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In response to the COVID-19 pandemic, many countries have adopted a broad spectrum of containment measures, from recommendations to stay at home to quarantines of large geographic regions. As part of this response, corporations and governments alike have strongly encouraged workers to telecommute where possible. More than 3.4 billion people in 84 countries have been confined to their homes, as estimated in late March 2020, which potentially translates to many millions of workers temporarily exposed to telecommuting. Since 2000, the emergence of digital and broadband internet has facilitated the development of home telework. Despite limited research interest on its impact on occupational health, several health benefits and risks of telework have been identified in academic or grey literature (table 1) (for a review see Ref. 1). …

Introduction Previous studies on occupational health focussed predominately on the occurrence of occupational diseases. Relatively few studies have measured how employment is associated with the use of healthcare services. This study investigates the association between employment and the extent and range of healthcare use, such as medical expenditures, of women in South Korea. Methods We analyze data of the Korean Health Panel, an ongoing longitudinal national representative survey, from 2008 to 2017, to identify the status of economic activity of women by year and age group. We estimate the association between female employment status and medical expenditures by using random effect panel Tobit models. Furthermore, we investigate the association between employment status and the range of healthcare services in biomedicine and traditional Korean medicine (KM) by conducting conditional fixed-effects logistic regression analyses. Results For women aged between 25 and 65 in 2017, the majority of them were employed or self-employed. (The proportion of employment of self-employment equals 64.80%). In addition, working women spent 11.6% less on healthcare than nonworking women, and self-employment lowered the healthcare expenditure by 13.1%. Neither work nor the type of work is related to the types and range of healthcare service use. Being employed or self-employed is negatively associated with women’s expenditure on healthcare. Conclusions The findings show that employment is associated with less spending on healthcare. They imply that employment has a positive impact on women’s health.

Zusammenfassung. Hintergrund: Fortbildungen für Pflegende auf der Intensivstation sind obligat, es fehlt jedoch oft an Kurzfortbildungen von bis zu 15 Minuten innerhalb der Arbeitszeit. Derzeit gibt es keine vergleichende Datenlage zur zeitlichen Verortung von Kurzfortbildungen. Fragestellungen: Welche Auswirkungen haben zeitlich unterschiedlich verortete Kurzfortbildungsveranstaltungen zu Beginn des Spätdienstes gegenüber zum Ende des Frühdienstes auf die Wissensaufnahme von Pflegenden auf der Intensivstation? Ergänzend sollten weitere Rahmenbedingungen und eine abschließende Empfehlung für die Veranstaltungen ermittelt werden. Methode: In einer Beobachtungsstudie mit Pflegenden, die Kurzfortbildungsveranstaltungen vor dem Spätdienst (VS) oder nach dem Frühdienst (VF) besuchten, kam ein Fragebogen zum Einsatz. Als primärer Outcome-Effekt wurde die Odds Ratio (OR) anhand von drei Quizfragen errechnet. Sekundäre Outcome-Parameter, zu denen u.a. eine pünktliche Teilnahme der Pflegenden sowie das Empfehlungsverhalten zählten, wurden mit Methoden deskriptiver Statistik ermittelt. Ergebnisse: Bei einem Rücklauf von 98,59% (n = 420) betrug die OR 1,22 (95%-KI: 0,90; 1,64) zugunsten der Gruppe VS im Vergleich zu VF. Pflegende aus VS konnten zu 96,73% (n = 237) und aus VF zu 80,13% (n = 121) die Veranstaltungen pünktlich besuchen. Weiterhin empfahlen Teilnehmende die Kurzfortbildungen auf einer Skala von 1 (unbedingt hingehen) bis 6 (lass lieber bleiben) in VS im Mittelwert mit 2,27 (SD 1,15) und in VF mit 2,21 (SD 1,07). Schlussfolgerung: Kurzfortbildungen sollten zu Beginn des Spätdienstes angeboten werden.

ObjectivesPrevious studies on the association between psychosocial work factors and blood pressure mainly focused on specific occupations or populations and had limited sample sizes. We, therefore, investigated the associations between psychosocial work factors and blood pressure in a large general working population in the Netherlands.MethodsWe included 63 800 employees from the Netherlands, aged 18–65 years, with blood pressure measurements and a reliable job code at baseline. Psychosocial work factors (job strain, effort–reward imbalance (ERI) and emotional demands) in the current job were estimated with three recently developed psychosocial job exposure matrices. To examine the associations, regression analyses adjusted for covariates (age, sex, body mass index, education, monthly income, pack-years, smoking, alcohol consumption and antihypertensive medication (not included for hypertension)) were performed.ResultsHigher job strain was associated with higher systolic blood pressure (SBP) (B (regression coefficients) (95% CI) 2.14 (1.23 to 3.06)) and diastolic blood pressure (DBP) (B (95% CI) 1.26 (0.65 to 1.86)) and with higher odds of hypertension (OR (95% CI) 1.43 (1.17 to 1.74)). Higher ERI was associated with higher DBP (B (95% CI) 4.37 (3.05 to 5.68)), but not with SBP or hypertension. Higher emotional demands were associated with lower SBP (B (95% CI) −0.90 (−1.14 to −0.66)) and lower odds of hypertension ((OR) (95% CI) 0.91 (0.87 to 0.96)).ConclusionsIn the general working population, employees in jobs with high job strain and ERI have higher blood pressure compared with employees with low job strain and ERI. Emotional demands at work are inversely associated with blood pressure.

Purpose The purpose is to report on the mental health response to the Grenfell incident within the London Fire Brigade (LFB). Design/methodology/approach The LFB implemented screening for the symptoms of posttraumatic stress disorder (PTSD) at 28 days, 3 months and 6 months for all personnel directly involved in the incident. Findings The prevalence of PTSD within frontline personnel was 13.4% at 28 days, falling to 7.6% at 6 months. The LFB's internal Counselling and Wellbeing Service offered treatment to those scoring above the cut-off for PTSD along with accepting self-referral and referrals from line managers and occupational health. There were 139 referrals within the 12-month period following the incident. Research limitations/implications The outcomes for those who engaged in treatment are broadly in line with other studies evaluating post-disaster interventions. Issues for consideration within national guidelines are discussed. Practical implications The screen and treat approach adopted by LFB was shown to be a feasible approach to use within such a scenario. Originality/value The current study reports on a screen and treat approach to one of the largest single incidents in the UK in recent years.

Men extend their employment beyond pensionable age more often than women, but the factors that contribute to this sex difference are unknown. This study aimed to examine sex differences in extending employment and the contribution of sociodemographic, work- and health-related factors to these differences. Participants of this prospective cohort study were 4,263 public sector employees from Finland who reached their individual pensionable date between 2014 and 2019 and responded to a survey on work- and non-work-related issues before that date. Extended employment was defined as continuing working for over six months beyond the individual pensionable date. We used mediation analysis to examine the contribution of explanatory factors to the association between sex and extended employment. Of the participants, 29% extended employment beyond the pensionable date. Men had a 1.29-fold (95% confidence interval 1.11-1.49) higher probability of extending employment compared with women. Men had a higher prevalence of factors that increase the likelihood of extended employment than women (such as spouse working full-time, no part-time retirement, low job strain, high work time control, and lack of pain) and this mediated the association of sex with extended employment by up to 83%. In conclusion, men were more likely to extend their employment beyond pensionable age than women. This difference was largely explained by men being more likely to have a full-time working spouse, low job strain, high work time control, no pain, and not being on part-time retirement.The online version contains supplementary material available at 10.1007/s10433-021-00663-1.

Background To examine the association of job strain with cognitive ability and the influence of life-course job strain on later life cognitive decline. Methods Data were derived from six waves of the Survey of Health, Aging, and Retirement in Europe. The study sample consists of 13349 participants aged 50 to 98 years at wave 2 and has been followed up for 12-years. Job strain status across working life was assessed using a short demand-control job strain model containing two core dimensions: job demands and job control collected in wave 3. Cognitive abilities concerning episodic memory was assessed by immediate recall and delayed recall tests, executive function was evaluated by verbal fluency test collected in all waves (waves 2–7) except wave 3. Mixed-effects model was used to estimate working life job strain and its cumulative effect on cognitive decline. Results Both passive and high strain jobs were associated with lower levels of cognitive ability (episodic memory and verbal fluency) in comparison with active job. Long exposure to active- or low strain-job was associated with higher cognitive ability whereas long exposure to passive job or moderate duration of high strain job was associated with lower cognitive ability. The rate of memory decline was positively related to moderate duration of passive job and negatively related to long-term exposure to low strain job. Limitations Information on working conditions was based on self-reported recollections. Conclusions Working life variation in job strain status and their duration may explain individual differences in cognitive ability in later life.

