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OBJECTIVES: This study aimed to investigate the reach of a large-scale health assessment delivered by the occupational health service in Sweden for almost 30 years. METHODS: A total of 418 286 individuals who participated in a health assessment (Health Profile Assessment, HPA) between 1995–2021 were included. A comparative sample was obtained from Statistics Sweden, comprising the entire working population for each year (4 962 127–6 011 829 unique individuals per time period). Sociodemographic and work organization characteristics were compared between the HPA and comparative population for six different periods. Under- and overrepresented groups in the private and public sectors were identified using the most recent data (2015–2021). RESULTS: With negative per cent indicating underrepresentation, the most notable changes over time in representation in the HPA population compared to the comparative were observed for women (-1.2% to -12.8%), private sector employees (-9.4% to 14.9%), individuals with ≥3 years of employment (14.5% to 0.9%), in personal care (0.8% to -8.8%) and manufacturing (0.7% to 6.4%) occupations. Consistently overrepresented groups (median representation across periods) included individuals who had a single income source (6.3%) and were middle-aged (10.8%), born in Sweden (5.9%), associate professionals (8.7%), and employed in companies with high operating profit (17.9%) and low staff turnover (14.3%). Conversely, individuals with low income (-34.0%) and employed in small companies/organizations (-10.9%) were consistently underrepresented. Middle-aged women in education occupations were most underrepresented in the public sector, while in the private sector, it was young women in service and shop sales occupations. CONCLUSIONS: This health assessment has reached many professionals, including hard-to-reach groups, but did not fully represents the Swedish workforce throughout the years.

Objectives This publication analyses the activities of physicians and occupational medicine units in Poland during this period. Material and Methods The analysis of the number of physicians and units of occupational medicine and the preventive and judicial activities they carried out was based on the MZ-35 and MZ-35A statistical forms, which constitute mandatory medical reporting. Results In Poland, during the pandemic, the number of physicians authorized to perform preventive examinations of employees decreased by 9.3% (6597 in 2019 vs. 5984 physicians in 2022). At the same time, the number of basic units of the occupational medicine where preventive examinations of employees decreased from 5974 to 5534 (by 7.4%). The average number of preventive examinations performed annually on employees throughout the pandemic decreased by 9.4% from 5 429 808 (in 2015–2019) to 4 923 161 (in 2020–2023). In the first 2 years of the pandemic, the share of decisions on health contraindications to perform professional activities in the position indicated in the referral increased slightly. During the pandemic, there was also a significant decrease in the number of visits carried out by occupational medicine physicians, both to entire workplaces (by 46%) and to individual positions (by 49%). During the COVID-19 pandemic, occupational medicine physicians reported almost 3 times more suspected occupational diseases than in previous years (an average of 1736 reports per year compared to 673 reports in 2015–2019). The most reports were recorded in 2020 (N = 2183). Conclusions The COVID-19 pandemic has significantly impacted the preventive activities performed by occupational medicine physicians. Reducing the number of mandatory medical examinations of employees during the pandemic could have led to the construction of a health debt of the working population, both in terms of limiting the unfavourable impact of working conditions and worsening the chances of early detection of lifestyle diseases. Int J Occup Med Environ Health. 2024;37(5):535–44

Abstract Background The aim of this study was to compare and describe different professionals’ experiences of workplace psychological and social factors in occupational health (OH) organizations in Sweden. Methods This cross-sectional study with a descriptive and comparative design included 472 respondents with common professions in the occupational health service (OHS) in Sweden. Data were collected with “The General Nordic Questionnaire for Psychological and Social Factors at Work” (QPSNordic). The professions have been compared pairwise using the Independent Samples Kruskal-Wallis test, adjusted by Bonferroni correction for multiple tests on subscales and single items and these are presented descriptively. Results The experience of the psychological and social work environment on job task measurement level differed between the professionals. Experiences on social and organizational as well as on individual measurement levels are similar between the professionals who perceive them as satisfactory. Out of the 472 respondents, 7% reported that they had seen someone being subjected to harassment and bullying at the workplace during the last six months. Conclusions The experience among the professionals differs most in the Job task measurement level. The results indicate that although different OH professionals experience psychological and social factors at work in different ways, their experiences are generally satisfactory even though harassment and bullying do exist. The research about occupational health professionals and their work environment is sparse. Further applied research is needed for the planning and development of occupational health services in Sweden.

China has a large, advanced, and rapidly aging population, coupled with a trend of decreasing birth rates that is exacerbating the issue of an aging society. It is expected that by 2030, China will become a hyper-aged society. As the demographic dividend gradually diminishes, the working-age population is shrinking in size and becoming increasingly older, making elderly labor force an important resource. Japan and South Korea have accumulated rich experience in promoting the healthy employment and occupational health services for the elderly workforce. It is necessary for China to thoroughly consider the issue and implement corresponding measures. This article compared and analyzed the current employment situation of aging populations in China, Japan, and South Korea, revealing that Japan and South Korea presented certain advantages in healthy employment policies, occupational health measures for the elderly, and digital economy. Taking into account the circumstances in China, we can further strengthen occupational health promotion activities, optimize employment structure, utilize new technologies such as artificial intelligence, promote active aging, ensure the sustainable development of elderly labor force resources, steadily enhance comprehensive national strength, and meet the increasing demand for better quality of life among the people.

Background: The aim of this study was to compare and describe different professionals' experiences of workplace psychological and social factors in occupational health (OH) organizations in Sweden. Methods: This cross-sectional study with a descriptive and comparative design included 472 respondents with common professions in the occupational health service (OHS) in Sweden. Data were collected with "The General Nordic Questionnaire for Psychological and Social Factors at Work" (QPSNordic). The professions have been compared pairwise using the Independent Samples Kruskal-Wallis test, adjusted by Bonferroni correction for multiple tests on subscales and single items and these are presented descriptively. Results: The experience of the psychological and social work environment on job task measurement level differed between the professionals. Experiences on social and organizational as well as on individual measurement levels are similar between the professionals who perceive them as satisfactory. Out of the 472 respondents, 7% reported that they had seen someone being subjected to harassment and bullying at the workplace during the last six months. Conclusions: The experience among the professionals differs most in the Job task measurement level. The results indicate that although different OH professionals experience psychological and social factors at work in different ways, their experiences are generally satisfactory even though harassment and bullying do exist. The research about occupational health professionals and their work environment is sparse. Further applied research is needed for the planning and development of occupational health services in Sweden. [ABSTRACT FROM AUTHOR]

