Risk factors for functional status decline in community-living elderly people: a systematic literature review.

Objectives: To carry out a prospective combined quantitative analysis of the associations between all cause mortality and ambient particulate matter and sulphur dioxide. Design: Analysis of time series data on daily number of deaths from all causes and concentrations of sulphur dioxide and particulate matter (measured as black smoke or particles smaller than 10 μm in diameter (PM10)) and potential confounders. Setting: 12 European cities in the APHEA project (Air Pollution and Health: a European Approach). Main outcome measure: Relative risk of death. Results: In western European cities it was found that an increase of 50 μg/m3 in sulphur dioxide or black smoke was associated with a 3% (95% confidence interval 2% to 4%) increase in daily mortality and the corresponding figure for PM10 was 2% (1% to 3%). In central eastern European cities the increase in mortality associated with a 50 μg/m3 change in sulphur dioxide was 0.8% (-0.1% to 2.4%) and in black smoke 0.6% (0.1% to 1.1%). Cumulative effects of prolonged (two to four days) exposure to air pollutants resulted in estimates comparable with the one day effects. The effects of both pollutants were stronger during the summer and were mutually independent. Conclusions: The internal consistency of the results in western European cities with wide differences in climate and environmental conditions suggest that these associations may be causal. The long term health impact of these effects is uncertain, but today9s relatively low levels of sulphur dioxide and particles still have detectable short term effects on health and further reductions in air pollution are advisable. Key messages Evidence is accumulating that air pollution below the levels of national and international standards has adverse short term health effects In this study data from 12 European cities showed that increases in sulphur dioxide and particulate matter are associated with increased total mortality The effects of the two pollutants seem to be independent Associations were stronger and more consistent in western European cities Current low levelsof sulphur dioxide and particles stillaffect health and further reductions in pollution are needed

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Short term effects of ambient sulphur dioxide and particulate matter on mortality in 12 European cities: Results from time series data from the APHEA project

Sleep disturbances, work stress and work hours: A cross-sectional study

OBJETIVO; Investigar a influencia de fatores socioeconomicos e demograficos relativos a saude, bem como os fatores ligados as atividades sociais e a avaliacao subjetiva da saude sobre a capacidade funcional dos idosos. METODOS: Estudo transversal, integrante de estudo multicentrico, em amostra representativa do municipio de Sao Paulo, realizado em 1989. A capacidade funcional foi avaliada atraves da escala de atividades da vida diaria pessoal e instrumental e investigada como variavel dicotomica: ausencia de dependencia - incapacidade/dificuldade em nenhuma das atividades versus presenca de dependencia moderada/grave - incapacidade/dificuldade em 4 ou mais atividades. Analise de regressao logistica multipla foi aplicada aos fatores hierarquicamente agrupados. RESULTADOS: As caracteristicas que se associaram com a dependencia moderada/grave foram analfabetismo, ser aposentado, ser pensionista, ser dona de casa, nao ser proprietario da moradia, ter mais de 65 anos, ter composicao familiar multigeracional, ter sido internado nos ultimos 6 meses, ser "caso" no rastreamento de saude mental, nao visitar amigos, ter problemas de visao, ter historia de derrame, nao visitar parentes e ter avaliacao pessimista da saude ao se comparar com seus pares. CONCLUSOES: As caracteristicas identificadas que se associaram a dependencia moderada/grave sugerem uma complexa rede causal do declinio da capacidade funcional. Pode-se supor, entretanto, que acoes preventivas especificamente voltadas para certos fatores podem propiciar beneficios para o prolongamento do bem estar da populacao idosa.

/pdf/determinant-factors-of-functional-status-among-the-elderly-1o89q20us3.pdf

Determinant factors of functional status among the elderly

https://academiccommons.columbia.edu/doi/10.7916/D8PV6XBS/download

Losing life and livelihood: a systematic review and meta-analysis of unemployment and all-cause mortality.

Aims: To analyse the effects of age and occupational factors on both the incidence and the disappearance of chronic neck and shoulder pain after a five year follow up period. 

Methods: A prospective longitudinal investigation (ESTEV) was carried out in 1990 and 1995 in seven regions of France. A random sample of male and female workers born in 1938, 1943, 1948, and 1953 was selected from the occupational physicians' files. In 1990, 21 378 subjects were interviewed (88% of those contacted), and 87% were interviewed again in 1995. Chronic neck and shoulder pain satisfying specific criteria, and psychosocial working conditions were investigated by a structured self administered questionnaire and a clinical examination. 