Background The prevailing global work scenario and deteriorating health facilities in economies indulge the risk perspective in the labor market model. This is the reason that the risk factor is cautiously attributed to wages and labor market efficiencies specifically in developing and emerging economies. In this respect, Occupational Injuries of Workers (OIW) is considered essential to demonstrate the risk and Occupational Health and Safety (OHS) setups given the constraints of the labor. Intuitively, the prime objective of this study is to make an assessment of the labor market considering the OIW through the indicators of industry division, employment status, occupational distribution, adopted treatment, gender and regionality. Methods The assessment strategy of the study has been categorized into trend analysis and Index Value Calculation (IVC) segments employing the data from 2001 to 2018. Results The pattern of the selected indicators of the OIW has been observed in the available data while the IVC estimations are considered through time and reference categories. The findings of both exercises revealed absolute and relative heterogeneities at both industry and occupational levels. Conclusion The consistency for gender and regional distribution of both assessments points out the need for effective policy initiatives. The study suggests separate analyses of industry and occupations for a better understanding of the OHS setups and up-gradation in Pakistan.

Objectives: Our aim was to validate the “Wulira App” a mHealth application against gold standard audiometry as a pragmatic audiometry solution for under-served and vulnerable groups of patients at risk of hearing loss. The specific objectives were as follows: To compare hearing thresholds determined using the Wulira app to standard pure tone audiometry among patients on MDR-TB treatment. To determine the correlation between the measured hearing loss with the Wulira app and standard audiometry with patient reported hearing loss. To determine the proportion of patients on MDR-TB treatment that experience hearing loss? Materials and Methods: We consecutively recruited patients ≥18 years old and receiving kanamycin in their treatment regimen between February and June 2019 for this study. Clinical and demographic data were obtained from each participant and documented in a secure database. Participants had hearing assessment performed once at enrolment with paired standard audiometry and the Wulira mobile phone app in a soundproof room. Results: A total of 120 MDR-TB patients with a mean age of 34.0 (±9.6) years were recruited for this study and 69 (57.5%) were male. When compared to pure tone audiometry, the Wulira app was able to correctly detect 91.4% hearing loss in right ear and 88.4% in the left ear. The specificity of the Wulira app was equally high, reaching 93.2% in the right ear and 91.5% in the left ear. Conclusion: The Wulira app may be a useful alternative home-based tool for hearing assessment in MDR-TB patients, essentially for early detection of hearing loss following commencement of second-line injectable drugs.

Objective To identify latent components from among 13 work and non-work stressors and to examine whether the accumulation of stress factors within these components was associated with sleep problems. Methods A cohort of older employees (n = 2771 individuals, n = 3921 person-observations) responded to at least two surveys. Principal Component Analysis (PCA) was used to identify latent components. Analysis of variance was used to examine their associations with sleep. Results The components were: 'Physical workload and shift work', 'Psychosocial workload', 'Social and environmental non-work adversity' and 'Life event- and health-related non-work adversity'. They were consistently associated with sleep problems, except for 'Physical workload and shift work'. 'Social and environmental non-work adversity' was associated with sleep problems at follow-up. Conclusions Clusters of work- and non-work-related stressors were identified, and their accumulation was associated with sleep problems among older employees.

Objectives Previous studies on the effect of low social support at work on blood pressure showed mixed results. Few previous studies have used ambulatory blood pressure and examined whether the effect of low social support at work vary among men and women. The aim of this study was to examine the association between low social support at work, ambulatory blood pressure means and hypertension prevalence, in a sample of white-collar workers men and women. Methods A repeated cross-sectional design was used. Data were collected three times during a 5-year period, among 3919 white-collar women and men. At each time, coworker and supervisor social support at work were measured using validated scales. Ambulatory blood pressure was measured every 15 min during a working day. General estimating equations were used. Results In adjusted models, women exposed to low coworker (+0.6 mmHg) and low supervisor social support at work (+0.7 mmHg) had slightly higher diastolic blood pressure means when compared to unexposed women. In men, those with low coworker social support at work had higher diastolic (+0.7 mmHg) blood pressure while those with low supervisor social support had a higher prevalence of hypertension (prevalence ratio = 1.14, 95% CI: 1.04–1.24). Conclusions Men with low supervisor social support at work had a higher prevalence of hypertension. Low social support at work was associated with modest increases in diastolic blood pressure among men and women. Workplace prevention strategies aiming to increase social support at work could lead to beneficial effects on worker’s cardiovascular health.

Workers who experience language barriers are more likely to get injured or sick because of their work and have poorer claim and return-to-work outcomes compared to other workers. To better understand the systemic factors that shape access to compensation in contexts of language barriers, we compared language accommodation policies and practices in the Quebec and Ontario workers’ compensation systems. We uncovered gaps limiting access to professional interpreters in both provinces, although gaps were more pronounced in Quebec where workers were responsible for the cost of interpreters. We argue that simply improving the linguistic competence of workers’ compensation systems is not sufficient to tackle access barriers and must be accompanied by efforts to address the root causes of social and economic inequities for workers who experience language barriers.

Publisher Copyright: © 2021 The Author(s). Published with license by Taylor & Francis Group, LLC. Physicians often work long hours and on-call shifts, which may expose them to circadian misalignment and negative health outcomes. However, few studies have examined whether these working hour characteristics, ascertained using objective working hour records, are associated with the physicians’ risk of sickness absence. We investigated the associations of 14 characteristics of payroll-based working hours and on-call work with the risk of short sickness absence among hospital physicians. In this cohort study, 2845 physicians from six Finnish hospital districts were linked to electronic payroll-based records of daily working hours, on-call duty and short (1–3 days) sickness absence between 2005 and 2019. A case-crossover design was applied using conditional logistic regression with the 28 day case and control windows to estimate odds ratios (ORs) and 95% confidence intervals (CI) for short sickness absence. After controlling for weekly working hours and the number of normal (≤12 h) shifts, a higher number of long (>12 h) shifts (ORs for ≥5 versus none: 2.54, 95% CI 1.68–3.84), very long (>24 h) shifts (ORs for ≥5 versus none: 2.62, 95%CI 1.61–4.27), and on-call shifts (OR for ≥5 versus none: 2.15, 95% CI 1.44–3.21) and a higher number of short (

ZusammenfassungZiel der Studie „Real world“-Daten aus der ambulanten Gesundheitsversorgung sind in Deutschland nur schwer systematisch und longitudinal zu erlangen. Unsere Vision ist eine permanente Datenablage mit repräsentativen, de-identifizierten Patienten- und Versorgungsdaten, längsschnittlich, fortwährend aktualisiert und von verschiedenen Versorgern, mit der Möglichkeit zur Verknüpfung mit weiteren Daten, etwa aus Patientenbefragungen oder biologischer Forschung, zugänglich für andere Forscher. Wir berichten methodische Vorgehensweisen und Ergebnisse aus dem RADAR Projekt.Methodik Untersuchung des Rechtsrahmens, Entwicklung prototypischer technischer Abläufe und Lösungen, mit Machbarkeitsstudie zur Evaluation von technischer und inhaltlicher Funktionalität sowie Eignung für Fragestellungen der Versorgungsforschung.Ergebnisse Ab 2016 entwickelte ein interdisziplinäres Wissenschaftlerteam ein Datenschutzkonzept für Exporte von Versorgungsdaten aus elektronischen Praxisverwaltungssystemen. Eine technische und organisatorische Forschungsinfrastruktur im ambulanten Sektor wurden entwickelt und im Anwendungsfall „Orale Antikoagulation“ (OAK) umgesetzt. In 7 niedersächsischen Hausarztpraxen wurden 100 Patienten gewonnen und nach informierter Einwilligung ihre ausgewählten Behandlungsdaten, reduziert auf 40 relevante Datenfelder, über die Behandlungsdatentransfer-Schnittstelle extrahiert, unmittelbar vor Ort in identifizierende bzw. medizinische Daten getrennt und verschlüsselt zur Treuhandstelle (THS) bzw. an den Datenhalter übertragen. 75 Patienten, die die Einschlusskriterien erfüllten (mind. 1 Jahr Behandlung mit OAK), erhielten einen Lebensqualitäts-Fragebogen über die THS per Post. Von 66 Rücksendungen wurden 63 Fragebogenergebnisse mit den Behandlungsdaten in der Datenablage verknüpft.Schlussfolgerung Die rechtskonforme Machbarkeit der Gewinnung von pseudonymisierten hausärztlichen Routinedaten mit expliziter informierter Patienteneinwilligung und deren wissenschaftliche Nutzung einschließlich Re-Kontaktierung und Einbindung von Fragebogendaten konnte nachgewiesen werden. Die Schutzkonzepte Privacy by design und Datenminimierung (Artikel 25 mit Erwägungsgrund 78 DSGVO) wurden systematisch in das RADAR Projekt integriert und begründen wesentlich, dass der Machbarkeitsnachweis rechtskonformer Primärdatengewinnung und sekundärer Nutzung für Forschungszwecke gelang. Eine Nutzung hinreichend anonymisierter, aber noch sinnvoller hausärztlicher Gesundheitsdaten ohne individuelle Einwilligung ist im bestehenden Rechtsrahmen in Deutschland schwerlich umsetzbar.