Objectives: This publication analyses the activities of physicians and occupational medicine units in Poland during this period. Material and Methods: The analysis of the number of physicians and units of occupational medicine and the preventive and judicial activities they carried out was based on the MZ-35 and MZ-35A statistical forms, which constitute mandatory medical reporting. Results: In Poland, during the pandemic, the number of physicians authorized to perform preventive examinations of employees decreased by 9.3% (6597 in 2019 vs. 5984 physicians in 2022). At the same time, the number of basic units of the occupational medicine where preventive examinations of employees decreased from 5974 to 5534 (by 7.4%). The average number of preventive examinations performed annually on employees throughout the pandemic decreased by 9.4% from 5 429 808 (in 2015--2019) to 4 923 161 (in 2020--2023). In the first 2 years of the pandemic, the share of decisions on health contraindications to perform professional activities in the position indicated in the referral increased slightly. During the pandemic, there was also a significant decrease in the number of visits carried out by occupational medicine physicians, both to entire workplaces (by 46%) and to individual positions (by 49%). During the COVID-19 pandemic, occupational medicine physicians reported almost 3 times more suspected occupational diseases than in previous years (an average of 1736 reports per year compared to 673 reports in 2015--2019). The most reports were recorded in 2020 (N = 2183). Conclusions: The COVID-19 pandemic has significantly impacted the preventive activities performed by occupational medicine physicians. Reducing the number of mandatory medical examinations of employees during the pandemic could have led to the construction of a health debt of the working population, both in terms of limiting the unfavourable impact of working conditions and worsening the chances of early detection of lifestyle diseases. [ABSTRACT FROM AUTHOR]

Background: Designing and enhancing resilient occupational health and safety systems is a challenge. This fact makes it clear that occupational health professionals must be able to develop their full range of competencies. From this premise, it is appropriate to define and deepen the strengths and weaknesses of occupational health nursing (OHN), as well as to point out the opportunities and realities that address its performance. Sources of evidence: In the history of the professionalization of this speciality, different circumstances have conditioned its projection: the absence of its own body of doctrine, the lack of professional recognition, limited autonomy, and the definition of a clear regulatory framework. In addition to an epistemological limitation and the absence of clear leadership. Discussion: In the consolidation of this speciality, there is a limited capacity to implement its own competencies, the invisibility of nursing care, the absence of leadership that incorporates research findings and difficulties in the application of scientific evidence, in addition to the influence of regulatory provisions and the idiosyncrasies of the company. Conclusions and implications for nursing and health policy: The analysis of classical models with a transformative approach invites a more fluid and coordinated communication between occupational health, occupational risk prevention, primary care and public health, a proposal that induces collaboration and a more holistic approach to care for workers. [ABSTRACT FROM AUTHOR]

Background Voivodeship Occupational Medicine Centres (VOMC), being higher-level units towards basic units providing preventive care for employees in Poland, play a consultative, appeal, supervisory and registration role towards them. Additionally, they perform many other tasks specified in the Occupational Medicine Service Act, including conducting diagnostic and jurisprudential activities related to occupational diseases and postgraduate education in occupational medicine. Material and Methods The analysis covers data from 2017–2022 on VOMCs activities, derived from mandatory MZ-35 reporting. Results Over 6 years, the number of employed physicians at VOMCs decreased from 830 in 2017 to 820 in 2022, with >20% of employment contracts transitioning to other forms of cooperation. The number of employed nurses decreased from 375 to 342, and the number of psychologists from 86 to 82. During the 3 years of the pandemic (2020–2022), compared to 2017–2019, the consultative activity of VOMCs for basic units of occupational health service decreased by nearly 30%, while appeal and supervisory activities decreased by 15.2% and 15.8%, respectively. The number of individuals receiving outpatient medical rehabilitation for occupational pathology decreased by >32%, and the number of services provided for established occupational pathology decreased by >14%. The number of certifications for occupational diseases decreased from 3963 in 2019 to 3518 in the first year of the pandemic, then increased to 4145 in 2021 and 3990 in 2022. Conclusions The COVID-19 pandemic had a significant impact on the functioning of VOMCs. Changes in specific areas of their judicial, consultative, appeal, supervisory, training and rehabilitation activities corresponded with the socio-legal changes observed between 2020–2022. The structure of employment at VOMCs and the scope of their tasks remained stable during the pandemic. The observed changes in employment of medical staff were in line with general trends in healthcare institutions and regional conditions. Med Pr Work Health Saf. 2024;75(4):367–381

Virgínia António Sande Chico,1 Adilson Fernando Loforte Bauhofer,2,3 Diocreciano Matias Bero1,2 1Falcudade de Ciências de Saúde, Mestrado em Saúde Pública, Universidade Zambeze, Tete, Mozambique; 2Direcção de Pesquisa, Departamento de Regulação e Promoção da Investigação em Saúde, Instituto Nacional de Saúde, Marracuene, Província de Maputo, Mozambique; 3Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisboa, PortugalCorrespondence: Diocreciano Matias Bero, Instituto Nacional de Saúde, Parcela n° 3934, Vila de Marracuene, CEP n° 0205-02, Provincia de Maputo, Mozambique, Tel +258 82 54 77 380, Email diocreciano.bero@ins.gov.mzAbstract: The quality of the health services offered are very important to guarantee access to quality health and promote well-being for all, at all ages, as recommended in the Sustainable Development Goals 2030. This study aims to assess the degree of satisfaction of users of the Occupational Health Service of the Tete Provincial Hospital. A cross-sectional study was conducted. The data was collected between September 15th and December 20th, 2022, for 335 participants through a self-administered questionnaire. Descriptive statistics was used to describe the data. Overall satisfaction was 87.5% (293/335). Participants age, gender, marital status, and level of education were associated with overall satisfaction (p < 0.001). The factors that influence the satisfaction of users of the Occupational Health Service were the cleanliness of the hospital, opening hours, ease of care, speed and waiting time. The satisfaction of users of the Occupational Health Service of the Tete Provincial Hospital was high.Keywords: quality, satisfaction, occupational health service, tete

Abstract Background Optimizing return to work (RTW) after knee arthroplasty (KA) is becoming increasingly important due to a growing incidence of KA and poor RTW outcomes after KA. We developed the Back At work After Surgery (BAAS) clinical pathway for optimized RTW after KA. Since the effectiveness and cost analysis of the BAAS clinical pathway are still unknown, analysis on effectiveness and costs of BAAS is imperative. Method This protocol paper has been written in line with the standards of Standard Protocol Items: Recommendations for Interventional Trails. To assess the effectiveness and cost-effectiveness for RTW, we will perform a multicenter prospective cohort study with patients who decided to receive a total KA (TKA) or an unicompartmental KA (UKA). To evaluate the effectiveness of BAAS regarding RTW, a comparison to usual care will be made using individual patient data on RTW from prospectively performed cohort studies in the Netherlands. Discussion One of the strengths of this study is that the feasibility for the BAAS clinical pathway was tested at first hand. Also, we will use validated questionnaires and functional tests to assess the patient’s recovery using robust outcomes. Moreover, the intervention was performed in two hospitals serving the targeted patient group and to reduce selection bias and improve generalizability. The limitations of this study protocol are that the lead author has an active role as a medical case manager (MCM) in one of the hospitals. Additionally, we will use the data from other prospective Dutch cohort studies to compare our findings regarding RTW to usual care. Since we will not perform an RCT, we will use propensity analysis to reduce the bias due to possible differences between these cohorts. Trail Registration This study was retrospectively registered at clinicaltrails.gov ( https://clinicaltrials.gov/ct2/show/NCT05690347 , date of first registration: 19–01-2023).

