Showing papers in "Journal of Occupational and Environmental Medicine in 2008"
TL;DR: There is a relative lack of well-founded prospective studies targeting the association between leadership and employee health, but the few available good studies suggest an important role of leadership on employee job satisfaction, job well-being, sickness absences, and disability pensions.
Abstract: Objective:The aim of this systematic literature analysis was to study the association between leadership and well-being at work and work-related health. These intermediate outcomes are supposed to predict work-related loss of productivity and disability at work.Methods:Original articles publ
473 citations
TL;DR: The research suggests that the work impact of depression is related to symptom severity and that symptom relief only partly reduces the adverse work outcomes of depression.
Abstract: Objective To assess the work impact of depression. Methods A review of research articles published since 2002, reporting on the magnitude and/or nature of depression's impact on work. Results This research is characterized by the use of three outcome indicators (employment status, absenteeism, and presenteeism metrics) and three research designs (population-based, workplace, and clinical). The literature documents that, compared to non-depressed individuals, those with depression have more unemployment, absences, and at-work performance deficits. Methodological variation makes it difficult to determine the magnitude of these differences. Additionally, the research suggests that the work impact of depression is related to symptom severity and that symptom relief only partly reduces the adverse work outcomes of depression. Conclusions Research has contributed to knowledge of the multidimensional work impact of depression. Further developing intervention research is an important next step.
448 citations
TL;DR: There is moderate evidence that work health promotion decreases sickness absences and exercise seems to increase overall well-being and work ability, and activities involving exercise, lifestyle, and ergonomics are potentially effective.
Abstract: Objective:The aim of this systematic literature analysis was to study the association between work health promotion and job well-being, work ability, absenteeism, and early retirement. This systematic review is a part of a large research project studying multiple workplace factors and interventions
305 citations
TL;DR: The relationship between BMI and presenteeism is characterized by a threshold effect, where extremely or moderately obese workers are significantly less productive than mildly obese workers.
Abstract: Objective:To examine whether obesity is associated with increased presenteeism (health-related limitations at work).Methods:Randomly selected manufacturing employees (n = 341) were assessed via height and weight measures, demographic survey, wage data, and the Work Limitations Questionnaire.
278 citations
TL;DR: Exposure to NO2, a marker of traffic-related air pollutants, was associated withDM prevalence among women, suggesting that common air pollutants are associated with DM and warrant more investigation to determine if this is a cause-and-effect relationship.
Abstract: Objective:Air pollution is associated with an increased risk for cardiovascular events. Many of the biological pathways involved could also promote diabetes mellitus (DM). We therefore investigated the association between DM prevalence and exposure to traffic-related air pollution (nitrogen
255 citations
TL;DR: Using sophisticated methodology, this study suggests that a comprehensive health promotion program can lower the rate of health care cost increases and produce a positive ROI.
Abstract: Objective:To determine the return on investment (ROI) of Highmark Inc.’s employee wellness programs.Methods:Growth curve analyses compared medical claims for participants of wellness programs versus risk-matched nonparticipants for years 2001 to 2005. The difference was used to define savings. ROI w
202 citations
TL;DR: In this paper, the authors compared 2005 health care resources among matched samples of employees with fibromyalgia, osteoarthritis, and controls, using a claims database of privately insured individuals.
Abstract: Objectives:To compare 2005 health care resources among matched samples of employees with fibromyalgia (FM), osteoarthritis (OA), and controls.Methods:Using a claims database of privately insured individuals, FM and OA samples were derived from those with two or more disease-specific claims i
179 citations
TL;DR: CD and UC are costly diseases with a significant cost burden related to health care utilization and productivity loss and indirect costs were also high for employed patients with these conditions.
Abstract: Objective To estimate the direct medical and indirect (absenteeism and short-term disability) cost burden of Crohn's Disease (CD) and Ulcerative Colitis (UC). Methods Data were obtained from 1999 to 2005 MarketScan databases. Twelve-month expenditures for patients with CD and UC were compared to expenditures among an equal number of propensity score matched comparison group patients. Regression analysis controlled for demographics and case-mix. Results Annual medical expenditures were significantly higher for commercially insured CD and UC patients compared to matched comparison group patients ($18,963 vs $5300 for CD patients, $15,020 vs $4982 for UC patients, respectively, all P Conclusions CD and UC are costly diseases with a significant cost burden related to health care utilization and productivity loss.