Resume Introduction L'objectif de cette etude consiste a comparer l'hypothese de vulnerabilite et l'hypothese d'expression pour expliquer la plus grande detresse psychologique des femmes en emploi. Ces deux hypotheses sont contrastees en integrant les stresseurs du travail, de la famille, le conflit travail-famille et les ressources psychosociales. Methode Les modeles conceptuels ont ete testes par des analyses de chemins en multiniveaux aupres de 2026 employes quebecois (Canada) repartis dans 63 etablissements. Resultats Les resultats soutiennent partiellement les deux hypotheses. Dans le cas de l'hypothese de vulnerabilite, la monoparentalite, les problemes avec les enfants et l'estime de soi sont indirectement impliques dans la variation du niveau de la detresse psychologique parmi les femmes par l'intermediaire de l'interference famille-travail. Dans le cas de l'hypothese d'expression, bien que l'interference famille-travail soit associee a plus de detresse psychologique parmi les femmes, ce stresseur est associe a davantage de consommation d'alcool a risque parmi les hommes. Les tensions avec le conjoint et le sentiment de controle participent egalement au mecanisme d'expression a travers l'interference famille-travail. Conclusion Ces resultats soulignent l'importance de considerer les multiples mecanismes par lesquels le genre contribue aux inegalites de sante mentale. Ils invitent egalement a distinguer les deux directions du conflit travail-famille comme mediateurs genres.

PURPOSE To identify predictors of return to work, duration of time off work, and claim closure for first responders experiencing injuries or illnesses, and summarize the claim data. METHODS First responder claims collected between January 2012 and July 2017 were obtained from a disability management company. Known predictors of return to work were extracted from the data including age, sex, diagnosis, years of service, claim lag, medical report lag, and the return-to-work duties. Survival analyses were performed to identify predictors of return to work and claim closure using the Cox proportional regression analysis. Log-rank tests were performed to identify predictors that affected the rate of return to work and claim closure. Summary statistics were performed for the injury and return-to-work data. RESULTS 60 of the 67 (89.6%) identified first responders returned to work within the data collection period. Musculoskeletal injuries predicted an increased likelihood of returning to work (hazard ratio = 2.0, 95%CI = 1.14-3.60) and a shorter duration of time off work (37 days on average) compared to mental health issues. Everyday of claim lag and medical report lag predicted a 2% decrease in likelihood of return to work. Returning to work was the only predictor of claim closure. 45 (67.2%) first responders returned to their pre-absence duties. 22 (32.8%) mental health claims and 45 (67.2%) injury claims were identified. CONCLUSIONS 89.6% of first responders returned to work, although only 67.2% returned to their pre-absence duties. Predictors of return to work included injury type, as first responders with musculoskeletal injuries returned to work sooner, and claim and medical lag delayed the return to work.

Background: The associations between adverse working conditions and mental disorders are well established. However, associations between adverse working conditions and poor mental health functioning is a less explored area. This study examines these associations among younger public sector employees of the City of Helsinki, Finland. Methods: We use data from the Young Helsinki Health Study with a representative sample of the employees of the City of Helsinki, aged 19–39 years (n=4 217). Mental health functioning was measured with mental composite summary of the Short Form 36. Working conditions included factors related to both the psychosocial (job control and job demands) and the physical work environment (physical workload). To examine the associations, we used logistic regression models with adjustments for socio-demographics, other working conditions and health-related covariates. Results: After adjustment for sociodemographic characteristics, poor health, health behaviours and other occupational exposures, high job demands (OR=1.69; 95% CI=1.45–1.97) and low job control (OR=1.65; 95% CI=1.40–1.94) were associated with poor mental health functioning. High physical workload was not associated with the outcome (OR=0.87; 95% CI=0.72–1.05) after the adjustments. Conclusions: Adverse psychosocial working conditions were associated with mental health functioning, whereas physical working conditions were not. As impaired functioning is likely to cause health-related lost productivity and can lead to work disability, further research and interventions with a balanced approach focusing on both psychosocial working conditions and mental health functioning are recommended.

Publisher Copyright: © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under CC BY-NC-ND 4.0 license Background: High emotional demands at work can affect employees’ health and there is a need to understand whether such an association might be modified by other working conditions. We aimed to examine emotional demands at work as a risk factor for long-term sickness absence and analyse whether influence, possibilities for development, role conflicts, and physical demands at work might modify this risk. Methods: We did a nationwide, population-based, prospective cohort study in Denmark and included employed individuals who were residing in Denmark in 2000, aged 30–59 years, who had complete data on age, sex, and migration background, with information on emotional demands and possible effect modifiers from job exposure matrices, and covariates and outcome (sickness absence) from population registers. Individuals with long-term sickness absence (≥6 weeks of consecutive sickness absence) between Jan 1, 1998, and Dec 31, 2000, and self-employed individuals were excluded. We assessed long-term sickness absence during a 10-year period from Jan 1, 2001, to Dec 31, 2010. Using Cox regression, we estimated hazard ratios (HRs) and 95% CIs and tested interaction as departure from additivity, estimating relative excess risk due to interaction (RERI). Multivariable adjusted models included sex, age, cohabitation, migration background, and income. Findings: 1 521 352 employed individuals were included and contributed data between Jan 1, 2000, and Dec 31, 2010. During 11 919 021 person-years (mean follow-up 7·8 years), we identified 480 685 new cases of long-term sickness absence. High emotional demands were associated with increased risk of long-term sickness absence compared with low emotional demands, after adjusting for age, sex, cohabitation, migration background, income, and the four possible effect modifiers (adjusted HR 1·55 [95% CI 1·53–1·56]). The association between high emotional demands and risk of long-term sickness absence was stronger in a synergistic way when individuals were also exposed to low possibilities for development (RERI 0·35 [95% CI 0·22–0·47]; 28·9 additional cases per 1000 person-years) and high role conflicts (0·13 [0·11–0·15]; 22·0 additional cases per 1000 person-years). No synergy was observed for influence and physical demands at work. Interpretation: People in occupations with high emotional demands were at increased risk of long-term sickness absence. Our findings on synergistic interactions suggest that, in emotionally demanding occupations, increasing possibilities for development and reducing work-related role conflicts might reduce long-term sickness absence. Further interventional studies are needed to confirm or refute this hypothesis. Funding: Danish Work Environment Research Fund, NordForsk.

Purpose Physical work exposures are associated with sickness absence among older employees. We aimed to examine if they similarly contribute to all-cause sickness absence during early and mid-careers. Methods We used questionnaire data on physical work exposures linked to register data on sickness absence from 3542 municipal employees aged 19–39 years. Follow-up for the number of sickness absence days was 12 months. Exposures to physical workload, occupational environmental hazards, and sedentary work were divided into quartiles. In addition, duration of daily exposure to heavy work was included. Negative binomial regression models were used. Results Higher exposure to physical workload or hazardous exposures was associated with a higher number of sickness absence days. The age and gender adjusted rate ratios for sickness absence days among the participants whose exposure to physical workload was in the highest exposure quartile were 2.1 (95% CI 1.8‒2.5) compared with those whose exposure was in the lowest quartile. In addition, rate ratios for sickness absence days among participants who reported that they do heavy physical work 1.1‒2.0 h, 2.1‒4.0 h or over 4 h daily were 1.6 (1.3‒1.9), 1.5 (1.3‒1.8) and 1.7 (1.5‒2.1), respectively, compared with those who reported not doing physical work. Further adjustment for lifestyle factors or health characteristics attenuated the associations only slightly. Conclusion Exposure to physically demanding work is associated with a higher number of sickness absence days among municipal employees below 40 years of age. Physical working conditions should be considered when aiming to support later work ability.