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The World Health Organization considers the workplace as one of the best contexts for the prevention and control of non-communicable diseases. Implementing combined and de-medicalised interventions in Occupational Health Services (OHS) in a sustainable way over time can facilitate access to early detection, and management of musculoskeletal pain at work and improve workers' health. However, developing and implementing such interventions is challenging. Therefore, it is necessary to share previous interventions that describe both implementation and evaluation, in order to be used as practical examples that can inspire different OHS to implement sustainable interventions…

OBJECTIVE: This study tested and validated an existing tool for its ability to predict the risk of long-term (ie, ≥6 weeks) sickness absence (LTSA) after four days of sick-listing. METHODS: A 9-item tool is completed online on the fourth day of sick-listing. The tool was tested in a sample (N=13 597) of food retail workers who reported sick between March and May 2017. It was validated in a new sample (N=104 698) of workers (83% retail) who reported sick between January 2020 and April 2021. LTSA risk predictions were calibrated with the Hosmer-Lemeshow (H-L) test; non-significant H-L P-values indicated adequate calibration. Discrimination between workers with and without LTSA was investigated with the area (AUC) under the receiver operating characteristic (ROC) curve. RESULTS: The data of 2203 (16%) workers in the test sample and 14 226 (13%) workers in the validation sample was available for analysis. In the test sample, the tool together with age and sex predicted LTSA (H-L test P=0.59) and discriminated between workers with and without LTSA [AUC 0.85, 95% confidence interval (CI) 0.83–0.87]. In the validation sample, LTSA risk predictions were adequate (H-L test P=0.13) and discrimination was excellent (AUC 0.91, 95% CI 0.90–0.92). The ROC curve had an optimal cut-off at a predicted 36% LTSA risk, with sensitivity 0.85 and specificity 0.83. CONCLUSION: The existing 9-item tool can be used to invite sick-listed retail workers with a ≥36% LTSA risk for expedited consultations. Further studies are needed to determine LTSA cut-off risks for other economic sectors.

Background: Optimizing return to work (RTW) after knee arthroplasty (KA) is becoming increasingly important due to a growing incidence of KA and poor RTW outcomes after KA. We developed the Back At work After Surgery (BAAS) clinical pathway for optimized RTW after KA. Since the effectiveness and cost analysis of the BAAS clinical pathway are still unknown, analysis on effectiveness and costs of BAAS is imperative. Method: This protocol paper has been written in line with the standards of Standard Protocol Items: Recommendations for Interventional Trails. To assess the effectiveness and cost-effectiveness for RTW, we will perform a multicenter prospective cohort study with patients who decided to receive a total KA (TKA) or an unicompartmental KA (UKA). To evaluate the effectiveness of BAAS regarding RTW, a comparison to usual care will be made using individual patient data on RTW from prospectively performed cohort studies in the Netherlands. Discussion: One of the strengths of this study is that the feasibility for the BAAS clinical pathway was tested at first hand. Also, we will use validated questionnaires and functional tests to assess the patient's recovery using robust outcomes. Moreover, the intervention was performed in two hospitals serving the targeted patient group and to reduce selection bias and improve generalizability. The limitations of this study protocol are that the lead author has an active role as a medical case manager (MCM) in one of the hospitals. Additionally, we will use the data from other prospective Dutch cohort studies to compare our findings regarding RTW to usual care. Since we will not perform an RCT, we will use propensity analysis to reduce the bias due to possible differences between these cohorts. Trail Registration: This study was retrospectively registered at clinicaltrails.gov (https://clinicaltrials.gov/ct2/show/NCT05690347, date of first registration: 19–01-2023). [ABSTRACT FROM AUTHOR]

The study findings have important implications for hospital-based occupational health practices in assessing work-related illnesses and fitness for return to work. Policies that support integrated care may help workers claim compensation and return to work healthily from occupational diseases and injuries. Objective: To evaluate the provision of occupational health services at hospitals following the establishment of the Network of Occupational Disease and Injury Service in 2007. Methods: A review of occupational health services during 2008 to 2021 was conducted. The medical practice–based reporting system was compared with the database of compensated occupational diseases (ODs) from Taiwan's Labor Insurance. Results: First-time outpatient visits for occupational evaluation and total visits to Network of Occupational Disease and Injury Service health care institutions increased from 1777 and 9435 to 12,092 and 23,210, respectively. Reported ODs increased from 1626 to 2043 with a peak of 2791. Up to 1380 workers evaluated for work resumption in 2021. Similar to the increasing trend in reported ODs, the number of compensated ODs increased over years. Conclusion: The health service needs of Taiwanese workers from OD evaluation to vocational rehabilitation are increasing. [ABSTRACT FROM AUTHOR]

Background In 2020, the first year of the COVID-19 pandemic, there were a number of factors affecting employees, employers, and consequently, both directly and indirectly, the occupational health service (OHS). The purpose of this publication is to analyze the activity of physicians and OHS units in this period in Poland. Material and Methods The analysis of the number of physicians, OHS units and their activities was performed on the basis of the MZ-35 and MZ-35A statistical forms, which represent obligatory medical reporting. Results There were 6349 occupational medicine physicians in Poland, who are entitled to conduct prophylactic examinations of employees and provide preventive health care, necessary due to working conditions (less by 248 [3.8%] compared to 2019). At the same time, the number of OHS basic units decreased to 5784 (by 3.2%). In 2020, occupational health physicians reported 4 314 520 prophylactic examinations of employees and job applicants, what is over 1 million 231 thousand (22.2%) less than in the year preceding the pandemic. In addition, they reported the performance of 255 887 prophylactic examinations related to the practical vocational training of pupils, students, participants in qualification vocational training and Ph.D. candidates (less by 157 220 [38.1%]). In 2020, they performed 1 933 355 preliminary examinations (23.9% less), 1 924 929 periodic examinations (25.1% less) and 456 236 follow-up examinations (5.1% more). In 2020, there was also a significant decrease in the number of visits to entire workplaces (from 6437 to 3625) and individual positions (from 46 197 to 26 389) carried out by OHS units. Also in 2020, an almost threefold increase (to 2183) in the number of suspected occupational diseases was reported by OHS physicians. In 2019, the duty to submit an annual report regarding prophylactic activities on the MZ-35A form has been obeyed by only 3607 (56.8%) obliged physicians. Conclusions The COVID-19 pandemic has significantly affected preventive activities carried out by occupational physicians. Med Pr. 2022;73(1):19–24

