Showing papers in "Journal of Occupational and Environmental Medicine in 2019"

Who is Engaged at Work? : A large-Scale Study in 30 European Countries

Abstract: Objective:The aim was to investigate differences in the levels of work engagement across demographic and work- and organization-related factors, and their relative importance for work engagement.Methods:The study was on the basis of a sample of 17,498 male and 17,897 female employees from the sixth

Burnout and Satisfaction With Work-Life Integration Among Nurses

Abstract: Objectives:To evaluate characteristics associated with burnout and satisfaction with work–life integration (WLI) among nurses and compare their experience to other American workers.Methods:We used data from 8638 nurses and 5198 workers to evaluate factors associated with burnout and satisfaction wit

Risk Factors and Mechanisms Underlying Cross-Shift Decline in Kidney Function in Guatemalan Sugarcane Workers.

Abstract: Objective:Identify early biomarkers and mechanisms of acute kidney injury in workers at risk of developing chronic kidney disease of unknown origin (CKDu).Methods:We assessed cross-shift changes in kidney function and biomarkers of injury in 105 healthy sugarcane workers. We obtained pre-harvest cli

Selective Associations of Recent Low Concentrations of Perfluoroalkyl Substances With Liver Function Biomarkers: NHANES 2011 to 2014 Data on US Adults Aged ≥20 Years.

Abstract: OBJECTIVE Perfluoroalkyl substances (PFAS) and liver function biomarkers were reexamined for relatively lower serum concentrations of PFAS observed in recent years. METHODS National Health and Nutrition Examination Survey 2011 to 2014 data were analyzed for obese and nonobese participants for serum perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), perfluorodecanoic acid (PFDA), perfluorohexane sulfonate (PFHxS), perfluorononanoic acid (PFNA) as well as four liver function biomarkers in risk-adjusted analysis. RESULTS Among obese participants only, alanine aminotransferase (ALT) was positively associated with PFOA (β = 0.07065, P < 0.01), PFHxS (β = 0.051349, P < 0.01), and with PFNA (β = 0.072742, P < 0.01). PFOA (β = 0.07422, P = 0.03) and PFNA (β = 0.077995, P < 0.01) were associated with gamma glutamyl transferase (GGT) in obese participants. CONCLUSIONS Recent lower levels of PFOA, PFHxS, and PFNA are associated with higher serum liver functions but only among obese participants. The findings are consistent with PFAS animal toxicology concerning steatosis.

Does Help Seeking Behavior Change Over Time Following a Workplace Mental Health Intervention in the Coal Mining Industry

Abstract: OBJECTIVES To investigate help seeking behavior and attitudes to mental health in mining employees. METHODS A pre-post survey study of employees from two Australian coal mines. Data were collected prior to, at baseline, at 6 and 18 months following delivery of the MATES in mining (MIM) peer support mental health intervention. RESULTS Help seeking behaviors increased, with participants' sex, age, relationship status, shift type, and psychological distress significantly associated with likelihood of seeking help (P <0.05). In relation to stigma, significantly more participants' disagreed that they would be treated differently by friends or colleagues following disclosure of mental illness (P < 0.01). CONCLUSIONS Results provide an understanding of help seeking behaviors of mining employees; support the MATES in Mining peer support program in the men dominated industry and provide information to guide mental health workplace program development more broadly.

A Comparison of Job Stress Models: Associations With Employee Well-Being, Absenteeism, Presenteeism, and Resulting Costs.

Abstract: Objective:This study investigates the associations between Effort–Reward–Imbalance (ERI), Overcommitment (OC), Job–Demand–Control (JDC), and Organizational Injustice (OIJ) with employee well-being, absenteeism, and presenteeism, as well as the costs incurred.Methods:Cross-sectional data from 1440 Ge

Posttraumatic Stress Disorder and Job Burnout Among Jail Officers.