Violence and Violence Prevention in Nursing Homes during the COVID-19 Pandemic - A partial analysis of Interviews with Managers or Team Leaders Abstract. Background: During the first wave of the COVID-19 pandemic, strict infection control measures were in force in long-term residential care in Germany that burdened staff and isolated residents socially. Both are considered risk factors for violence in long-term residential care. Questions: How does violence develop in nursing homes under pandemic conditions from the point of view of managers and how do strategies for preventing violence change? Methods: Semi-structured telephone interviews were conducted with staff in 43 nursing homes: 25 with service managers, 15 with nurse managers, 28 with nursing team leaders and 10 with registered nurses with extended tasks. The interviews were recorded as audio, transcribed and analysed in five steps following the "Thematic Framework Analysis". Results: The infection control measures were partly perceived as deprivation of freedom. Residents, relatives and staff partly reacted most with verbal violence. Nevertheless, the issue of violence was not a major concern for management and preventive measures were not carried out. Conclusions: The results show that strategies to prevent violence might not be sufficiently established in the institutions involved and would have to be adapted to the conditions of the pandemic. Further research is needed to evaluate infection control measures in their potential to increase the incidence of violence.

Resume L’evaluation de l’exposition est difficile pour le chercheur du domaine des risques professionnels. L’objectif du travail est de developper et de valider une matrice emplois-exposition (MEE) pour l’exposition professionnelle au SARS-CoV-2 appelee « Mat-O-Covid ». Grâce a un groupe d’expert francais, la matrice a ete developpee pour tous les travailleurs sur la profession et les categories socioprofessionnelles de 2003 (avec une passerelle de transcodage vers la Classification internationale type des professions de 2008) et un focus sur le secteur de soin et medicosocial. La moyenne des codages des experts a ete utilisee comme estimation pour l’exposition « sujets » (collegues et/ou public) et « patients » pour le focus secteurs sanitaires, ainsi que la probabilite de prevention pour chaque. Les correlations intraclasses ont ete considerees comme bonnes a excellentes, sauf pour la prevention en sante. Comparees a la matrice americaine O*Net, l’evaluation a ete consideree comme satisfaisante. En conclusion, une MEE « Mat-O-Covid » fournissant une probabilite d’exposition professionnelle au SARS-CoV-2 aura des implications pour la recherche et en sante publique, sous reserve de connaitre ses limites et de poursuivre sa validation.

Background Rapid population aging in developed countries has resulted in the working-age population increasingly being tasked with the provision of informal care. Methods An educational intervention was delivered to 21 carer-employees employed at a Canadian University. Work role function, job security, schedule control, work–family conflict, familywork conflict, and supervisor and coworker support were measured as part of an aggregated workplace experience score. This score was used to measure changes pre/post intervention and at a follow-up period approximately 12 months post intervention. Three random intercept models were created via linear mixed modeling to illustrate changes in participants' workplace experience across time. Results All three models reported statistically significant random and fixed effects intercepts, with a positive coefficient of change. Conclusion This suggests that the intervention demonstrated an improvement of the workplace experience score for participants over time, with the association particularly strong immediately after intervention.

Background: The present study investigated the association between two domains of physical activity (occupational physical activity [OPA] and leisure-time physical activity [LTPA]) and sleep duration. Methods: We investigated 3,421 paid workers from the Korea National Health and Nutrition Examination Survey, 2014–2015. Sleep duration was categorized into three categories (short for less than 5 h, optimal for 5–9 h, and long for more than 9 h). OPA and LTPA were defined in terms of answers to relevant questions. Odds ratios were calculated for sleep duration according to each physical activity domain using multinomial logistic regression models. Results: There were 464 subjects (13.6%) who showed short sleep duration, and 169 subjects (4.9%) who showed long sleep duration. Prevalence of OPA and LTPA was higher in male workers than in female workers (for OPA: 3.67% and 1.76%, respectively, p = 0.0108; for LTPA: 16.14% and 6.07%, respectively, p

Background This study aimed to assess the possibility of benzene exposure in workers of a Korean semiconductor manufacturing company by reviewing the issued patents. Methods A systematic patent search was conducted with the Google “Advanced Patent Search” engine using the keywords “semiconductor” and “benzene” combined with all of the words accessed on January 24, 2016. Results As a result of the search, we reviewed 75 patent documents filed by a Korean semiconductor manufacturing company from 1994 to 2010. From 22 patents, we found that benzene could have been used as one of the carbon sources in chemical vapor deposition (CVD) for capacitor; as diamond-like carbon for solar cell, graphene formation, or etching for transition metal thin film; and as a solvent for dielectric film, silicon oxide layer, nanomaterials, photoresist, rise for immersion lithography, electrophotography, and quantum dot ink. Conclusion Considering the date of patent filing, it is possible that workers in the CVD, immersion lithography, and graphene formation processes could be exposed to benzene from 1996 to 2010.

Hazardous area classification design is required to reduce the explosion risk in process plants. Among the international design guidelines, only IEC 60079-10-1 proposes a new type of zone, namely zone 2 NE, to prevent explosion hazards. We studied how to meet the zone 2 NE grade for a facility handling hydrogen gas, which is considered as most dangerous among explosive gases. Zone 2 NE can be achieved considering the grade of release, as well as the availability and effectiveness of ventilation, which are factors indicative of the facility condition and its surroundings. In the present study, we demonstrate that zone 2 NE can be achieved when the degree of ventilation is high by accessing temperature, pressure, and size of leak hole. The release characteristic can be derived by substituting the process condition of the hydrogen gas facility. The equations are summarized considering relation of the operating temperature, operating pressure, and size of leak hole. Through this relationship, the non-hazardous condition can be realized from the perspective of inherent safety by the combination of each parameter before the initial design of the hydrogen gas facility.

Backround Working condition surveys are widely recognized as useful tools for monitoring the quality of working life and the improvements introduced by health and safety policy frameworks at the European and national level. The Italian Workers' Compensation Authority carried out a national survey (Insula) to investigate the employer's perceptions related to working conditions and their impact on health. Methods The present study is based on the data collected from the Italian survey on health and safety at work (INSULA) conducted on a representative sample of the Italian workforce (n = 8,000). This focuses on the relationship between psychosocial risk factors and self-reported health using a set of logistic and linear regression models. Results Working conditions such as managerial support, job satisfaction, and role act as protective factors on mental and physical health. On the contrary, workers' risk perceptions related to personal exposure to occupational safety and health risks, concern about health conditions, and work-related stress risk exposure determine a poorer state of health. Conclusions This study highlights the link between working conditions and self-report health, and this aims to provide a contribution in the field of health at work. Findings show that working conditions must be object of specific preventive measures to improve the workers' health and well-being.

Background The surface mining industry has one of the highest fatality rates among private industries in the United States. Despite recent decreases in the fatality rates of comparable industries, the fatality rate in the surface mining industry has increased. Meanwhile, a lack of safety research in surface mining has hindered efforts to improve safety strategies in the surface mining workplace. Method This study examined quarry workers' hazard identification skills by conducting a case study of a surface mining facility in the Mid-Atlantic region of the United States. Semistructured interviews were conducted with eight quarry workers who were employed at the mine facility. In addition to the interviews, data were collected through field notes, notes from an expert meeting with safety managers, and site photographs to explore quarry workers' safety behaviors in the workplace. Results The results showed that quarry workers identified hazards and improved their safety performance by translating safety knowledge learned from training into practice, acquiring hands-on work experience, learning from coworkers, and sharing responsibilities among team members. Conclusion This study contributes to understanding quarry workers' safe performance beyond what they have learned in safety training to include their interaction with other workers and hand-on experience in the workplace. This study informs practitioners in the surface mining industry to build a safe work environment as they design effective safety programs for employees.