Purpose: Optimizing return to work after knee arthroplasty is becoming more important because of the growing incidence of KA among workers and poor return to work outcomes. The purpose of this study is to investigate the feasibility of Back At work After Surgery (BAAS): an integrated clinical pathway for return to work after knee arthroplasty. Method: Working patients who received unicompartmental knee arthroplasty (UKA) or total knee arthroplasty (TKA) between January 2021 and November 2021, younger than 65 years and motivated to return to work were eligible to participate. Feasibility was investigated on five domains: reach, dose delivered, dose received, fidelity and patients' attitudes. These outcomes were obtained by a patient‐reported questionnaire and an interview with the occupational case manager and medical case manager. Results: Of the eligible 29 patients, eleven were willing to participate (response rate 38%; due to travel distance to and from the hospital). The dose delivered was between 91 and 100%, except information given about return to work from the orthopedic surgeon which was 18%. The dose received was 100%. For fidelity, case managers reported nine shortcomings for which five solutions were mentioned. In terms of patients' attitude, all patients were satisfied and one patient mentioned an improvement. Conclusions: In terms of reach, participation was low: only 29%. The BAAS clinical pathway seems feasible based on dose delivered, dose received, fidelity and patient attitudes. The next step is to assess the effectiveness of the BAAS clinical pathway for return to work. [ABSTRACT FROM AUTHOR]

Purpose In order to support people with low back pain (LBP) to stay at work, work arrangements are regarded important. This study aimed to evaluate the effectiveness of a workplace intervention using a participatory approach on work disability of workers with ongoing or recurrent LBP. Methods A total of 107 workers with LBP, with duration of pain for at least two consecutive weeks or recurrent pain of any duration during the last year, were randomized either to the intervention (n = 51) or control group (n = 56). The intervention included arrangements at the workplace, along with individual guidance provided by an occupational physiotherapist (OPT). The randomized intervention study used standard counselling and guidance by an OPT without workplace intervention as a comparison. Surveys were completed at baseline, and 6 and 12 months after baseline. Results There were no statistically significant differences between the intervention and control groups on the primary outcome measure, i.e. self-assessed work ability. We found no between-group differences in perceived health, self-assessed work productivity, number of sickness absence days and severity of back pain. However, there were significant positive within-group changes in the intervention group in the intensity of LBP, perceived health and the number of sickness absence days due to LBP. Conclusion Workplace arrangements are feasible using participatory ergonomics, but more quantitative and qualitative research is needed on its utilization and effectiveness among workers with LBP. [ABSTRACT FROM AUTHOR]

Objective This study tested and validated an existing tool for its ability to predict the risk of long-term (ie, ≥6 weeks) sickness absence (LTSA) after four days of sick-listing. Methods A 9-item tool is completed online on the fourth day of sick-listing. The tool was tested in a sample (N=13 597) of food retail workers who reported sick between March and May 2017. It was validated in a new sample (N=104 698) of workers (83% retail) who reported sick between January 2020 and April 2021. LTSA risk predictions were calibrated with the Hosmer-Lemeshow (H-L) test; non-significant H-L P-values indicated adequate calibration. Discrimination between workers with and without LTSA was investigated with the area (AUC) under the receiver operating characteristic (ROC) curve. Results The data of 2203 (16%) workers in the test sample and 14 226 (13%) workers in the validation sample was available for analysis. In the test sample, the tool together with age and sex predicted LTSA (H-L test P=0.59) and discriminated between workers with and without LTSA [AUC 0.85, 95% confidence interval (CI) 0.83–0.87]. In the validation sample, LTSA risk predictions were adequate (H-L test P=0.13) and discrimination was excellent (AUC 0.91, 95% CI 0.90–0.92). The ROC curve had an optimal cut-off at a predicted 36% LTSA risk, with sensitivity 0.85 and specificity 0.83. Conclusion The existing 9-item tool can be used to invite sick-listed retail workers with a ≥36% LTSA risk for expedited consultations. Further studies are needed to determine LTSA cut-off risks for other economic sectors. [ABSTRACT FROM AUTHOR]

BACKGROUND: Scientific research has identified a lack of psychometrically well-tested methods for evaluation of the work environment in healthcare settings. The Structured Multidisciplinary Work Evaluation Tool (SMET) questionnaire has been evaluated and has shown good content validity, as well as intra-rater and test-retest reliability. There are, however, still unknowns regarding the psychometric properties. If the SMET questionnaire is to be used in practical occupational health service (OHS) work and scientific research in healthcare settings, further psychometric evaluation is needed. OBJECTIVE: The aim of this study was to gain further understanding of the psychometric properties of the SMET questionnaire when used in research and clinical OHS practice in healthcare settings. METHODS: The psychometric evaluation was conducted using classical test theory (Cronbach's alpha, explorative factor analysis) and Rasch analysis (measurement targeting, category threshold order, person separation index) on data previously collected in development projects within the healthcare sector. RESULTS: The results support the use of the SMET questionnaire as a psychometrically well-tested method for evaluation of the work environment in healthcare settings. They support the use of the initial 1–10 scale since all 10 steps are used. The results also support the trichotomization procedure since the trichotomized scale captures the construct of the work environment with good measurement targeting and good category threshold order. CONCLUSION: The results of this study support the use of the SMET questionnaire as a psychometrically well-tested method for a broad multifactorial evaluation of the work environment in healthcare settings. [ABSTRACT FROM AUTHOR]