158 citations
TL;DR: There is a pressing need to better understand and effectively manage fatigue in the workplace in occupationally active breast cancer survivors.
Abstract: INTRODUCTION Residual symptoms such as fatigue, cognitive limitations, and emotional distress can be experienced by cancer survivors. These symptoms may impact their abilities at work. It is unclear to what degree these symptoms are associated with work in occupationally active breast cancer survivors, the most prevalent cancer survivor group. METHODS A sample of 100 women working part- or full-time with a history of breast cancer and a noncancer comparison group (n = 103) completed questionnaires related to physical fatigue, depression, anxiety, and cognitive limitations. Demographic variables, job stress, type of job, stage at diagnosis, treatment exposure, and health behaviors were also measured as potential confounders. RESULTS Four years postdiagnosis breast cancer survivors reported higher levels of age-adjusted work limitations (F = 32.708, P < 0.001). Significant group by fatigue (beta = -0.311, 95% CI = -0.545 to -0.076) and group by depression (beta = 0.331, 95% CI = 0.024 to 0.638) interactions were observed. Fatigue was more strongly related to work limitations in the cancer survivor group whereas depressive symptoms were more strongly related to limitations at work in the noncancer group. Although fatigue accounted for 22% of the variance in the model, it explained 71% of the contribution of symptom burden to the overall model. CONCLUSIONS Fatigue was more strongly related to work in the breast cancer survivor group after accounting for many potential confounders. There is a pressing need to better understand and effectively manage fatigue in the workplace in occupationally active breast cancer survivors.
153 citations
TL;DR: High psychological distress is pervasive across all employee subtypes and remains largely untreated and will guide the targeting of mental health promotion, prevention and screening programs.
Abstract: Objective: There is limited occupational health industry data pertaining to 1) the prevalence of psychological distress in various employee subtypes and 2) risk factors for employee psychological distress. Method: The employees of 58 large public and private sector employers were invited to complete the Kessler 6 (K6) as part of the Health and Performance at Work Questionnaire. A K6 score of >= 13 was chosen to indicate high psychological distress. Results: Data on 60,556 full-time employees indicate that 4.5% of employees have high psychological distress of which only 22% were in current treatment. Occupational risk factors identified include long working hours, sales staff and non-traditional gender roles. Conclusion: High psychological distress is pervasive across all employee subtypes and remains largely untreated. Risk factors identified will guide the targeting of mental health promotion, prevention and screening programs.
135 citations
TL;DR: Evidence-based quality improvement interventions in the primary care system that have been shown in randomized trials to the improve quality of care and outcomes of patients with depression are described to be a high value intervention.
Abstract: Objective:To describe evidence-based quality improvement interventions in the primary care system that have been shown in randomized trials to the improve quality of care and outcomes of patients with depression.Methods:Medical literature review, focused on the concept of population-based care and r
TL;DR: Hearing difficulty was differentially distributed across various industries and employers and workers should take preventive action to reduce the risk of occupational hearing loss.
Abstract: Objective:To estimate the national burden of hearing difficulty among workers in US industries and occupations.Methods:Data on 130,102 employed National Health Interview Survey respondents between the ages of 18 to 65 years who were interviewed between 1997 and 2003 were analyzed to estimate the pop
TL;DR: Long duration of shoulder flexion and forceful exertion (especially pinch) in a job are significant risk factors for RCS among active workers.
Abstract: Objective:To identify factors associated with rotator cuff syndrome (RCS) among active workers.Methods:Seven hundred thirty-three workers in 12 worksites participated in a cross-sectional study with individual structured physical and psychosocial health interviews, physical examinations, and exposur
TL;DR: It is found that a brief and easily adaptable web-based stress management program can simultaneously reduce worker stress and address stigmatized behavioral health problems by embedding this prevention material into a more positive stress management framework.