Background Law enforcement communications (i.e., 911 dispatch and call takers) is a challenging and stressful occupation. The purpose of this study is to identify the main stressors associated with employment in law enforcement communications, and to identify and provide context to how these stressors affect workers' health and wellbeing. Methods This research study included focus groups with 23 call takers and 911 dispatchers employed by a large, urban law enforcement agency in 2018. Thematic analyses were conducted to identify trends. Results Four themes of stressors emerged (i.e., the high stakes nature of some 911 calls for service, understaffing, supervisor-related stress, and recruiting practice). Two health-related themes emerged as being occupation-related: weight gain and poor sleep patterns/insufficient sleep). Specifically, participants reported negative eating habits resulting in weight gain and obesity, lack of sleep and irregular sleep schedules, and development of hypertension and/or diabetes since beginning their jobs. Conclusion Law enforcement communications professionals experience a number of the same stressors facing law enforcement officers in patrol. These stressors, combined with the sedentary nature of the job, could result in long-term, chronic health problems.

Zusammenfassung Corona-Pandemie, Digitalisierung, Green Deal – die mittelständischen Unternehmen stehen in den kommenden Jahren neben ihren branchen- und größenspezifischen Aufgaben vor großen Herausforderungen. Diese können sie nur bewältigen, wenn die Politik ihnen einen verlässlichen Rahmen bietet, innerhalb dessen sie wirtschaftlich agieren können. Friederike Welter und Britta Levering zeigen in ihrem Beitrag, worauf die Mittelstandspolitik in Gesetzgebung und Gestaltung von Unterstützungsmaßnahmen aus Sicht der Mittelstandsforschung achten sollte, damit die Wettbewerbs- und Innovationsfähigkeit der mittelständischen Unternehmen nachhaltig gestärkt wird.

Occupational heat exposure is linked to the development of kidney injury and disease in individuals who frequently perform physically demanding work in the heat. For instance, in Central America, an epidemic of chronic kidney disease of nontraditional origin (CKDnt) is occurring among manual laborers, whereas potentially related epidemics have emerged in India and Sri Lanka. There is growing concern that workers in the United States suffer with CKDnt, but reports are limited. One of the leading hypotheses is that repetitive kidney injury caused by physical work in the heat can progress to CKDnt. Whether heat stress is the primary causal agent or accelerates existing underlying pathology remains contested. However, the current evidence supports that heat stress induces tubular kidney injury, which is worsened by higher core temperatures, dehydration, longer work durations, muscle damaging exercise, and consumption of beverages containing high levels of fructose. The purpose of this narrative review is to identify occupations that may place US workers at greater risk of kidney injury and CKDnt. Specifically, we reviewed the scientific literature to characterize the demographics, environmental conditions, physiological strain (i.e., core temperature increase, dehydration, heart rate), and work durations in sectors typically experiencing occupational heat exposure, including farming, wildland firefighting, landscaping, and utilities. Overall, the surprisingly limited available evidence characterizing occupational heat exposure in US workers supports the need for future investigations to understand this risk of CKDnt.

We identified the occupations that employ California women and a list of chemicals of concern for breast cancer. We evaluated the likelihood of on-the-job exposure to the categories of chemicals by occupation among formally and informally employed women. We selected 145 occupations representing more than 6.6 million women (85% of California working women), along with an additional sixteen occupations for informal workers only. We organized 1012 chemicals (including mammary gland carcinogens, developmental toxicants, and endocrine-disrupting chemicals) into twenty-five categories. More than 80 percent of occupations investigated had possible or probable exposure to at least one category of chemicals. This is the first categorization of occupational exposure to chemicals of concern for breast cancer among California working women. Our investigation revealed significant data gaps, which could be improved by policy changes resulting in enhanced collection of data on occupation and chemical exposure.

Introduction The assessment of energy expenditure (EE) at workplaces maintains a central topic in occupational health due to increasing work-related issues. Today 80% of employees in the healthcare system are women. Limited research concerning their physical activity at work is available. The purpose of the study was the investigation of body composition, maximum physical capacity and quantification of physical work activity for female healthcare workers under real-time conditions. Methods Occupational physical activity (PA) of 33 female healthcare workers in a university hospital was quantified. Health associate professionals (HAP), health professionals (HP), and females working from cleaners and helpers (CH) department participated. All underwent cardio pulmonary exercise test. For every working task VO2, VCO2 and RER were measured and EE was calculated individually for each task. Results Forty-two different working tasks were identified and grouped in seven categories to compare physical activity (PA): ‘office and laboratory work’, ‘bedside patient care’, ‘instrument reprocessing, packing boxes’, ‘walking with patient, or alone’, ‘pushing carts or wheelchairs’, ‘strenuous cleaning in bent posture’ and ‘lifting heavy boxes, weights or items’. By comparing groups of healthcare workers, CH and HAP spent significant (p < 0.01) more EE (in kcal/min) 3.9 resp. 3.2 than HP 2.5. Light PA e.g. office and laboratory work (2.7 ± 0.6) and bedside patient care (2.9 ± 0.7) were accomplished by HP and HAP while HAP and CH performed moderate PA such as ‘packing boxes’ (3.6 ± 0.8), ‘pushing carts’ and ‘strenuous cleaning’ (4.7 ± 0.9). Work performed by CH and HAP, i.e. ‘strenuous cleaning’ and ‘lifting heavy items’ showed highest kcal per kg Fat Free Mass (FFM) per hour with 5.80 [4.05–7.81] and 6.94 [5.18–9.03] kcal/kgFFM/h. Conclusion Our findings lend preliminary support to the hypothesis that the majority of activities in female healthcare workers were of low and moderate PA and can be accomplished by middle aged and even older female workers. CH performed tasks with heavy physical activities (PA) like cleaning and lifting heavy weights. HAP performed light/moderate PA below their maximum physical capacity.

Zusammenfassung Hintergrund Die Pandemie stellt Menschen mit Beeinträchtigung vor vielfältige Herausforderungen, insbesondere auch beim Umgang mit Gesundheitsinformationen. Bislang ist nur wenig über die Rolle der Selbsthilfe bei der Förderung der Gesundheitskompetenz ihrer Mitglieder während der Pandemie bekannt. Methodik Der Studie „Gesundheitskompetenz von Mitgliedern der Selbsthilfe: Herausforderungen durch die Corona-Pandemie (GeMSeHeCo)“ liegt ein qualitatives Studiendesign zugrunde. Der Feldzugang erfolgte deutschlandweit über die Selbsthilfegruppen. Von Juli bis Oktober 2020 wurden N = 19 Telefoninterviews mit Vertreter*innen von Selbsthilfegruppen durchgeführt, transkribiert und inhaltsanalytisch ausgewertet. Ergebnisse Vertreter*innen der Selbsthilfe berichteten über Stärken und Schwächen der Mitglieder im Umgang mit Gesundheitsinformationen während der Corona-Pandemie. Schwächen wurden v. a. bei älteren Mitgliedern, Menschen mit niedrigem Bildungsniveau und mit Migrationshintergrund berichtet. Stärken beobachteten die Vertreter*innen bei langjährigen Mitgliedern und bei Mitgliedern, die sich zu ihrer Krankheit kontinuierlich weiterbilden. Diskussion Die Selbsthilfe wird während der Pandemie als wichtige Unterstützung der Mitglieder im Umgang mit Gesundheitsinformationen wahrgenommen. Ein Vorteil für die Mitglieder besteht insbesondere in der Prüfung und Zusammenstellung von Gesundheitsinformationen nach individuellen Bedarfen durch die Selbsthilfe. Herausforderungen können aufgrund von Sprach- und Verständnisschwierigkeiten entstehen, bspw. durch einen Migrationshintergrund. Der Ausbau von digitalen Angeboten hat sich in dieser Zeit als hilfreich erwiesen. Dabei sollte die Unterstützung vermehrt Ältere und Mitglieder mit geringen finanziellen Möglichkeiten berücksichtigen, da diese während der Pandemie weniger Zugang zu digitalen Angeboten aufweisen.

Objective Precarious workers have increased over the past two decades in South Korea. Employment instability, especially among young adults, is considered a serious social problem. The unstable employment status of precarious workers has negative impacts on their mental health, such as suicidal behavior. This study aims to identify the effect of the unstable employment conditions on the suicidal behavior of precarious workers.Methods An online survey was conducted with a panel sample of South Korean adults (n=797) who were precarious workers aged between 25–34 years. We applied Model 6 of SPSS PROCESS MACRO 3.5 to examine the multiple mediation effects of depression and anger in the relationship between employment instability and suicide.Results Unstable employment had no direct effect on suicidal behavior. The path of unstable employment to suicidal behavior via depression and anger had a significant indirect effect. However, employment and anger were negatively related. The indirect effect of depression and anger on the relation between unstable employment and suicidal behavior was statistically significant.Conclusion This study suggests an association between unstable employment and suicidal behavior, mediated by depression and anger. Specifically, a high level of unstable employment status increased depression. In contrast, a low level of unstable employment status increased anger, which ultimately led to an increase in suicidal behavior. These contrasting findings are likely to reflect the heterogeneity of precarious workers. Further longitudinal studies are necessary to identify the causality between precarious employment and suicidal behavior over time.