Abstract Background Work disability is a complex issue that requires preventive efforts from healthcare systems and individuals, and that too often results in disability pensions (DP). While many studies have attempted to characterize risk factors of work disability, many showing for example a link between socioeconomic positions, working conditions and frequent attendance to OH primary care it is not known if frequent attendance is associated with DP despite the sociodemographic factors. This study aims to address this gap and examine the association between frequent attendance to OH primary care and DP, when adjusted by sociodemographic factors. Methods This study combines routine medical record data of an occupational health service provider with comprehensive national registers. Medical record data were used to define groups of frequent attenders to OH primary care (FA) (1-year-FA, 2-year-FA, persistent-FA and non-FA) from 2014 to 2016. The sociodemographic factors (including i.e. educational level, occupational class, unemployment periods) were derived from Statistic Finland and DP decisions were derived from Finnish Centre for Pensions. Association of frequent attendance to OH primary care with DP decisions were analyzed and adjusted by sociodemographic factors. Results In total, 66,381 patients were included. Basic and intermediate education along with manual and lower non-manual work predicted frequent attendance to OH primary care. Unemployment in 2013 did not predict frequent attendance to OH primary care. Frequent attendance to OH primary care was associated with DP within next two years, even when adjusted for sociodemographic factors. The association of frequent attendance to OH primary care with DP grew stronger as high service use persisted over time. Conclusions Frequent attendance to OH primary care is associated with DP risk in the near future despite the underlying sociodemographic differences. Patients using OH primary care services extensively should be identified and rehabilitative needs and measures necessary to continue in the work force should be explored. Sociodemographic issues that co-exist should be explored and considered when planning interventions.

OBJECTIVE: This study aimed to investigate the effectiveness of brief training in the guideline-oriented biopsychosocial management of low-back pain (LBP) in occupational health services using a cluster-randomized design. A small sample of physiotherapists and physicians from the intervention units (N=12) were given three- to seven-day training focusing on the biopsychosocial management of LBP, while professionals in the control units (N=15) received no such training. METHODS: Eligible patients with LBP, with or without radicular pain, aged 18–65, were invited to participate. A web-based questionnaire was sent to all recruited patients at baseline, three months and one year. The primary outcome measure was disability (Oswestry Disability Index, ODI) over one year. Between-group differences were analyzed using linear and generalized linear mixed models adjusted for baseline-response delay as well as variables showing between-group imbalance at baseline. RESULTS: The final study sample comprised 234 and 81 patients in the intervention and control groups, respectively at baseline, and 137 and 47 patients, respectively, at one year. At baseline, the mean duration of pain was longer in the intervention group (P=0.017), and pain-related fear concerning physical activity was lower (P=0.012). We observed no significant difference between the groups’ primary outcome measure (adjusted one-year mean difference in the ODI: 2.3; 95% confidence interval -1.0–5.7; P=0.175) or most secondary outcomes. CONCLUSIONS: Brief training in guideline-oriented biopsychosocial management of LBP for occupational health professionals did not appear to be effective in reducing patients’ symptom over one-year follow-up compared to treatment as usual.

Examination of health fitness to work of a jobseeker or an employee is extremely important in the field of employment relations and aims to ensure a proof for the employer that the person will be able to perform the agreed type of work and this work will not endanger his/her life or health. Therefore, it is a legitimate interest of the employer to accept in an employment relationship only such a person who is medically capable to perform the agreed work, respectively to assign the work only to employees who are medically capable to do so. The paper describes the duality of the Slovak legislation in issuing the medical opinions of health fitness to work. Its aim is to offer the professionals for discussion an interpretation leading to the fact that the Public Health Protection Act is a lex specialis in relation to the Health Care Act in process of issuing the medical opinions of health fitness to work and has a priority in application.

Background: Psychotherapeutic consultation services in the workplace (PSIW) have been developed to provide collaborative mental health care for employees. The aim of this study was to analyze participant characteristics, the role of PSIW in treatment courses, and the development of sick leave before and after PSIW start. Methods: Routine data from PSIW and health insurance of 155 participants were analyzed descriptively and by means of a multilevel negative binomial regression. Results: Eighty-four percent of users were male, and 72% were diagnosed with a mental disorder. The number of PSIW consultations varied from 1 to 13 (mean = 4). For 34% of participants, PSIW sessions were sufficient, 33% received a recommendation for outpatient psychotherapy, and 20% for inpatient mental health treatment. While recommendations for inpatient treatment displayed a high adherence rate (74%), recommendations for outpatient treatment were followed by 37%. Compared with the period of a half-year before PSIW, sick-leave days were reduced from the period of the second half-year after PSIW start and in the subsequent observed half-year periods. Trajectories of sick leave by subgroups showed differences. Conclusions: PSIW is a flexible care offer, and results indicate a possible effect of PSIW on sick leave. In future studies, control group designs and inclusion of further variables are needed. [ABSTRACT FROM AUTHOR]

This review includes information about the number of private health insurance and medical subscriptions in Poland, as well as the level of increases in premium rates, and the scale of health promotion and prevention conducted by Polish employers. The aim of this article is to present the current situation on the supplementary private medical market, which is involved in employees’ healthcare, and the challenges that both employers and medical providers with health insurers are now facing, and also to present the reasons why prevention and health promotion are important factors of healthcare under private health insurance. For the purpose of this review, scientific publications devoted to health promotion at the workplace were used, along with statistical data presented in the studies released by the Polish Insurance Association, the Polish Social Security Institution, the World Health Organization and the Organization for Economic Co-operation and Development. The literature search was carried out using the electronic databases of PubMed. Search terms included medical subject headings and free text words. No year of publication restriction was imposed. The conducted analysis shows that the demand for private medical care is rising. Employers are willing to invest in private medical care for their employees, although the scale is much lower among small and medium-sized entrepreneurs due to fiscal burdens. Given the rising demand and an insufficient number of specialists, access to medical services is deteriorating, and the premium rates and costs are rising. More employers are investing in health promotion at the workplace in order to decrease absenteeism and presenteeism, lower the utilization of medical packages, and improve their attractiveness on the market. Although the interest in private medical care is rising, employers should focus on health promotion and prevention at the workplace, and adapt their actions to the employees’ current needs and health issues. Med Pr. 2020;71(6):735–42

Abstract Background Vaccination is the most effective prevention of seasonal influenza. Despite its recommendation and active promotion, vaccination coverage remains low among healthcare staff. The goal of the study was to test if a pre-employment health check is a good opportunity to promote future vaccination against influenza among healthcare workers newly hired by a university hospital. Methods All new hospital employees active at the bedside who underwent a pre-employment health check between the end of 2016’s influenza epidemic and the start of the next influenza vaccination campaign were randomly allocated to a control group or an intervention group. The intervention consisted of a semi-structured dialog and the release of an information leaflet about influenza and influenza vaccination during the check-up, and the shipment of a postcard reminder 2 weeks before the next vaccination campaign. Vaccination rates during the campaign were compared among the two groups. Results Three hundred fifty-seven employees were included. Vaccination rates were similar in both groups: 79/172 (46%) in the control and 92/185 (50%) in the intervention group. A significantly higher rate of vaccination was noted among physicians (70/117, 60%) than among other employees (101/240, 42%, p = 0.001). In a pre-defined exploratory analysis among physicians, the vaccination rate was higher in the intervention group (36/51, 71%) than in the control group (34/65, 52%, p = 0.046). Conclusions Promotion of the influenza vaccine during pre-employment health check did not improve the vaccination rate of newly hired hospital healthcare workers overall during the next influenza vaccination campaign. Results suggest a favourable impact on the vaccination rate of physicians. Thus, there may be an interest in using communication strategies tailored to the different categories of healthcare workers to promote the influenza vaccine during pre-employment health check. Trial registration ClinicalTrials, NCT02758145 . Registered 26 April 2016.