Abstract: OBJECTIVE The aim of this study was to explore posttraumatic stress disorder (PTSD) symptom prevalence and health characteristics among jail correctional officers, a generally understudied population of public safety workers. METHOD A Conservation of Resources (COR)-inspired framework explored relationships to PTSD symptoms among jail officers (N = 320) employed in Midwest US jails. RESULTS More than half (53.4%) of jail officers screened positively for PTSD. Hierarchical regression analysis indicates that burnout was a significant predictor of symptoms of PTSD (B = 0.25, P < 0.001). Self-efficacy (B = -0.42, P < 0.01), emotional labor (B = 0.20, P < 0.01), and an anxiety- or depression-related diagnosis (B = 0.92, P < 0.001) remained significant predictors of PTSD-related symptoms in the final step. CONCLUSIONS Our findings highlight the potentially high prevalence and impact of PTSD among jail officers, and offer implications for public safety workplace health interventions.

Does Social Capital in the Workplace Predict Job Performance, Work Engagement, and Psychological Well-Being? A Prospective Analysis.

Abstract: OBJECTIVE The aim of this study was to investigate the prospective association between social capital in the workplace and self-reported job performance, work engagement, and psychological well-being. METHODS Survey data on 538 employees in the dairy industry were analyzed using linear multilevel regression analysis. Social capital was analyzed as individual-level and aggregated team-level variables. Follow-up time was approximately 2 years. Analyses were adjusted for age, sex, outcome measured at T1, and random effects at team level. RESULTS Individual-level social capital at T1 predicted self-reported job performance, and psychological well-being at T2. Changes in individual-level and team-level social capital from T1 to T2 were significantly associated with self-reported job performance, work engagement, and psychological well-being at T2. CONCLUSIONS Social capital in the workplace is associated with relevant outcomes for work organizations. Workplace interventions to enhance social capital are recommended.

MRI Signal Intensity and Parkinsonism in Manganese-Exposed Workers.

Abstract: Objective T1-weighted brain magnetic resonance imaging (MRI) of the basal ganglia provides a noninvasive measure of manganese (Mn) exposure, and may also represent a biomarker for clinical neurotoxicity. Methods We acquired T1-weighted MRI scans in 27 Mn-exposed welders, 12 other Mn-exposed workers, and 29 nonexposed participants. T1-weighted intensity indices were calculated for four basal ganglia regions. Cumulative Mn exposure was estimated from work history data. Participants were examined using the Unified Parkinson's Disease Rating Scale motor subsection 3 (UPDRS3). Results We observed a positive dose-response association between cumulative Mn exposure and the pallidal index (PI) (β = 2.33; 95% confidence interval [CI], 0.93 to 3.74). There was a positive relationship between the PI and UPDRS3 (β = 0.15; 95% CI, 0.03 to 0.27). Conclusion The T1-weighted pallidal signal is associated with occupational Mn exposure and severity of parkinsonism.

Nurse Work Environment and Stress Biomarkers: Possible Implications for Patient Outcomes.

Abstract: Objective:To examine associations between nurse work environment, serum biomarkers, and patient outcomes in a large hospital.Methods:A work environment questionnaire was administered in 2017 to the total sample of nurses in a Midwestern hospital. A subsample of nurses (n = 83) provided blood samples

How to Know if You're Really There: An Evaluation of Measures for Presenteeism in Nursing

Abstract: Objectives To report presenteeism prevalence across presenteeism measures from the work-stress and sickness domains. To evaluate the psychometric fit of those measures in a nursing population. Methods Cross-sectional descriptive survey of 447 US RNs using five reliable and validated measures of presenteeism: Stanford Presenteeism Scale (SPS), Job-Stress-Related Presenteesim Scale (JSRPS), Healthcare Productivity Scale (HPS), Nurses Work Functioning Questionnaire (NWFQ), and Health and Work Questionnaire (HWQ). The survey was evaluated using descriptive, exploratory, and confirmatory factor analysis. Results Mean rates among nurses (SPS = 19.50, JSRPS = 2.1, HPS = -15.1, NWFQ = 17.0, and HWQ = 6.7) were higher than previously published and spanned both job-stress and sickness domains of presenteeism. We identified different factor structures than previously published for three of the five instruments. Conclusion An inclusive conceptualization of presenteeism that includes work-stress and sickness domains is crucial to developing future measures and interventions for presenteeism.

