Shift work schedule and night work load: Effects on body mass index

A four-year longitudinal study
Objectives: The aim of this study was to investigate changes in body mass index (BMI) between different work schedules and different average number of yearly night shifts over a four-year follow-up period.
Methods: A prospective study of Norwegian nurses (N=2965) with different work schedules was conducted: day only, two-shift rotation (day and evening shifts), three-shift rotation (day, evening and night shifts), night only, those who changed towards night shifts, and those who changed away from schedules containing night shifts. Paired student's t-tests were used to evaluate within subgroup changes in BMI. Multiple linear regression analysis was used to evaluate between groups effects on BMI when adjusting for BMI at baseline, sex, age, marital status, children living at home, and years since graduation. The same regression model was used to evaluate the effect of average number of yearly night shifts on BMI change.
Results: We found that night workers [mean difference (MD) 1.30 (95% CI 0.70–1.90)], two shift workers [MD 0.48 (95% CI 0.20–0.75)], three shift workers [MD 0.46 (95% CI 0.30–0.62)], and those who changed
work schedule away from [MD 0.57 (95% CI 0.17–0.84)] or towards night work [MD 0.63 (95% CI 0.20–1.05)] all had significant BMI gain (P<0.01) during the follow-up period. However, day workers had a non-significant BMI gain. Using adjusted multiple linear regressions, we found that night workers had significantly larger BMI gain compared to day workers [B=0.89 (95% CI 0.06–1.72), P<0.05]. We did not find any significant association between average number of yearly night shifts and BMI change using our multiple linear regression model.
Conclusions: After adjusting for possible confounders, we found that BMI increased significantly more among night workers compared to day workers.

Source: Buchvold ,H.V., Pallesen, S, Waage, S., Bjorvatn, B. (2018). Scand J Work Environ Health.

Job burnout in mental health providers

A meta-analysis of 35 years of intervention research
Burnout is prevalent among mental health providers and is associated with significant employee, consumer, and organizational costs. Over the past 35 years, numerous intervention studies have been conducted but have yet to be reviewed and synthesized using a quantitative approach. To fill this gap, we performed a meta-analysis on the effectiveness of burnout interventions for mental health workers. We completed a systematic literature search of burnout intervention studies that spanned more than 3 decades (1980 to 2015). Each eligible study was independently coded by 2 researchers, and data were analyzed using a random-effects model with effect sizes based on the Hedges' g statistic. We computed an overall intervention effect size and performed moderator analyses. Twenty-seven unique samples were included in the meta-analysis, representing 1,894 mental health workers. Interventions had a small but positive effect on provider burnout (Hedges' g = .13, p = .006). Moderator analyses suggested that person-directed interventions were more effective than organization-directed interventions at reducing emotional exhaustion (Qbetween = 6.70, p = .010) and that job training/education was the most effective organizational intervention subtype (Qbetween = 12.50, p < .001). Lower baseline burnout levels were associated with smaller intervention effects and accounted for a significant proportion of effect size variability. The field has made limited progress in ameliorating mental health provider burnout. Based on our findings, we suggest that researchers implement a wider breadth of interventions that are tailored to address unique organizational and staff needs and that incorporate longer follow-up periods.

Source: Dreison, K. C., Luther, L., Bonfils, K. A., Sliter, M. T., McGrew, J. H., & Salyers, M. P. (2018). Journal of Occupational Health Psychology, 23(1), 18-30.

Perception du risque infectieux professionnel dans le Bâtiment et les travaux publics

Cette étude est une exploration du risque infectieux d'origine professionnelle dans le domaine du BTP. Elle s'intéresse à la perception du risque et à sa gestion par les acteurs de prévention. L'étude comprend deux enquêtes, l'une qualitative dans une entreprise concernée par les risques biologiques et l'autre quantitative au sein d'un service interentreprises de santé au travail du BTP en 2015. Les résultats de cette étude permettent de mettre en évidence des pistes d'amélioration pour la prévention.

Source: Lanotte, M., Richomme, X., Chipier, V. (2017). Références en santé au travail (152).