PurposeWorkplace health promotion (WHP) is an investment in human capital that can lead to substantial organizational and individual benefit. However, this depends on high participation rates, which are rarely reached. The aim of this article thus is to examine necessary conditions for WHP success by analyzing employee perceived determinants of participation.Design/methodology/approachBased on a qualitative study, a questionnaire was designed. The determinants of participation were assessed regarding underlying categories and importance via factor analysis.FindingsPersonal benefit, social aspects, information, uncomplicated use, security and autonomy plus time and participation in offer design emerged as relevant factors. For the population studied, uncomplicated use, personal benefit and information were rated as most important.Originality/valueThe study is based on determinants voiced by the workforce only, not expert-rated aspects. Moreover, it was carried out in small and medium-sized organizations, which are understudied regarding WHP. By reducing data using factor analysis, a basis for further research is created. Also, a basic questionnaire is suggested via the items employed that can help organizations to investigate the WHP-related wishes and needs that matter most to the workforce.

Background: Occupational physicians work directly with individual employees regarding diseases that has been caused or exacerbated by workplace factors. However, employees are increasingly required to travel for their work, including to tropical countries where they risk exposure to diseases they would not normally encounter at home (i.e., malaria). Such disease/s may also take days to months to incubate before becoming symptomatic, even after their return home, thus delaying and complicating the diagnosis. Proving this was an occupational disease with respective sick leave entitlement or compensation can be challenging. There is a lack of data concerning occupational diseases caused by tropical infections. Material and methods: Employee case records for the period 2003-2008 from the State Institute for Occupational Health and Safety of North-Rhine Westphalia in Germany were analysed and assessed within Germany’s regulatory framework. These records included Germany’s largest industrial zone. Results: From 2003-2008the suspected cases of “tropical diseases and typhus”, categorized as occupational disease “Bk 3104” in Germany, have decreased significantly. A high percentage of the suspected cases was accepted as occupational disease, but persistent or permanent sequelae which conferred an entitlement to compensation were rare. Conclusion: There is scope to improve diagnosis and acceptance of tropical diseases as occupational diseases. The most important diseases reported were malaria, amoebiasis, and dengue fever. Comprehensive pre-travel advice and post-travel follow-ups by physicians trained in travel and occupational health medicine should be mandatory. Data indicate that there is a lack of knowledge on how to prevent infectious disease abroad.

The British Occupational Hygiene Society (BOHS) COVID-19 Working Group developed a control banding matrix to provide guidance for employers and others to help assess the risks of COVID-19 infection during the pandemic. The matrix was based on occupational hygiene principles and the judgement of the occupational health practitioners involved; since objective data on workers’ exposure were unavailable. Users of the matrix identify one of five exposure categories based on generic job descriptions and example occupations, and these categories are linked to generic guidance on interventions at source, on the exposure pathway and for individual workers. The risk matrix was published on the BOHS website and the guidance has been downloaded more than 2000 times. The matrix has had limited evaluation for reliability, but the data suggest that the highest exposure ranked jobs were associated with higher age-standardized mortality in Britain during the pandemic. However, there was considerable variability in exposure assignments between assessors, which underlines the need for the control guidance to be precautionary. The BOHS calls on academic researchers to undertake further work to validate the reliability of the tool.

Zusammenfassung Hintergrund Um mit den zunehmenden Belastungen und Herausforderungen umgehen zu können, wird Gesundheitskompetenz (GK) im Alltag und Arbeitskontext immer wichtiger. Ziel der Arbeit Das Ziel dieser Arbeit ist es, eine Analyse der selbsteingeschätzten GK der Mitarbeitenden eines Unternehmens der verarbeitenden Metallindustrie durchzuführen und auf deren Grundlage Handlungsempfehlungen zur Stärkung der GK herauszustellen. Material und Methoden In dieser Arbeit wurde die GK der Mitarbeitenden mit der Kurzform des European Health Literacy Questionnaire (HLS-EU-Q16) sowie Angaben zum soziodemographischen Hintergrund, Gesundheitsverhalten, Gesundheitszustand und Wohlbefinden erhoben und analysiert. Mit Hilfe einer Online- und Paper-pencil-Befragung sollte in dieser quantitativen Erhebung eine repräsentative Stichprobe aus der Gesamtbelegschaft generiert werden. Ergebnisse Die meisten Mitarbeitenden der 458 teilgenommenen Personen verfügten über eine ausreichende GK (39,7 %). Mehr als die Hälfte der Mitarbeitenden (60,3 %) wies jedoch eine problematische oder inadäquate GK auf. Es konnten Zusammenhänge zwischen der GK und dem Wohlbefinden, Gesundheitszustand und verschiedenen gesundheitsförderlichen Verhaltensweisen festgestellt werden. Diskussion Die Ergebnisse verdeutlichen, dass ein Handlungsbedarf zur Stärkung der GK von Beschäftigten besteht. Durch die genannten Handlungsempfehlungen kann diese erzielt werden. Um deren Wirksamkeit zu überprüfen, sollte eine Folgeerhebung als Vergleich dienen. Weiterhin benötigt es einer dauerhaften Sensibilisierung aller Führungskräfte und Mitarbeitenden für die Förderung der GK.

BackgroundWe hypothesised that occupational exposures differently affect subtypes of adult-onset asthma.ObjectiveWe investigated potential relations between occupation and three subtypes of adult asthma, namely atopic asthma, non-atopic asthma and asthma–COPD overlap syndrome (ACOS).MethodsThis is a population-based case–control study of incident asthma among working-age adults living in Pirkanmaa Hospital District in Southern Finland. The determinant of interest was occupation at the time of diagnosis of asthma or the job that the subject had quit due to respiratory symptoms. Asthma was divided into three mutually exclusive subtypes on the basis of any positive IgE antibody (atopic and non-atopic asthma) and presence of persistent airways obstruction in spirometry (ACOS). We applied unconditional logistic regression analysis to estimate adjusted OR (aOR), taking into account gender, age and smoking.ResultsThe following occupational groups showed significantly increased risk of atopic asthma: chemical industry workers (aOR 15.76, 95% CI 2.64 to 94.12), bakers and food processors (aOR 4.69, 95% CI 1.18 to 18.69), waiters (aOR 4.67, 95% CI 1.40 to 15.56) and those unemployed (aOR 3.06, 95% CI 1.52 to 6.17). The following occupations showed clearly increased risk of non-atopic asthma: metal workers (aOR 8.37, 95% CI 3.77 to 18.59) and farmers and other agricultural workers (aOR 2.36, 95% CI 1.10 to 5.06). Some occupational groups showed statistically significantly increased OR of ACOS: electrical and electronic production workers (aOR 30.6, 95% CI 6.10 to 153.35), fur and leather workers (aOR 16.41, 95% CI 1.25 to 215.85) and those retired (aOR 5.55, 95% CI 1.63 to 18.97).ConclusionsOur results show that different occupations are associated with different subtypes of adult-onset asthma.

Background Recent increases in common mental disorders (CMDs) among young adults are of great concern although studies of CMDs in young employees are sparse. This study investigated the independent and interacting effects of sector of employment, occupational class and CMDs. Additionally, associations between type of employment branch and CMDs within each sector were examined. Methods This population-based longitudinal cohort study included 665 138 employees, 19–29 years, residing in Sweden in 2009. Employment sector (i.e. private/public) and occupational class (non-manual/manual workers) were measured in 2009. Risk estimates of CMDs, measured as new prescription of antidepressants and/or psychiatric care with a diagnosis of CMDs, between 2010 and 2016, were calculated as hazard ratios (HRs) with 95% confidence intervals (CIs), using Cox multivariable regression analysis. Results Public sector employees (whereof 60% manual workers) had an elevated risk for CMDs compared to private sector employees [adjusted HR: 1.14 (95% CI 1.12–1.16)]. Within each sector, manual workers were at increased risk of CMDs compared to non-manual workers. There was an interaction between sector of employment and occupational class; manual workers in the public sector had the highest CMD risk [adjusted synergy index: 1.51 (95% CI 1.29–1.76)]. The most elevated risk for CMDs was observed in those employed in health and social services and the lowest risk among construction workers. Conclusion Sector of employment and occupational class play a role in CMDs in young employees. These findings should be taken into account in the attempts to reduce CMDs in the young working population.