Predictors of Presenteeism among Hospital Employees: A Cross-Sectional Questionnaire-Based Study in Switzerland.

Abstract: OBJECTIVE: The aim of this cross-sectional study was to examine work- and person-related predictors of the largely "invisible" behaviour and phenomenon of presenteeism among employees in a health-care setting in German-speaking Switzerland. METHODS: Self-reported survey data from 1,840 employees of four hospitals and two rehabilitation clinics collected in 2015 and 2016 were utilized and analyzed. RESULTS: All studied work-related factors such as patient contact, job satisfaction, high work load, forced overtime, fear of job-loss, and particularly mental strain turned out to be significant and relevant predictors of presenteeism. Younger employees, female workers and employees with a chronic disease also were more likely to show presenteeism. CONCLUSION: Work stress, work without patients, job dissatisfaction, a chronic disease and/or a younger age or rather less work experience seem to increase the chances of presenteeism among health-care workers.

Individual, Workplace, and Combined Effects Modeling of Employee Productivity Loss.

Abstract: Objective Systematically and simultaneously investigate a wide range of influences on workplace productivity loss. Methods Data were collected from 31,950 employees in the UK. Influences of employees' socioeconomic characteristics, lifestyle, commuting, physical and mental health, well-being, and job and workplace environment were assessed using structural equation models, allowing systematic decomposition of the complex network of influences and creating new, deeper insights. Results Mental health, physical health, job characteristics, and support from organization are the most important (direct or indirect) determinants of employees' productivity. 93% of the indirect influences are mediated through mental and/or physical health. Some influences that appear as strong predictors in simple models lose most of their explanatory power in more complex models with additional explanatory variables. Conclusions There is a need for a more tailored strategy to improve employees' wellbeing as well as the overall organizational, work, and management culture.

Wildland Firefighting: Adverse Influence on Indices of Metabolic and Cardiovascular Health

Abstract: OBJECTIVE The purpose of this study was to evaluate pre- and postseason measures of body composition, skeletal muscle, and blood parameters/liver lipid in wildland firefighters (WLFF) over the fire season. METHODS Alaskan WLFF (N = 27) crews were evaluated pre- and postwildfire season, which included 63 ± 10 operational days. Body composition, thigh muscle area, and liver lipid were quantified using dual-energy radiograph absorptiometry and magnetic resonance imaging, respectively. Blood metabolic and lipid panels were also collected and analyzed. RESULTS Total body, fat, and visceral fat mass increased from pre- to postseason (P < 0.05). Total cholesterol, LDL, and total globulin also increased (P < 0.05). There was a trend (P = 0.06) towards an increase in intrahepatic lipid. CONCLUSIONS The observed maladaptive changes in adipose tissue, blood lipids, and hepatic function may reflect adaptations/consequences to occupational demands/conditions and warrant evaluation of appropriate countermeasures.

Exhaustion and Impaired Work Performance in the Workplace: Associations With Presenteeism and Absenteeism.

Abstract: OBJECTIVE: The aim of this study was to investigate the association between presenteeism and absenteeism during the previous year and the current levels of exhaustion and impaired work performance ...

Laboratory Validation of Hexoskin Biometric Shirt at Rest, Submaximal Exercise, and Maximal Exercise While Riding a Stationary Bicycle.

Abstract: Objective Evaluate Hexoskin performance on a stationary bike against "gold standard" laboratory equipment and develop adjustment models for future use in field settings. Methods Compared respiratory rate (RR), tidal volume (VT), minute ventilation (VE), and heart rate (HR) measured by the Hexoskin shirt to simultaneous spirometry and full 12-lead electrocardiogram during a laboratory based incremental exercise test on a stationary bicycle. Results Data from 17 participants demonstrated Hexoskin VT and VE had the best agreement in the submaximal exercise level (discrepancies less than or equal to 5.3%) with larger discrepancies observed at rest (less than or equal to 15.3%) and at maximal exercise level (less than or equal to 11.7%). The discrepancies for HR and RR were lower at all levels (less than 10%). Adjusting for sex and body weight allowed for a single VE algorithm across the entire range of effort (r = 0.89). Conclusion These discrepancies are acceptable for field use in comparison to the ranges typical of bicycle commuting.