Safety and health in micro and small enterprises in the EU

From policy to practice - description of good examples
This report presents a selection of case studies of successful efforts to reach out to micro and small enterprises (MSEs) to help them improve occupational safety and health (OSH). The more than 40 inspiring examples from 12 EU Member States are grouped by themes such as multi-dimensional strategies and initiatives by non-OSH intermediaries. The aim is to show that, while MSEs can struggle with managing safety and health, initiatives to improve OSH in MSEs can succeed and are transferable to different countries and sectors. By collecting and analysing these case studies, the report aims to answer the vital question ‘What works, for whom and under what circumstances?


Working conditions of workers of different ages

Demographic change is changing the face of working life across the EU. The increased demand on a shrinking pool of workers to provide for the social needs of an ageing population is leading to increases in the employment rate of older workers and a lengthening of working life. Policy reforms have – on the whole – focused on raising the statutory retirement age and providing financial incentives for older workers to remain in work beyond retirement age. However, a range of other factors also influence workers' decision to continue working into old age – including health and well-being, work–life balance, career prospects and job security, and working conditions such as autonomy, hours of work and psychosocial aspects of the workplace. This report analyses these factors in depth for the 28 EU Member States, using data from the latest European Working Conditions Survey (EWCS 2015) and in the context of Eurofound's concept of ‘sustainable work over the life course'. An executive summary is available - see Related content.


Night Shift Work Increases the Risks of Multiple Primary Cancers in Women

A Systematic Review and Meta-analysis of 61 Articles
A growing number of studies have examined associations between night shift work and the risks of common cancers among women, with varying conclusions. We did a meta-analysis to identify whether long-term night shift work increased the risks of common cancers in women. We enrolled 61 articles involving 114,628 cases and 3,909,152 participants from Europe, North America, Asia, and Australia. Risk estimates were performed with a random-effect model or a fixed-effect model. Subgroup analyses and meta-regression analyses about breast cancer were conducted to explore possible sources of heterogeneity. In addition, we carried out a dose–response analysis to quantitatively estimate the accumulative effect of night shift work on the risk of breast cancer. A positive relationship was revealed between long-term night shift work and the risks of breast [OR = 1.316; 95% confidence interval (CI), 1.196–1.448], digestive system (OR = 1.177; 95% CI, 1.065–1.301), and skin cancer (OR = 1.408; 95% CI, 1.024–1.934). For every 5 years of night shift work, the risk of breast cancer in women was increased by 3.3% (OR = 1.033; 95% CI, 1.012–1.056). Concerning the group of nurses, long-term night shift work presented potential carcinogenic effect in breast cancer (OR = 1.577; 95% CI, 1.235–2.014), digestive system cancer (OR = 1.350; 95% CI, 1.030–1.770), and lung cancer (OR = 1.280; 95% CI, 1.070–1.531). This systematic review confirmed the positive association between night shift work and the risks of several common cancers in women. We identified that cancer risk of women increased with accumulating years of night shift work, which might help establish and implement effective measures to protect female night shifters.

Source: Yuan, X., Zhu, C., Wang, M., Mo, F., Du, W. et Ma, X. (2018). Cancer Epidemiology, Biomarkers & Prevention, 27(1).

Quelles sont les évolutions récentes des conditions de travail et des risques psychosociaux?

Les premiers résultats de la dernière enquête « Conditions de travail » conduite en 2016 font état d'une stabilisation des contraintes de rythme de travail et d'une baisse de certaines contraintes psychosociales (charge mentale en diminution, horaires moins contraignants, soutien social fort et stabilisation de la demande émotionnelle) qui s'accompagnent d'un recul des comportements hostiles. En revanche l'autonomie des salariés poursuit son recul. Les contraintes physiques sont globalement stabilisées à un niveau qui reste élevé.