Abstract: Objective: To evaluate the effectiveness of a web-based multimedia health promotion program for the workplace, designed to help reduce stress and to prevent depression, anxiety, and substance abuse. Methods: Using a randomized controlled trial design, 309 working adults were randomly assigned to the web-based condition or to a wait-list control condition. All participants were assessed on multiple selfreported outcomes at pretest and posttest. Results: Relative to controls, the web-based group reduced their stress, increased their knowledge of depression and anxiety, developed more positive attitudes toward treatment, and adopted a more healthy approach to alcohol consumption. Conclusions: We found that a brief and easily adaptable web-based stress management program can simultaneously reduce worker stress and address stigmatized behavioral health problems by embedding this prevention material into a more positive stress management framework. (J Occup Environ Med. 2008;50:960–968) T
TL;DR: Working overtime is associated with increased levels of anxiety and depression, and a dose-response relationship between work hours and anxiety or depression is suggested.
Abstract: Objective:To examine whether long work hours are associated with increased levels and prevalences of anxiety and depression.Methods:Overtime workers (n = 1350) were compared with a reference group of 9092 workers not working overtime regarding anxiety and depression by means of the Hospital
TL;DR: Evidence on the workplace prevalence and correlates of major depressive episodes and treatment quality guarantees are reviewed, with a particular focus on the National Comorbidity Survey Replication, the most recent national survey to focus on these issues.
Abstract: Although surveys designed to estimate the prevalence and correlates of mental disorders in the workplace as well as in larger community samples have been carried out in the United States since the end of World War II,1–3 it was not until the early 1980s that the development of fully structured diagnostic interviews made it possible to assess specific mental disorders with accuracy in such assessments.4,5 Several large-scale surveys using fully structured psychiatric diagnostic interviews have been carried out since that time. However, changes in the criteria for major depression in successive editions of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) have hampered efforts to replicate results. The most recent nationally representative population data on the prevalence and correlates of depression come from the National Comorbidity Survey Replication (NCS-R).6 The NCS-R data also provide useful information about the workplace consequence of depression.7 The current report presents an overview of NCS-R results on the prevalence and correlates of depression and relates these results to those in previous studies.
TL;DR: This longitudinal study of veterans of Operation Ranch Hand, the unit responsible for spraying Agent Orange and other 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD)-contaminated herbicides in Vietnam from 1962 to 1971, found associations between TCDD and diabetes and between T CDD and cancer in Ranch Hand veterans are strengthened after adjustment.
Abstract: Background:The Air Force Health Study was launched in 1980 as part of a Federal effort to resolve the Agent Orange issue.Objectives:To study diabetes and cancer with additional adjustment for days of spraying, calendar period of service, and time spent in Southeast Asia (SEA).Methods:This was a long
TL;DR: This study lends support for the requirement to screen for OSA in commercial drivers by validating the recently published consensus criteria for screening commercial drivers for obstructive sleep apnea.
Abstract: OBJECTIVE: To validate the recently published consensus criteria for screening commercial drivers for obstructive sleep apnea (OSA). METHODS: A large, consecutive case series of commercial drivers was screened for OSA at a single occupational medicine clinic and those screening positive were referred for overnight polysomnography. RESULTS: One hundred ninety (13%) of 1443 individuals having commercial motor vehicle driver examinations screened positive for OSA. None of these would have been detected if the only screening were the questions on the current Commercial Driver Medical examination form. One hundred thirty-four underwent polysomnography, and of those 94.8% had OSA, which is the best estimate of the positive predictive value of these consensus criteria in a population of truck drivers. CONCLUSION: The proposed screening criteria have a high positive predictive value in this population. This study lends support for the requirement to screen for OSA in commercial drivers. Language: en
TL;DR: Incentive value and Communications and Organizational Commitment Level (Com/Org Level) were the strongest predictors of HPA completion rates and employer size and a Gateway Model were also significant predictors.
Abstract: Objectives: Investigate factors associated with employee participation rates in health risk assessments Methods: This cross-sectional study using multiple regression analyzed data from 124 employers with 882,275 eligible employees who completed 344,825 health and productivity assessments (HPAs) Results: Incentive value and Communications and Organizational Commitment Level (Com/Org Level) were the strongest predictors of HPA completion rates Employer size and a Gateway Model were also significant predictors In addition, a correlation of variables showed other important relationships To achieve a 50 % HPA completion rate, employers with a low Com/Org Level will need an incentive value of approximately $120 whereas employers with a high Com/Org Level only need approximately $40-a difference of $80 dollars Conclusion: This applied study offers empirical evidence to help employers increase their employees' participation in health risk assessments
TL;DR: Construction workers are at an increased risk of CTS so awareness should be raised and interventions should specifically target this risk group.