Direct and Indirect Cost of Obesity Among the Privately Insured in the United States: A Focus on the Impact by Type of Industry.

Abstract: OBJECTIVE To evaluate obesity-related costs and body mass index (BMI) as a cost predictor among privately insured employees by industry. METHODS Individuals with/without obesity were identified using the Optum Health Reporting and Insights employer claims database (January, 2010 to March, 2017). Direct/indirect costs were reported per-patient-per-year (PPPY). Multivariate models were used to estimate the association between obesity and high costs (more than or equal to 80th percentile) by industry. RESULTS Overall (N = 86,221), direct and absenteeism/disability cost differences between class I obesity (BMI 30.0 to 34.9) and reference were $1,775 and $617 PPPY, respectively (P < 0.05). Among employees with obesity (BMI more than or equal to 30), highest total costs were observed in the government/education/religious services, food/entertainment services, and technology industries. Class I obesity increased the odds of high costs (more than or equal to 80th percentile) within each industry (odds ratios vs reference = 1.09-5.17). CONCLUSIONS Obesity (BMI more than or equal to 30) was associated with high costs among employees of major US industries.

Sleep, Obesity, and Injury Among US Male Career Firefighters.

Abstract: Objective:The aim of this study was to determine the role of obesity on the association between sleep and on-duty injury among male career firefighters.Methods:Data on 1419 male career firefighters for this cross-sectional study came from two firefighter cohorts from 2008 to 2013. On-duty injury wit

Defining a Culture of Health in the Workplace.

Abstract: Define the concept of workplace culture of health in the workplace and what distinguishes it from other approaches, as discussed in the editorial by Safeer and Allen. Identify and discuss the six primary overlapping spheres of influence involved in the workplace culture of health. Summarize the editorial authors’ views regarding the measurement of culture of health and evidence for the value added by this concept. Wood Johnson Foundation and the US Centers for Disease Control and Prevention (CDC). A culture of health has also been the focus of recent articles in journals such as the American Journal of Health Promotion and the Journal of Occupational and Environmental Medicine. The increasing attention on culture is a great opportunity to move employee health and well-being beyond interventions that have until now focused almost exclusively on the individual as the locus of change. In our experience, a supportive culture increases the effectiveness of worksite health promotion; particularly in achieving the primary objectives of lowering population health risk and of helping employees achieve lasting lifestyle improvement goals. However, much of this potential will be unrealized if ‘‘culture of health’’ becomes a popular buzz phrase that lacks any reference to key culture frameworks and concepts. The workplace health promotion vendors, journals, and researchers appear to be rebranding the existing set of workplace programs without modifying their work so they actually align workplace cultures with health. This is a missed opportunity. Our goal is to better define a workplace culture of health and differentiate it from other approaches. Webster’s defines ‘‘culture’’ as ‘‘the behaviors and beliefs characteristic of a particular social, ethnic, or age group’’ (the workplace being the common denominator in our discussion). These behaviors and beliefs are often the result of a complex web of social influences. Culture, as it pertains to health, is often embedded and demonstrated in food choices, relationships, sleep patterns, work life balance, safety precautions, and tobacco use. Health culture influences us through formal (ie, workplace policies) and informal (ie, how we spend our lunch break) mechanisms. Cultural influences sometimes run contrary to a profession’s stated goal. Take for example, health care workers who regularly share foods high in sodium, fat, and sugar. Culture can be transmitted through formal training provided by leaders and the informal learning that is passed between peers. Cultures are often comprised of multiple subcultures that include unique subsets (ie, profession, work location, shift) of influences within a broader culture. With this understanding of culture, it is fitting for our professional community to define a ‘‘Culture of Health’’ in the workplace to be ‘‘a web of social influences that manifests itself in shared healthy beliefs and behaviors.’’ Contrast Webster’s definition of culture with that of the CDC’s. The CDC defines culture of health as ‘‘a working environment in which employee health and safety are valued, supported, and promoted through worksite health and well-being programs, policies, benefits, and environmental supports.’’ The CDC’s definition says nothing about cultural beliefs, norms, traditions, peer

A 37-year Update on Mortality Patterns in an Expanded Cohort of Vermont Talc Miners and Millers.

