. Despite these associations there is relatively little research on the development of practical measures of these ergonomic exposures. The present study examines the measurement properties of an upper-extremity specific self-report index of ergonomic exposures. Ninety-two symptomatic office workers completed a web-based questionnaire measuring demographic variables, ergonomic exposures, pain, job stress, and functional limitations. Comparisons of internal consistency, construct validity, and discriminative and predictive abilities were made between the self-report index and an observational exposure assessment checklist. Results indicated that the self-report index had acceptable measurement properties. Furthermore, higher levels of self-reported ergonomic exposures were associated with upper extremity pain, symptom severity, and functional limitations. In contrast, higher levels of observed exposure were only related to lower levels of general physical function. The self-report measure has potential for use in occupational health surveillance programs for office work environments and as an outcome measure of ergonomic exposure in intervention trials. These results also suggest the need for utilizing multiple methods when assessing ergonomic exposures.

To the Editor:The Joint Bank/Fund Health Services Department (HSD) in Washington, DC, was recently contacted with several requests regarding water temperature in the Bank’s restrooms. Because of the approaching cold/flu season, the staff was concerned that lukewarm water did not provide efficient ha

Editor-Margaret Ashwell and colleagues state that the ratio of waist circumference to height is the best simple anthropometric predictor of intra-abdominal fat ( r =0.83) in men and women.1 Kvist et al measured the abdominal sagittal diameter (the distance between the examination table and the highest point of the abdomen in the supine position) and showed a high correlation ( r =0.92) with intra-abdominal fat as measured by computed tomography in men.2 This …

Lateral humeral epicondylitis (tennis elbow) is often considered to be work related but the incidence and prevalence among industrial workers has not previously been studied In this study the prevalence of this condition and its relationship to some work factors was investigated in 540 workers in a modern engineering industry The prevalence was 7-4% (40/540). Work was found to be the probable cause in 35%, tennis in 8% and other leisure activities in 27% of the patients. No cause was found in the remaining 30%. There was no correlation with sex, while a significant correlation was found with age, the incidence increasing with advancing age On the basis of job classification according to their elbow stress, it was found that these workers with work-related epicondylitis had higher elbow stress jobs compared to other sufferers and to the workforce as a whole.

Neck and upper extremity symptoms (NES) are reported to increase among industrial workers. In order to quantify sickness absenteeism and relate it to some factors a questionnaire study was performed among 2814 workers occupied at a Swedish engineering industry. Questions pertaining to age, sex, worker category, work with vibrating handtools, type of job and smoking habits were analyzed and correlated to sickness absenteeism for the previous year (1983). We found that the average days lost for personal illness was 17.2 days; 16.2 for men and 23.5 days for women. Ninety-four persons, 77 men and 17 women comprising 3.0% of all employees were sicklisted for NES corresponding to 3.3% of total sickness time lost. Blue-collar workers were sicklisted for NES five times more often than white collar workers and women in type 3 jobs (high NE stress), twice that of men occupied in the same type of job. Smokers had significantly higher absenteeism than non-smokers for any reason studied including NES. The study indicated a high prevalence of present NES problems (23%) but also that NES as a cause of leave of absence was relatively rare (3%).