Développement du monoripage et conditions de travail

Depuis quelques années se développe la pratique du monoripage, c'est-à-dire la collecte des déchets par un équipage constitué d'un opérateur de collecte et d'un chauffeur. Une étude menée par l'INRS révèle que dans les conditions observées une telle collecte est physiquement plus intense que celle réalisée en biripage.
Elle présente alors un risque plus élevé de troubles musculosquelettiques et une astreinte cardiaque excessive. L'étude montre qu'il est possible, pour une collectivité territoriale, d'imposer dans le cahier des charges d'un marché de collecte, les conditions sous lesquelles les entreprises sont autorisées à proposer des collectes en monoripage, de façon à préserver la santé et la sécurité des opérateurs.

Source: Delecroix, B., Salmon, I., Desbrosses, K., Vieira, M., Adam, B. (2017). Références en santé au travail (152), 53-63.

Work Addiction Risk Test - WART

Ce document appartient à une série publiée régulièrement dans la revue. Elle analyse les questionnaires utilisés dans les démarches de diagnostic et de prévention du stress et des risques psychosociaux au travail. L'article, par les mêmes auteurs, " Les questionnaires dans la démarche de prévention du stress au travail " (TC 134, Doc Méd Trav. 2011 ; 125 : 23-35), présente cette série et propose au préventeur une aide pour choisir l'outil d'évaluation le mieux adapté.

Source: Langevin V., Boini S. (2017). Références en santé au travail (152).

Mental Health in the Working World - Determining the current state of scientific evidence

The "Mental Health in the Working World" project aimed to assess psychological strain factors in terms of substantiated scientific and academic research, to gain new information surrounding the new work-related requirements arising due to the changing world of work, and to identify open research questions.
Following a description of the project goals and approach, the project results have been presented under the differing topic fields of "Work tasks", "Leadership and organisation", "Working time", "Technical factors", "Design approaches" and "Mental health". As a result, it has proven possible to analyse and describe the correlations between more than 20 work condition factors in terms of psychological problems, muscular-skeletal and cardiovascular illnesses, general health and well-being, symptoms and performance. In the majority of cases, a consistent correlation was found between the work condition factors and mental health, which enabled the work requirements to be divided into stress factors and resources. The findings gained demonstrate that the individual work condition factors are of differing relevance to the design.
The results are being discussed from the perspectives of both science and practice. Subsequently, recommendations will be made regarding both the individual topic areas and the subject-spanning questions in terms of a continued addressing of the topic area of "Mental health".


Shift work and the risk of cardiovascular disease

A systematic review and meta-analysis including dose–response Relationship
Objectives: The aim of this review was to assess the risk of cardiovascular disease (CVD) events associated with shift work and determine if there is a dose–response relationship in this association.
Method: Electronic databases (PubMed, Scopus, and Web of Science) were searched for cohort or case–control control study designs in any population, reporting exposure to shift work as the main contributing factor to estimate CVD risk. For each study, adjusted relative risk (RR) ratios and 95% confidence intervals (CI) were extracted, and used to calculate the pooled RR using random-effect models. Meta-regression analysis was conducted to explore potential heterogeneity sources. Potential non-linear dose–response relationships were examined using fractional polynomial models.
Results: We included 21 studies with a total of 173 010 unique participants. The majority of the studies were ranked low-to-moderate risk of bias. The risk of any CVD event was 17% higher among shift workers than day workers. The risk of coronary heart disease (CHD) morbidity was 26% higher (1.26, 95% CI 1.10–1.43, I2= 48.0%). Sub-group analysis showed an almost 20% higher risk of CVD and CHD mortality among shift workers than those who did not work shifts (1.22, 95% CI 1.09–1.37, I2= 0% and 1.18, 95% CI 1.06–1.32 I2=0%; respectively). After the first five years of shift work, there was a 7.1% increase in risk of CVD events for every additional five years of exposure (95% CI 1.05–1.10). Heterogeneity of the pooled effect size (ES) estimates was high (I2=67%), and meta-regression analysis showed that sample size explained 7.7% of this.
Conclusions: The association between shift work and CVD risk is non-linear and seems to appear only after the first five years of exposure. As shift work remains crucial for meeting production and service demands across many industries, policies and initiatives are needed to reduce shift workers’ CVD risk.