Abstract: Objectives:The aim of this study was to update a cohort of Vermont talc workers to include 37 additional years of follow-up time.Methods:Standardized mortality ratios (SMR) and 95% confidence intervals (CIs) were calculated for 70+ causes of death. US population mortality rates were used as referenc

The Relationship Between Organizational Dehumanization and Outcomes: The Mediating Role of Emotional Exhaustion.

Abstract: OBJECTIVE The present research examines the influence of organizational dehumanization on the core dimension of burnout, that is, emotional exhaustion. In addition, we examine how emotional exhaustion in turn influences employees' health (ie, psychological strains and physical complains) and turnover intentions. In other words, we investigated the mediating role played by emotional exhaustion in the relationship between organizational dehumanization and employees' health and turnover intentions. METHODS Data were collected among a sample of Belgian employees through questionnaires. RESULTS As expected, the results of structural equation modeling analyses indicated that emotional exhaustion mediates the relationships between organizational dehumanization on the one hand and employees' health and turnover intentions on the other hand. CONCLUSIONS These findings contribute to the literature on employees' burnout by highlighting a new predictor of this syndrome and its subsequent outcomes.

Health Links™ Assessment of Total Worker Health® Practices as Indicators of Organizational Behavior in Small Business.

Abstract: Objective The aim of this study was to conduct a cross-sectional assessment of the adoption of Total Worker Health (TWH) policies and practices by business size and evaluate extent and alignment of their safety and health. Methods We conducted an analysis of 382 businesses that completed the Health Links Assessment. We measured organizational adoption of TWH across six benchmarks: organizational supports, workplace assessments, health policies and programs, safety, engagement, and evaluation. Results Benchmark scores were significantly associated with business size. Larger businesses were more likely to score higher across each benchmark. Conclusion Small businesses are implementing TWH in a variety of ways and the level of implementation differs by business size. Practical interventions as well as dissemination and implementation research should take business size into account to ensure that TWH is both effective and sustainable in meeting the needs of employees.

Associations Between Job-Strain, Physical Activity, Health Status, and Sleep Quality Among Swedish Municipality Workers.

Abstract: OBJECTIVE To examine the associations between work-stress and physical activity (PA) with sleep quality while controlling for covariates, including social support. METHODS A cross-sectional study among employees of a municipality (n = 2765). Data from respondents (n = 1973) with good/poor sleep quality were included. Prevalence ratios (PR) were estimated using modified Poisson regression analyses. RESULTS A significant interaction was observed between job-strain and self-reported health in the explanation of sleep quality. Consequently, interaction (job strain × self-rated health) adjusted PRs were calculated. The PRs for high job strain were 1.986 (95% CI 1.58 to 2.49) and 1.220 (95% CI 1.04 to 1.44) compared with the reference groups. CONCLUSIONS Findings show that high job strain and low PA levels are associated with poor sleep quality, and that self-rated health plays an important moderating role in the association between job strain and sleep quality.

Diurnal Cortisol Variation According to High-Risk Occupational Specialty Within Police: Comparisons Between Frontline, Tactical Officers, and the General Population.

Abstract: Objective The aim of this study was to compare diurnal salivary cortisol among high-risk occupational police specialties and the general population (n = 18,698). Methods Tactical and frontline officers provided salivary cortisol samples for 2 days (four times: wake, 30 minutes, 11 hours, and 17 hours post-awakening) and were compared with a general population sample of group field studies utilizing similar methodology. Samples were analyzed for free cortisol concentrations (nmol/L) using chemiluminescence immunoassay. Results Repeated-measures mixed-model analysis of variance (ANOVA) revealed significantly greater salivary diurnal cortisol among tactical than frontline officers. Furthermore, both tactical and frontline officers had higher cortisol levels on average at all time points than the general population sample. Conclusion Results suggest that diurnal cortisol response may be associated with level of risk exposure in hazardous occupational subspecialties within policing compared with the general population.