Abstract: Objective: To assess whether work-related physical activities are associated with Carpal tunnel syndrome (CTS), even when controlling for personal risk factors. Methods: A cross-sectional assessment of 1108 workers from eight employers and three unions completed nerve conduction testing, physical examination, and questionnaires. CTS was defined by median neuropathy and associated symptoms. Results: Eighteen workers had CTS and 131 had evidence of median neuropathy. CTS was highest among construction workers (3.0%) compared to other subjects (<1%). Logistic regression models for median neuropathy both personal and work-related risk factors. Work-related exposures were estimated by two methods: self-report and job title based ratings. Conclusions: Both work and personal factors mediated median nerve impairment. Construction workers are at an increased risk of CTS so awareness should be raised and interventions should specifically target this risk group.
TL;DR: Depression is a strong predictor of decrements in work performance and other conditions that often co-occur with depression, including anxiety and fatigue-sleep disturbance, exacerbate the adverse effect of depression.
Abstract: Objectives: To present data on the comparative and interactive workplace costs of depression relative to other health problems in the workforce of a large employer. Methods: The World Health Organization Health and Work Performance Questionnaire was used to assess self-reported health problems and work performance. Survey data were linked to medical-pharmacy claims data. Regression analysis was used to assess comparative effects of depression in the absence and presence of comorbidities on Health and Work Performance Questionnaire measures of work performance. Results: Depression had the largest individual-level effect on work performance of any condition examined. Several comorbid conditions exacerbated the effect of depression, but had no effects in the absence of depression. Conclusions: Depression is a strong predictor of decrements in work performance. Other conditions that often co-occur with depression, including anxiety and fatigue-sleep disturbance, exacerbate the adverse effect of depression.
TL;DR: The novel finding is that mental ill-health produces little to no absenteeism in white-collar workers yet a profound absenteeism increase in the blue-collar sector.
Abstract: Objective: Mental ill-health results in substantial reductions in employee productivity (absenteeism and presenteeism). This paper examines the relationship between employee psychological distress, employee type and productivity. Method: Utilizing the Health and Performance at Work Questionnaire, in a sample of 60,556 full-time employes, the impzact that psychological distress (Kessler 6) imposes on employee productivity by occupation type is examined. Results: Comparison of white-collar workers absenteeism rates by low and high psychological distress reveals no statistically significant difference, Neverthless, the same comparison for blue-collar workers reveals that high psychological distress results in an 18% increase in absenteeism rates. High K6 score resulted in a presenteeism increase of 6% in both blue and white-collar employees. Conclusion: The novel finding is that mental ill-health produces little to no absenteeism in white-collar workers yet a profound absenteeism increase in the blue-collar sector. (J Occup Environ Med. 2008;50:1228-1243)
TL;DR: Evidence demonstrates that occupational exposures are causally linked with chronic obstructive pulmonary disease (COPD), and population-based findings add to the literature linking occupational exposures to COPD.
Abstract: Objective:Evidence demonstrates that occupational exposures are causally linked with chronic obstructive pulmonary disease (COPD). This case-control study evaluated the association between occupational exposures and prevalent COPD based on lifetime occupational history.Methods:Cases (n = 388) aged 4
TL;DR: There was a substantial payer burden associated with OA resulting from the drug, medical, and disability costs and OA-related comorbidities and high concomitant medication utilization.
Abstract: Objective:To assess the health care utilization and cost of illness for osteoarthritis (OA) patients taking pain medications. Specifically, the goals were to estimate the direct health care and indirect costs of OA.Methods:A claims database of privately insured patients was used to identify OA patie
TL;DR: A strategy to prevent depression in the workplace can include developing individual resilience, screening high-risk individuals and reducing that risk, improving organizational literacy, and integrating workplace and health care systems to allow access to proactive quality interventions.