The Australian Senate announced a Select Committee in December of 2020 “to inquire into and report on the impact of insecure or precarious employment on the economy, wages, social cohesion and workplace rights and conditions.” This New Solutions “Document” is a submission to the Australian Senate from independent Australian researchers focusing on the role of perceived job (in)security in this context, acknowledging that it only briefly addresses the role of unemployment, precarious employment, and other aspects of the broader phenomenon of insecure work. Submissions closed in March of 2021, and the Australian Senate is due to report its findings on 30 November 2021.

Background Precarious employment is a potent occupational health risk, but little is known about its association with work-related disability and its causes. This study analyzes whether employment precariousness is associated with receiving disability pension (DP) due to depression and whether this differs according to gender. Methods Statistics Finland’s Quality of Work Life Surveys (1997, 2003, 2008 and 2013) were merged with register-based DP data obtained from the Finnish Centre for Pensions. The survey material was used to measure employment precariousness using five variables: fear of job loss, poor employability prospects, previous unemployment, low earnings and temporary contracts. We followed 20–60-year-old employees until 2016 and studied Cox proportional hazard ratios (HRs) for receiving DP among women and men, adjusting for sociodemographic covariates, working conditions and health at baseline. Results The overall risk of receiving DP tended to increase as precarious job features accumulated. Among men, a higher risk of receiving DP due to depression was associated with previous unemployment [HR 2.2, 95% confidence interval (CI) 1.1–4.2] and poor employability (HR 2.4, 95% CI 1.3–4.7), whereas no corresponding association was found among women. Conclusions Employment precariousness may reflect a psychological stress mechanism that predisposes the individual to mental health problems, predicting future disability. Work disability risk shows gendered differences depending on the cause of DP. Promoting employability at workplace and policy levels could offset the health risks associated with precariousness.

BACKGROUND Nurses and medical social workers’ (MSW’s) stress has an impact on health, which ultimately has an effect on quality care of the patients. Stress problems are one of the leading causes of sleep disturbance. We wanted to evaluate the association of quality and pattern of sleep with work stress levels in nurses and medico-social workers in this study. METHODS A cross-sectional study was conducted on nurses and MSW’s of Tertiary Care Hospitals of Wardha city using questionnaire, containing 24 questions. A total of 513 Nurses and 36 MSW’s of Tertiary Care Hospitals were taken in this study, sampling was done by simple random sampling method. The stress was evaluated using 10 items “Global perceived stress scale” (GPSS) and for sleep quality “Pittsburgh Sleep Quality Index” (PSQI) of total 14 items was used. The variables were compared in unpaired t test and Pearson correlation test to know the level of significance of determinacy which was set at less than 0.05. RESULTS The overall PSS scores in nurses (12.57 ± 3.7) and MSWs (12.87 ± 3.1) were almost similar and were statistically significant. Subjective sleep quality score of MSWs (2.19 ± 0.66) was higher than that of nurses (2.00 ± 0.19) and was statistically insignificant according to the specialization. The statistically relevant sleep duration was greater in MSWs (13.50 ± 03.56) than in nurses (12.16 ± 02.73). Moderate positive correlation between perceived stress severity and Pittsburgh Sleep Quality Index was observed. CONCLUSIONS Certain characteristics of work shift among nurses and MSW’s is directly affected by the stress and sleep quality and indirectly affects the patient care and treatment. The study indicates that work characteristics may influence sleep quality and stress among nurses and MSW’s. We needed to improve work shift schedule in order to provide good health and well-being of nurses and MSW’s which would further improve the quality of patient care. KEY WORDS Nurses, MSW’s, Sleep Quality, Stress

The dominant position among the reasons of working-age population’s health deterioration belongs to diseases of the peripheral nervous system (PNS), the peak prevalence of which occurs at the age of 35–40. PNS diseases are diagnosed in about 76.0% of industrial workers, and account for more than half of all occupational diseases. They are the main cause of incapacitation and long-term disability. Publications on disability due to PNS diseases are isolated.The aim of the work. Clinical and functional characteristics of PNS disorders that cause disability in the working-age population.Material and methods. Among 91 496 first recognized as disabled in the Republic of Bashkortostan in 2014–2018, all disabled people of working age were selected due to PNS diseases, in which the main independent diagnosis was radiculopathy, polyneuropathy, neuropathy and vibratory disease with indication to lumbar-sacral radiculopathy with polyneuropathy of the upper extremities. 107 people were identified to constitute a closed cohort for a comprehensive study of the clinical-functional state and patterns of disability formation in them. The clinical-functional characteristic is given on the basis of the results of studies set forth in the directional medical documents and the assessment by an expert neurologist of the Main Bureau of Medical and Social Expertise. Statistical analysis was performed in Microsoft Excel.Results. The prevalence of PNS diseases has been found to be increasing. Three of the newly diagnosed neurological patients have been the carriers of PNS disease. PNS diseases are formed and reach peak in working age. Characterized by a chronic, progressive course, they often cause temporary and persistent disability. On average, there are 0.1 ± 0.028 persons with disabilities per 10 thousand of the able-bodied population due to PNS diseases, the level of which in dynamics for 2014–2018 increased by 1.7 times. Persons with disabilities (69.0%) are mainly represented by men, every second (50.6%) is over 50 years old, with an average age of 48.7 ± 5.7 years. The clinical-functional state is characterized by constant pain, numbness, seizures, restriction of movements in the limbs, sensory disorders, vegetative-vascular disorders.Conclusion. The quantitative evaluation of the main types of the body functions and main categories of vital activity persistent disorders made it possible to detect that 69.3 ± 4.4% persons with disabilities have persistent moderate abnormalities of functions in the range 40–60% (II degree), another 24.4 ± 3.8 — persistent pronounced abnormalities in the range 70–80% (III degree) and 6.3 ± 6.0% — persistent significant abnormalities in the range 90–100% (IV degree). The severity of impaired functioning of the body is the basis for the level of persistent disability determination.

Objective To analyse the genotoxic risk of cytostatic drugs in health professionals after occupational exposure. Method Literature was searched for the databases PubMed, Lilacs, The Cochrane Library and Scopus with free and controlled language (MeSH terms) using boolean operators AND and OR. The research was limited to articles published between 2005–2016. Results 11 articles were selected depending on their relevancy to this review’s aim. Nine of the 11 articles proved the existence of damage to genetic material (DNA) of health workers, who were exposed to cytostatics. Furthermore, current security practices do not eliminate the chance of exposure completely. Therefore, the creation of new clinical trials is required. Conclusions Handling cytostatic drugs can cause a genotoxic risk to health workers who are exposed to these substances. This exposure may cause damage on the workers’ DNA. There are not enough data to prove a cause-effect relationship between the genotoxic risk and adverse reactions on individuals. Health education will be the main way to raise the awareness and prevention this problem.