Effects of Household Air Pollution From Solid Fuel Use and Environmental Tobacco Smoke on Child Health Outcomes in Indonesia.

Abstract: Objective:We assessed the combined effect of household air pollution from solid fuel use and from environmental tobacco smoke and child health outcomes in Indonesia.Methods:Survey subjects self-reported solid fuel use, frequency of indoor smoking, and health outcomes in children. We then evaluated t

The Physical Work Environment and Sleep: A Latent Class Analysis.

Abstract: Objective:To investigate the relationships between the physical work environment and sleep using a person-centered approach.Methods:A total of 542 Australian employees aged 18 to 60 years completed a survey assessing exposure to physical work environment stressors (eg, noise, poor air quality, and h

The Effects of Repeated Exposure to Zinc- And Copper-Containing Welding Fumes on Healthy Volunteers

Abstract: Objective Recently, the proinflammatory effects of welding fumes containing zinc and copper have been demonstrated. In the present study, it was investigated if the inflammation persists under repeated exposure. Methods Fifteen healthy male subjects were exposed to 6 hours of exposure with zinc- and copper-containing welding fumes on 4 consecutive days under controlled conditions. Results Inflammatory marker serum levels showed significant increases compared with baseline either 6 or 24 hours after the first exposure and stayed elevated for all following exposures. In nasal secret samples only C-reactive protein levels were increased compared with baseline. Conclusions The current study demonstrates a persistent increase of systemic inflammatory markers indicating an elevated risk for welders chronically exposed to zinc- and copper-containing welding fumes. Topical inflammation of the upper airways did not occur.

Improvements in an Organization's Culture of Health Reduces Workers' Health Risk Profile and Health Care Utilization

Abstract: Objective:To examine changes in internal and external cultures of health scores and relate those changes to employees’ health risks, health care utilization, and costs for 21 large employers (N = 641,901).Methods:We measured the relationship between changes in internal and external culture of health

Trait Mindfulness Helps Explain the Relationships Between Job Stress, Physiological Reactivity, and Self-Perceived Health.

Abstract: Objective The aim of this study was to assess, for the first time, the associations among work stress as measured by the job-demands resources (JD-R) model, trait mindfulness, and indices of the physiological stress response. Method Dairy farmers (N = 79) completed job stress (using the JD-R model), trait mindfulness, burnout, and self-reported health questionnaires and provided physiological indices of the stress response. Results Our findings suggest that those reporting higher mindfulness have better physical and mental health, and that being more mindful may buffer the effects of a large cortisol awakening response on poor physical health. Conclusion Although assessments of both psychological and physiological indicators of stress and ill-health will inform the underlying mechanisms of the associations between work stress and disease, assessing the role of trait mindfulness in this relationship may prove useful.

Diagnostic Tests for Low Back Disorders.

Abstract: Objective The aim of this study was to summarize evidence-based diagnostic guidelines for low back disorders. Methods A comprehensive literature review was conducted. A total of 101 articles of high or moderate quality addressing low back disorders diagnostic evaluation met the inclusion criteria. Evidence-based recommendations were developed and graded from (A) to (C) in favor and against the specific diagnostic test, with (A) level having the highest quality body of literature. Expert consensus was employed for insufficient evidence (I) to develop consensus guidance. Results Recommendations are given for these diagnostic tests: functional capacity evaluations, roentgenograms (x-rays), magnetic resonance imaging (MRI), computerized tomography, myelography, bone scans, single proton emission computed tomography, electromyography, surface electromyography, ultrasound, thermography, fluoroscopy, videofluoroscopy, lumbar discography, MRI discography, and myeloscopy. Conclusion Diagnostic testing is not indicated for the majority of patients with low back pain.