Background The number and activities of occupational medicine physicians and occupational health service (OHS) units can be determined on the basis of obligatory medical reporting. Material and Methods The paper covers an analysis of the MZ-35 and MZ-35A statistical forms dated 2014–2018. In order to assess the scope of medical reporting, an online questionnaire survey among occupational medicine experts was performed. Results the scope of medical reporting, an online questionnaire survey among occupational medicine experts was performed. Results: There were 6685 occupational medicine physicians, 6005 basic OHS units and 20 regional occupational health centers (ROHC) registered in Poland in 2018. Certain regional differences in access to OHS can be noticed. On average, there were 3481 persons of productive age per 1 occupational medicine physician. On average, in 2014–2018, 5 223 000 prophylactic examinations of workers were performed annually, along with 322 000 examinations (also annually) related to the practical vocational training of pupils, students, participants in qualification vocational training and Ph.D. candidates. For the first time in history, in 2018 more preliminary than periodic examinations were performed. Every year, approximately 0.03% of the medical certificates regarding the existence or lack of medical contraindications to perform work, which are issued by basic OHS units, are being questioned by either employees or employers. In 58% of such cases, the initial decision was changed as a result of an appeal procedure in ROHC. The duty to submit an annual report regarding prophylactic praactivities has been obeyed by

BackgroundPoor knowledge of the language has been identified as a barrier to up-to-date occupational safety and health information, however, this question has not been addressed in the context of occupational safety and health expert competence in providing advice for employers in a small, non-English speaking country.ObjectivesTo analyze the available data on the use of languages for searching professional information by occupational safety and health (OSH) experts, and the sources of information on COVID-19 during the first wave of the pandemic in Latvia, and to assess if the knowledge of the English language among these experts is sufficient to react rapidly and effectively in case of emergency.MethodsData were compiled from several different sources: three web-based surveys of occupational safety and health experts (data from 2006, 2010, and 2018) and ten focus group discussions with employers and occupational safety and health experts (data from 2020).ResultsThe results of the surveys show that between 2006 and 2018, the percentage of respondents using only one language (Latvian) for searching professional information in occupational safety and health has increased from 25 to 35.3%. In 2018, the English language was mentioned by only 42.8% of respondents and Russian by 46.8%. During the focus group discussions, the use of English was mentioned for obtaining trustful information from international organizations, for analysis of information received within international companies, for searching international experience, and for finding county-specific information.DiscussionOur study shows that knowledge of the English language for occupational safety and health experts working in Latvia is not sufficient. The companies providing external occupational safety and health services should establish a well-functioning internal training system to provide their non-English speaking experts with up-to-date information. Occupational safety and health-related non-governmental institutions should strengthen their capacity in sharing information related to different occupational safety and health aspects into the national language (Latvian in this particular case).

BackgroundPsychotherapeutic consultation services in the workplace (PSIW) have been developed to provide collaborative mental health care for employees. The aim of this study was to analyze participant characteristics, the role of PSIW in treatment courses, and the development of sick leave before and after PSIW start.MethodsRoutine data from PSIW and health insurance of 155 participants were analyzed descriptively and by means of a multilevel negative binomial regression.ResultsEighty-four percent of users were male, and 72% were diagnosed with a mental disorder. The number of PSIW consultations varied from 1 to 13 (mean = 4). For 34% of participants, PSIW sessions were sufficient, 33% received a recommendation for outpatient psychotherapy, and 20% for inpatient mental health treatment. While recommendations for inpatient treatment displayed a high adherence rate (74%), recommendations for outpatient treatment were followed by 37%. Compared with the period of a half-year before PSIW, sick-leave days were reduced from the period of the second half-year after PSIW start and in the subsequent observed half-year periods. Trajectories of sick leave by subgroups showed differences.ConclusionsPSIW is a flexible care offer, and results indicate a possible effect of PSIW on sick leave. In future studies, control group designs and inclusion of further variables are needed.

Background: Voivodeship Occupational Medicine Centres (VOMC), being higher-level units towards basic units providing preventive care for employees in Poland, play a consultative, appeal, supervisory and registration role towards them. Additionally, they perform many other tasks specified in the Occupational Medicine Service Act, including conducting diagnostic and jurisprudential activities related to occupational diseases and postgraduate education in occupational medicine., Material and Methods: The analysis covers data from 2017-2022 on VOMCs activities, derived from mandatory MZ-35 reporting., Results: Over 6 years, the number of employed physicians at VOMCs decreased from 830 in 2017 to 820 in 2022, with >20% of employment contracts transitioning to other forms of cooperation. The number of employed nurses decreased from 375 to 342, and the number of psychologists from 86 to 82. During the 3 years of the pandemic (2020-2022), compared to 2017-2019, the consultative activity of VOMCs for basic units of occupational health service decreased by nearly 30%, while appeal and supervisory activities decreased by 15.2% and 15.8%, respectively. The number of individuals receiving outpatient medical rehabilitation for occupational pathology decreased by >32%, and the number of services provided for established occupational pathology decreased by >14%. The number of certifications for occupational diseases decreased from 3963 in 2019 to 3518 in the first year of the pandemic, then increased to 4145 in 2021 and 3990 in 2022., Conclusions: The COVID-19 pandemic had a significant impact on the functioning of VOMCs. Changes in specific areas of their judicial, consultative, appeal, supervisory, training and rehabilitation activities corresponded with the socio-legal changes observed between 2020-2022. The structure of employment at VOMCs and the scope of their tasks remained stable during the pandemic. The observed changes in employment of medical staff were in line with general trends in healthcare institutions and regional conditions. Med Pr Work Health Saf. 2024;75(4):367-381., (This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.)