Abstract: Objective:To explore the literature regarding prevention of depression in the workplace.Method:Literature review of what the author believes are seminal articles highlighting workplace factors and interventions in preventing depression in the workplace.Results:Employees can help prevent depression b
TL;DR: Arsenic exposure (urinary arsenic >200 &mgr;g/L) was negatively associated with hemoglobin among all men and among women with hemochemistry <10 d/L; among women, the use of contraceptives predicted higher hemoglobin.
Abstract: Objective:The purpose of this study was to examine the association between arsenic exposure and anemia, based on blood hemoglobin concentration.Methods:Hemoglobin measures, skin lesions, arsenic exposure, and nutritional and demographic information were collected from 1954 Bangladeshi participants i
TL;DR: Police personnel reported symptoms of PTSD and depression associated with work-related and personal factors following Hurricane Katrina, and depressive symptoms were associated with rare family contact, uninhabitable home, isolation from the NOPD, assault, and injury to a family member.
Abstract: OBJECTIVE:: We examined symptoms of depression and posttraumatic stress disorder (PTSD) among New Orleans Police Department (NOPD) personnel who provided law enforcement and relief services to affected communities following Hurricane Katrina. METHODS:: We conducted a cross-sectional survey of mental health outcomes related to personal and work-related exposures of police personnel 8 weeks after the Hurricane. RESULTS:: Of the 912 police personnel who completed the questionnaire, 227 (26%) reported symptoms consistent with depression and 170 (19%) reported symptoms consistent with PTSD. Risk factors associated with PTSD include recovery of bodies, crowd control, assault, and injury to a family member. Depressive symptoms were associated with rare family contact, uninhabitable home, isolation from the NOPD, assault, and injury to a family member. CONCLUSIONS:: Police personnel reported symptoms of PTSD and depression associated with work-related and personal factors following Hurricane Katrina. Language: en
TL;DR: This study demonstrates the contribution of quality program components to superior program engagement rates and health outcomes.
Abstract: Objective: To assess the prevalence of “best practice” program components across a select sample of organizations, and to explore differences in engagement rates and health risk reduction between organizations using “best-practice” and “common-practice” health management approaches. Methods: Using a retrospective approach, researchers assigned organizations to a “best practice” or “commonpractice” group based on well-defined criteria. The study examined group differences in employee health assessment participation rates, health coaching program participation and completion rates, and organizational-level health risk reduction. Results: Best-practice organizations achieved higher levels of engagement than common-practice organizations in both health assessment and health coaching programs. Population-level and intervention-level health risk reduction was 2.35 and 1.08 times higher, respectively, among best-practice organizations compared with common-practice organizations. Conclusions: This study demonstrates the contribution of quality program components to superior program engagement rates and health outcomes. (J Occup Environ Med. 2008;50:633–641)
TL;DR: A targeted worksite intervention program may be an effective way to lower BP and promote exercise and weight loss among hypertensive employees participating in an employer-based BP screening program.
Abstract: Objective: To assess the impact of tailored intervention on body mass index (BMI) and blood pressure (BP) among hypertensive employees participating in an employer-based BP screening program. Methods: The quasi-experimental design involved screening subjects (n = 15,583) within the Merrill Lynch organization. A control group had BP and weight measurements plus education whereas experimental sites additionally received a pedometer, to measure physical activity, body fat measurement, and education encouraging physical activity. Change in BMI and BP were compared after 1 year. Results: The experimental group (n = 47) demonstrated statistically significant improvements in BMI (P < 0.01) and systolic BP (P = 0.04) versus control group (n = 94). Furthermore, 38.3% of the experimental group reported undertaking vigorous physical activity (≥3X/wk) at 1-year; a 100% increase compared with baseline. Conclusions: A targeted worksite intervention program may be an effective way to lower BP and promote exercise and weight loss.
TL;DR: The efficacy and effectiveness of antidepressants for MDD has been established in randomized clinical trials and effectiveness studies for acute and long-term treatment, but many patients do not achieve remission.
Abstract: Objective:Antidepressants treat major depressive disorder (MDD) with the burden of associated side effects and difficulties with compliance. The purpose of this article is to review the efficacy and effectiveness of antidepressants for MDD.Methods:The authors conducted a focused review of selected k