Results: Prevalence (men 7.8%, women 14.8% in 1990) and incidence (men 7.3%, women 12.5% for the period 1990–95) of chronic neck and shoulder pain increased with age, and were more frequent among women than men in every birth cohort. The disappearance rate of chronic neck and shoulder pain decreased with age. Some adverse working conditions (repetitive work under time constraints, awkward work for men, repetitive work for women) contributed to the development of these disorders, independently of age. Psychosocial factors seemed to play a role in both the development and disappearance of chronic neck and shoulder pain. Data did not show specific interactions between age and working conditions. 

Conclusions: The aging of the workforce appears to contribute to the widespread concern about chronic neck and shoulder pain. A better understanding of work activity regulation of older workers can open up new preventive prospects.

https://oem.bmj.com/content/oemed/59/8/537.full.pdf

Chronic neck and shoulder pain, age, and working conditions: longitudinal results from a large random sample in France

Study objectives To investigate the effects of occupational factors on both the incidence and the disappearance of sleep disorders after a five-year follow-up period. Design A prospective longitudinal investigation E.S.T.E.V. carried out in 1990 and 1995. Setting Seven regions of France. Subjects A random sample of employed men and women born in 1938, 1943, 1948, and 1953. In 1990, 21,378 subjects were interviewed (87% of those contacted), and 88% were interviewed again in 1995. Measures Sleep disorders (SD), objectifiable and psychosocial working conditions. Results Prevalence of SD increased with age and were more frequent among women than men in every age group. Incidence of SD varied little with age, but their disappearance decreased with age. After adjustment for age and sex, SD in 1995 were found to be associated both with objectifiable working conditions and with psychosocial aspects of the way work is experienced. Among objectifiable occupational risk factors, shift work, work week often longer than 48 hours, and exposure to vibrations appeared to be the principal risk factors for SD. Among psychosocial occupational factors, finding it difficult or irksome to have to hurry appeared to be the principal risk factor. Conclusions Taking into account the adjustments for health criteria, sociodemographic characteristics, and leisure activities, these results suggest useful courses of action for prevention which, it seems to us, must not be only limited to objectifiable working conditions. Issues about work organization, while clearly difficult to resolve, must also be taken into account.

Age, working conditions, and sleep disorders : a longitudinal analysis in the French cohort E. S. T. E. V.

To assess the short-term effects of sulphur dioxide (SO2) atmospheric pollution on mortality a study was conducted in two large French cities, using daily measures of pollution and mortality. A statistically significant association between daily SO2 pollution and respiratory deaths up to 10 days later was shown in both cities for both male and female populations together in the age group 65 years and over. No coherent results were found between SO2 pollution and cardiovascular deaths, or between suspended particulates and either respiratory or cardiovascular deaths. Particular emphasis was put on the use of correct statistical procedures using time series analysis and on the comparison of the part played by SO2 or suspended particulates on mortality.

Short-Term Effects of Sulphur Dioxide Pollution on Mortality in Two French Cities

This study's purpose was to identify occupational factors that may influence the age at natural menopause in a random sample of gainfully employed French women born in 1938 (n = 1,594). Occupational physicians selected the subjects from their files and interviewed them during their annual visits in 1990 and 1995. The authors used Kaplan-Meier survival curves to estimate median age at menopause (52 years) and multiple Cox models to estimate associations among women's characteristics, occupational factors, and age at menopause separately within two strata distinguished by a self-reported history of depression. Among women without such a history, earlier menopause was associated with smoking more than 10 cigarettes per day in 1990 (p < 0.001), a high-strain job (p = 0.01) in 1990, and difficult schedules before 1990 (p = 0.03). Later menopause was associated with higher educational status (p = 0.003) and repetitive work in 1990 (p = 0.005). Among women with a history of depression, a later menopause was associated with having at least one child (p < 0.001) and menarche later than the age of 13 years (p = 0.004). Earlier menopause was associated with a high job control in 1990 (p = 0.03) and high school education (p < 0.01). These results suggest that certain physical job stressors may be related to age at menopause.

F. Derriennic

Papers

Chronic neck and shoulder pain, age, and working conditions: longitudinal results from a large random sample in France

Age, working conditions, and sleep disorders : a longitudinal analysis in the French cohort E. S. T. E. V.

Short-Term Effects of Sulphur Dioxide Pollution on Mortality in Two French Cities

Work-related Factors Associated with Age at Natural Menopause in a Generation of French Gainfully Employed Women

The impact of job strain on social isolation: a longitudinal analysis of French workers.