Objectives: This study examined whether a fan‐attached jacket (FAJ) may mitigate the heat strain in hot or humid environment. Methods: Nine healthy men engaged in 60‐min sessions on a bicycle ergometer (4 metabolic equivalents [METs] workload) in hot‐dry (40°C and 30% relative humidity) and warm‐humid (30°C and 85% relative humidity) environments. Both are equivalent to an approximately 29°C wet‐bulb globe temperature. The experiment was repeated—once wearing an ordinal jacket (control condition) and once wearing a long‐sleeve FAJ that transfers ambient air at a flow rate of 12 L/s (FAJ condition)—in both environments. Results: Increases in core temperatures in hot‐dry environment were not statistically different between control and FAJ; however, that in the warm‐humid environment were significantly different between control and FAJ (0.96 ± 0.10°C and 0.71 ± 0.11°C in rectal temperature, P <.0001; and 0.94 ± 0.09°C and 0.61 ± 0.09°C in esophageal temperature, P <.0001). Changes in heart rate were different between control and FAJ in both environments (62 ± 3 bpm and 47 ± 7 bpm, P <.0001 in hot‐dry environment; and 61 ± 3 bpm and 46 ± 5 bpm, P <.0001 in the warm‐humid environment) and decrease of %weight change was different in hot‐dry environment (1.59 ± 0.12% and 1.25 ± 0.05%, P =.0039), but not in the warm‐humid environment. Conclusions: Wearing a FAJ may mitigate heat strain both in hot or humid environments. [ABSTRACT FROM AUTHOR]

Background: Work disability is a complex issue that requires preventive efforts from healthcare systems and individuals, and that too often results in disability pensions (DP). While many studies have attempted to characterize risk factors of work disability, many showing for example a link between socioeconomic positions, working conditions and frequent attendance to OH primary care it is not known if frequent attendance is associated with DP despite the sociodemographic factors. This study aims to address this gap and examine the association between frequent attendance to OH primary care and DP, when adjusted by sociodemographic factors.Methods: This study combines routine medical record data of an occupational health service provider with comprehensive national registers. Medical record data were used to define groups of frequent attenders to OH primary care (FA) (1-year-FA, 2-year-FA, persistent-FA and non-FA) from 2014 to 2016. The sociodemographic factors (including i.e. educational level, occupational class, unemployment periods) were derived from Statistic Finland and DP decisions were derived from Finnish Centre for Pensions. Association of frequent attendance to OH primary care with DP decisions were analyzed and adjusted by sociodemographic factors.Results: In total, 66,381 patients were included. Basic and intermediate education along with manual and lower non-manual work predicted frequent attendance to OH primary care. Unemployment in 2013 did not predict frequent attendance to OH primary care. Frequent attendance to OH primary care was associated with DP within next two years, even when adjusted for sociodemographic factors. The association of frequent attendance to OH primary care with DP grew stronger as high service use persisted over time.Conclusions: Frequent attendance to OH primary care is associated with DP risk in the near future despite the underlying sociodemographic differences. Patients using OH primary care services extensively should be identified and rehabilitative needs and measures necessary to continue in the work force should be explored. Sociodemographic issues that co-exist should be explored and considered when planning interventions. [ABSTRACT FROM AUTHOR]

Abstract Background Although workers’ health surveillance is an important preventive activity, it is not regularly performed. In addition to the occupational physician, the management of occupational health services can also be involved in the performance of workers’ health surveillance. The present study investigated the view and policy of the managements of occupational health services on the performance of workers’ health surveillance by occupational physicians. Method Semi-structured face-to-face interviews about the mission, view, and policy of the occupational health services with respect to workers’ health surveillance were conducted with eighteen randomly selected board members of occupational health services in the Netherlands. The results were transcribed verbatim and were analysed using MAXQDA software to form themes and categories. Results The first theme found was the view of the management of occupational health services. Categories found were mission statements of occupational health services and the attitude of the management of occupational health services towards workers’ health surveillance. Three types of mission statements were mentioned by the board members: keeping workers at work, improving the health of workers, or helping the employer with sick-leave management. Both positive and negative attitudes towards workers’ health surveillance appeared from the interviews. Some board members mentioned that workers’ health surveillance can improve workers’ health, and creates awareness about workers’ health. Other board members mentioned that performing workers’ health surveillance is eliciting problems, and that employers do not have a positive attitude towards workers’ health surveillance. The second theme was the policy on performing workers’ health surveillance. Categories found were the policy on performing workers’ health surveillance towards companies, and the policy on performing workers’ health surveillance towards professionals. Some occupational health services recommend workers’ health surveillance to all companies. However, in general workers’ health surveillance was only performed at request of companies, and no instructions or training programmes for occupational physicians were provided. Conclusion Although some of the mentioned views on workers’ health surveillance are positive, the policy of occupational health services on workers’ health surveillance does, so far, in general, not stimulate occupational physicians or employers to perform or organize workers’ health surveillance.

Introduction: Common mental disorders (CMD) are leading causes of decreased workability in Sweden and worldwide. Effective interventions to prevent or treat such disorders are important for public health. Objective: To synthesize the research literature regarding occupational health service (OHS) interventions targeting prevention or reduction of CMD among employees. The effect on workability (sickness absence, return-to-work and self-reported workability) and on CMD symptoms was evaluated in a narrative analysis. Data sources: The literature search was performed in four electronic databases in two searches, in 2014 and in 2017. Eligibility criteria (using PICO): Population: studies investigating employees at risk or diagnosed with CMD, as well as preventive workplace intervention targeting mental health. Intervention: studies where the recruitment or the intervention was delivered by the OHS or OHS personnel were included. Control: individuals or groups who did not receive the target intervention. Outcome: all types of outcomes concerning sickness absence and psychological health were included. Study quality was assessed using a Swedish AMSTAR-based checklist, and results from studies with low or medium risk of bias were narratively synthesized based on effect or absence thereof. Results: Thirty-three studies were included and assessed for risk of bias. Twenty-one studies had low or medium risk of bias. In 18 studies, rehabilitation interventions were evaluated, 11 studies concerned interventions targeting employees at risk for developing CMD and four studies investigated preventive interventions. Work-focused cognitive behavioral therapy and problem-solving skill interventions decreased time to first return-to-work among employees on sick leave for CMD in comparison with treatment-as-usual. However, effect on return to full-time work was not consistent, and these interventions did not consistently improve CMD symptoms. Selective interventions targeting employees at risk of CMD and preventive interventions for employees were heterogeneous, so replication of these studies is necessary to evaluate effect. Limitations: Other workplace interventions outside the OHS may have been missed by our search. There was considerable heterogeneity in the included studies, and most studies were investigating measures targeting the individual worker. Interventions at the workplace/organizational level were less common. Conclusions and implication of key findings: Return-to-work and improvement of CMD symptoms are poorly correlated and should be addressed simultaneously in future interventions. Further, interventions for CMD administered through the occupational health service require further study. Rehabilitative and preventive strategies should be evaluated with scientifically robust methods, to examine the effectiveness of such interventions. [ABSTRACT FROM AUTHOR]