**Hintergrund** Mit der digitalen Transformation und dem Zuwachs an digitalen Gesundheitsinformationen steigen auch die Möglichkeiten der Gesundheitsförderung und Prävention. Gleichzeitig erhöhen sich auch die Anforderungen an den Umgang mit Gesundheitsinformationen und damit an die (digitale) Gesundheitskompetenz. Vorliegende Studien zeigen jedoch, dass ein Großteil der Bevölkerung in Deutschland nicht über ausreichende Gesundheitskompetenz verfügt und hier großer politischer Handlungsbedarf besteht. **Ziel und Fragestellung** Der Beitrag geht der Frage nach, inwieweit es gelungen ist, Gesundheitskompetenz in Deutschland als Thema und als potenzielles neues Politikfeld zu etablieren. **Material und Methoden** In Anlehnung an die Diskussion zur Ausreifung von Politikfeldern werden in dem Beitrag fünf Kriterien ((1.) Problemwahrnehmung und Agenda Setting, (2.) Konsens über Definition und Ziele, (3.) empirische Belege, (4.) Wille zum Handeln und Veränderungsbereitschaft, (5.) Ressourcenausstattung) betrachtet, anhand derer der Reifegrad von Gesundheitskompetenz als neues Politikfeld einzuschätzen versucht wird. **Ergebnisse** Insgesamt zeigt sich, dass Gesundheitskompetenz in Deutschland eine rasante Themenkarriere durchlaufen hat und ein gesellschaftlich und politisch zunehmend relevantes Thema darstellt. Auch bei der Etablierung und Reifung als Politikfeld erfolgten in den letzten Jahren wichtige, auch international beachtete Schritte. Dabei wurde der Digitalisierung und der Verknüpfung beider bislang getrennt geführten Diskussionen und Entwicklungen jedoch zu wenig Beachtung geschenkt. Auch bis zur nachhaltigen Verankerung als Politikfeld sind noch etliche Herausforderungen zu bewältigen. **Schlussfolgerung** Die Bedeutung von Gesundheitskompetenz ist im digitalen Zeitalter größer denn je. Die Bewältigung dieser Herausforderungen stellt daher eine zukünftig wichtige Aufgabe dar., **Background** With the digital transformation and the increase in digital health information, the opportunities for health promotion and disease prevention are also increasing. At the same time, the demands on dealing with health information and thus for (digital) health literacy are also increasing. However, existing studies show that a large part of the population in Germany is not adequately health literate, which points to a great need for political action. **Objectives** This article therefore examines the extent to which health literacy has been successfully established as an issue and as a potential new policy area in Germany. **Materials and methods** Following the discussion on policy analysis, the paper considers five criteria ((1.) problem perception and agenda-setting, (2.) consensus on definition and objectives, (3.) empirical evidence, (4.) willingness to act and change, (5.) level of resources) against which it attempts to assess the development of health literacy as a new policy area. **Results** Overall, it can be shown that health literacy has undergone a rapid career as a topic in Germany and is becoming increasingly relevant both socially and politically. In recent years, important steps have been taken in establishing health literacy as a policy area, which have also attracted international attention. However, too little attention has been paid to digitalization and to linking the two discussions and developments, which have been conducted separately so far. To anchor health literacy sustainably as a policy field, several challenges have to be addressed. **Conclusions** The importance of health literacy in the digital age is greater than ever. Meeting these challenges will therefore be an important task in the future.

Introduction. In modern conditions of rapid development of information and communication technologies, healthcare workers start experiencing adverse health effects of such risk factors as an uncontrolled use of electronic devices and associated physical inactivity, sleep deprivation, and impaired work/rest patterns during their professional training. Our purpose was to study subjective assessment of risks from electronic device usage by medical workers. Methods. A specially developed questionnaire was distributed among 148 doctors, 72 nurses and paramedics, and 119 professors of medical universities. In addition to that, selective measurements of body composition were taken in homogeneous cohorts of female healthcare professionals serving as teachers of clinical departments of medical universities (33) or nurses (36) who gave an informed consent to participate in the study and filled out the questionnaire. The statistical software package Statistica 13 PL (StatSoft, USA) was used for statistical data processing. Results. In general, the respondents gave an adequate assessment of health effects of electronic device usage. Nurses and paramedics appeared to be the least trained in issues of the safe use of electronic devices. Almost 61 % of them had varying degrees of overweight and obesity; yet, 51.4 % of nurses and paramedics rated their health as good being aware of the risks related to overweight. Medical university staff adequately assessed potential health risks and demonstrated better skills of a safe use of electronic devices in everyday life, payed more attention to their physical activity and nutrition, and were committed to developing appropriate competencies in their students. Conclusion. Development of skills of a risk-free electronic device usage in healthcare professionals should begin in a medical school.

ObjectiveDespite increasing prevalence of end-stage renal disease (ESRD), little attention has been directed to how occupational exposures may contribute to risk. Our objective was to investigate the relationship between metalworking fluids (MWF) and ESRD in a cohort of 36 703 male autoworkers.MethodsWe accounted for competing risk of death, using the subdistribution hazard approach to estimate subhazard ratios (sHRs) and 95% CIs in models with cubic splines for cumulative exposure to MWF (straight, soluble or synthetic).ResultsBased on 501 ESRD cases and 13 434 deaths, we did not observe an association between MWF and ESRD overall. We observed modest associations between MWF and ESRD classification of glomerulonephritis and diabetic nephropathy. For glomerulonephritis, the 60th percentile of straight MWF was associated with an 18% increased subhazard (sHR=1.18, 95% CI: 0.99 to 1.41). For diabetic nephropathy, the subhazard increased 28% at the 60th percentile of soluble MWF (sHR=1.28, 95% CI: 1.00 to 1.64). Differences by race suggest that black males may have higher disease rates following MWF exposure.ConclusionsExposure to straight and soluble MWF may be related to ESRD classification, though this relationship should be further examined.

Resumen Objetivo Analizar el riesgo genotoxico de los farmacos citostaticos en personal sanitario tras su exposicion ocupacional. Metodo Revision narrativa mediante busqueda bibliografica en bases de datos Pubmed, Lilacs, The Cochrane Library y Scopus, con lenguaje libre y controlado (terminos MeSH) utilizando los operadores booleanos AND y OR. La busqueda se limito a articulos publicados entre 2005-2016. Resultados Se analizaron 11 articulos seleccionados para esta revision bibliografica en funcion de su relevancia, de los cuales 9 mostraban dano en el material genetico (ADN) del personal sanitario expuesto a citostaticos. Ademas, cabe senalar que las actuales practicas de seguridad no eliminan por completo las posibilidades de exposicion, por lo que es necesaria la creacion de nuevos estudios clinicos. Conclusiones La manipulacion de citostaticos puede causar un riesgo genotoxico al personal sanitario que se encuentra expuesto a estas sustancias. Dicho riesgo puede producir modificaciones en el ADN del organismo de estos trabajadores. No existen datos suficientes para demostrar la relacion causa-efecto entre el riesgo genotoxico y el efecto adverso en el individuo. La educacion para la salud sera el principal medio para la concienciacion y prevencion del personal en riesgo.

BackgroundMusculoskeletal disorders (MSDs), a common type of occupational diseases, have become the main cause of absenteeism and early retirement in the occupational population, as well as a major risk factor for occupational disability. The purpose of this study was to investigate the effects of occupational stress and mental health on MSDs in coal miners in Xinjiang, China, to provide a theoretical basis for reducing the incidence of MSDs in coal miners and improving their physical and mental health.MethodsIn this study, stratified cluster random sampling was used to randomly select six coal mining companies in Xinjiang, and 1675 coal miners were surveyed by questionnaire. The status of occupational stress, mental health and MSDs among coal miners was investigated by means of the Effort–Reward Imbalance questionnaire (ERI), Symptom Checklist-90(SCL-90), and Musculoskeletal disorders scale (MSDs) questionnaire.ResultsThe prevalence of MSDs among coal miners was higher, and there were statistical differences among different sexes, ages, working years, shifts, types of work, educational level and monthly income (P OR = 2.23, 95%CI.:1.50,3.33). The risk of MSDs was higher with age OR = 2.39, 95%CI.,1.68,3.40; 40-49 years,OR = 2.15, 95%CI.:1.52,3.04; 50-60 years:OR = 3.25, 95%CI.:2.09,5.07), and the longer the working years, the higher the risk of MSDs (OR = 1.90, 95%CI.:1.38,2.62). The two shifts group (OR = 2.18, 95%CI.:1.59,2.98) had an increased risk of developing MSDs compared with the fixed day shift group. The risk of MSDs was lower in heading drivers (OR = 0.41, 95%CI.:0.29,0.60,) and transport workers (OR = 0.30, 95%CI.:0.20,0.43). The higher the education level, the lower the risk of MSDs (high school:OR = 0.46, 95%CI.:0.34,0.62, junior college and above:OR = 0.12, 95%CI.:0.08,0.17), and the higher the monthly income, the lower the risk of MSDs (OR = 0.50, 95%CI.:0.34,0.74). Occupational stress (OR = 1.32, 95%CI.:1.05,1.67) and mental disorder(OR = 2.94, 95%CI.:2.25,3.84) increased the risk of MSDs. A Bayesian network diagram showed that occupational stress and MSDs have direct effects on mental disorders, and occupational stress can have indirect effects on mental disorders through MSDs.ConclusionOur research shows that MSDs are common among coal miners. Occupational stress and psychological disorders can increase the incidence of MSDs.