Based on earlier studies, farmers have poorer work ability compared to workers in most other occupations. The aim of this study was to explore if organic production has a positive effect on producers' work ability while controlling for demographic and production characteristics. This study used telephone interview data collected by the Finnish Institute of Occupational Health in 2014-2015. The material consisted of 2,164 farmers: 231 in organic production and 1,933 in conventional production. Work ability was measured with a single question regarding the farmers' current work ability compared with their lifetime best on a scale of 0 to 10, with 0 meaning unable to work. The data were analyzed using multivariable logistic regression. Organic production had a negative effect on work ability, while larger farm size, experiencing economic uncertainty rarely/never/occasionally (vs. often), age under 55 years, having occupational health coverage, and experiencing low amounts of physical strain or mental strain had positive effects in a multivariable model. While this study could not consider potential biases from the farmers' existing health status at the time of switching to organic production and other sources, it is clear that greater attention needs to be paid to improving worker health, safety, and wellness in organic farming. [ABSTRACT FROM AUTHOR]

In this article the authors attempted to analyze the arguments for considering diabetes as a work-related disease. An overview of literature has been done out of articles published in the years 1980–2016, with the use of combination of key words referring to employment, workplace, and diabetes. The PubMed database was the source of data. The authors indicate that the following arguments are in favor of diabetes being recognized as a work-related disease: diabetes is not an occupational disease, it is not directly related to the work environment or the way the work is performed, but there are observed adverse effects of occupational work-related nuisances, such as night shift work, long work hours, job strain or workplace standing time, which influence its development and course. The number of publications on diabetes, including the problem of occupational work is comparable to the number of analogous publications concerning work-related diseases such as hypertension or ischemic heart disease. Moreover, some aspects of professional activity and diabetes were also included in clinical recommendations for the workplace, which is uncommon in the case of other diseases, even those generally recognized as work-related. Data from medical references, indicating the effectiveness of workplace interventions aimed at preventing diabetes development and/or worsening of its course should be considered as an argument for the inclusion of diabetes into the group of work-related diseases. This should also support the need for further research and practical actions aimed at preventing diabetes at the workplace. Med Pr 2017;68(5):667–675

Marie Lydell,1 Cathrine Hildingh,1 Arne Söderbom,2 Kristina Ziegert1 1Center of Research on Welfare, Health and Sport (CVHI), School of Social and Health Sciences, 2Center for Innovation, Entrepreneurship and Learning Research (CIEL), School of Economics, Technology and Science, Halmstad University, Halmstad, Sweden Background: There is clearly a need for research in the field of occupational health service (OHS) for applying new perspectives. Proactive collaboration is needed between the OHSs and the companies. The customers of the companies using the services should be able to safeguard themselves from the health problems caused by the work environment through proactive collaboration with the OHSs. Objective: The main purpose of this interdisciplinary study was to explore how the stakeholders reflected to create and agree on core values for future challenges in OHS, as seen from the perspectives of OHS professionals and customer companies. Methodology: An action research process was conducted. This study was divided into three phases. In phase I, the data were collected from interviews and diaries of interdisciplinary occupational health professionals (n=12). A focus group that sampled the eight managers of the customer companies was also included. In phase II, a questionnaire was developed with 24 questions focusing on examining the future challenges for OHS. The questionnaire was sent to customer companies (n=116). In phase III, a scoping review was undertaken. Results: Three categories emerged from the analysis: “Balancing complex situations” clarified the complexity regarding senior employees; “Working with a proactive approach” indicated the need for working with a new proactive approach supporting sustainable health; and “Collaborate internally and externally” showed good relationships between the customer and the OHS, which is a mutual responsibility to both the partners. Conclusion: The results outlined that it is necessary to take action to apply new proactive health promotions, with a focus on workplace health promotion. The results also indicated that interventions for senior employees are of importance. This study was done in collaboration with the stakeholders from the occupational health care service center and the managers from the customer companies. The use of a participatory research design, including close collaboration with the participants, allows the researchers to see the challenges. Keywords: health-promoting workplace, managers, future challenges, participatory approach, senior workers

Abstract Background This study aimed to investigate the association between exposure to occupational hazards for pregnancy and sick leave (SL) in pregnant workers. Methods A cross-sectional study was performed in French occupational health services in 2014. Occupational hazards for pregnancy were assessed by occupational health physicians (OHPs). After delivery and at the time of returning to work, 1,495 eligible workers were interviewed by OHPs. Information on SL was self-reported. Risk ratios (RRs) were calculated from multivariable analyses based on a generalized linear model with a Bernoulli distribution and a log link adjusted for selected confounders for binary outcomes or zero-inflated negative binomial regression for count outcomes. Results Among recruited workers, 74.9% presented “at least one SL” during pregnancy. After adjustment, the cumulative index of occupational hazards (0, 1–2, 3–4, ≥ 5 risks) for pregnancy was significantly associated with “at least one SL” during pregnancy in a dose–response relationship. This gradient was also observed with “early SL” (

Background: Mandatory medical reports can be used to evaluate the scope of activity of occupational health services (OHS), including the number and kind of services. Material and Methods: The analysis comprised data for the period 1997–2014, derived from mandatory reports MZ-35A submitted by OHS units. Results: During the analyzed period the number of occupational medicine physicians decreased from 8507 to 6741, while the number of OHS units – responsible for prophylactic care – increased from 4967 to 6261. In the years under report 3,961 million mandatory health check-ups were performed, of which 99.3% resulted in issuing fitness for work certificates. Pre-employment examinations made 38.8%, while periodical ones – 52.8% and control ones – 6.7% of all check-ups. Moreover, 336 700 examinations of apprentices, students, vocational courses attendants and Ph.D. students were performed to evaluate any contradictions for vocational training. In 2014, there were 1871 workers provided with preventive care per 1 occupational physician. It was estimated that despite legal obligation, only 22.2% of employers had signed agreements with OHS units. Conclusions: The analysis of the number and kind of services provided by OHS units revealed high but not fully exploited potential for efficient prophylaxis of both directly occupational work-related and indirectly work-exacerbated diseases. Med Pr 2017;68(1):105–119