Source: Torquati L., Mielke G.I., Brown W.J., Kolbe-Alexander T. (2017). Scand J Work Environ Health

Utiliser la transformation numérique pour changer le travail

Utiliser la transformation numérique pour améliorer la QVT est nécessaire et possible si on réunit certaines conditions. Réussir la transition numérique nécessite d’accepter de mettre en oeuvre le changement autour
de 3 repères fondateurs :
- Placer l’utilisateur-trice des outils numériques au coeur de la transition ;
- Accepter la contradiction et considérer simultanément les effets facilitateurs et les effets contraignants
des nouveaux outils ;
- Prendre en compte les contextes organisationnels et individuels d’utilisation des outils numériques
et abandonner l’idée de solutions universelles et impersonnelles.


Pénibilité au travail en milieu scolaire, stratégie de faire face et stratégie de défense chez les enseignants débutants

Un autre regard sur les éléments contributifs d’une vulnérabilité au phénomène de décrochage professionnel
Cet article porte sur la pénibilité au travail en milieu scolaire dans l’enseignement secondaire en France. À partir de présupposés issus d’une approche transactionnelle du stress et d’une psychodynamique du travail son originalité est d’en documenter la complémentarité pour analyser les facteurs contributifs de cette pénibilité et pour comprendre les stratégies d’ajustement et les mécanismes individuels de défense déployés par les enseignants débutants confrontés aux situations aversives perçues et vécues au cours de leur première année en poste. Les recommandations et les pistes suggérées portent sur la prévention primaire des risques psychosociaux en milieu scolaire et visent à permettre aux enseignants débutants de disposer de ressources à l’issue de leur formation à l’université limitant leur risque de décrochage professionnel.

Source: Ciavaldini-Cartaut, S., Marquie-Dubie, H. et d’Arripe-Longueville, F. (2017). Perspectives interdisciplinaires sur le travail et la santé, (19-2 ).

Do resources buffer the prospective association of psychosocial work stress with depression?

Longitudinal evidence from ageing workers
Objectives: There is now convincing evidence that psychosocial work stressors are linked to depression. Few studies, however, have tested if individual resources can buffer the longitudinal effects of psychosocial work
stressors on depressive symptoms. This study investigates how two types of resources (internal and external resources) affect the association between psychosocial work stressors and depressive symptoms.
Methods: Data were obtained from the US Health and Retirement Study, with baseline information on psychosocial work stressors [job strain and effort–reward imbalance (ERI)] and on internal ("high mastery" and "low
constraints") and external resources ("private social support") among initially healthy workers. This information was linked to elevated depressive symptoms two years later. The sample includes 5473 observations and we report relative risks (RR) and effect modification on the additive and multiplicative scale.
Results: Psychosocial stressors and low resources (internal and external) were both independently related to depressive symptoms. Individuals with both, psychosocial stressors and low resources, had the highest risk of developing elevated depressive symptoms (eg, RRERI-LowMastery 3.32, 95% CI 2.49–4.42; RRJobStrain-LowMastery 2.89, 95% CI 2.18–3.84). Yet, based on interaction analyses, only social support from friends buffered the association between work stressors and depressive symptoms.
Conclusions: Our findings have demonstrated that psychosocial stressors at work are related to mental health, and that in most cases this relationship holds true both for people with high and with low resources. Therefore, there is no clear indication that internal or external resources buffer the association between psychosocial work stressors and depressive symptoms.

Source: Lunau, T., Wahrendorf, M., Müller, A., Wright, B., & Dragano, N. (2017). Scandinavian Journal of Work, Environment & Health.

A review of the impact of shift-work on cancer

Summary of the evidence for practitioners
Shift work that involves disruption to the body's circadian rhythm is classified as probably carcinogenic to humans based on limited evidence in humans and sufficient evidence in experimental animals. This article draws together the available information from the epidemiological, mechanistic and health and safety practice research to provide advice for practitioners. There is evidence that the increase in breast cancer risk amongst women who have worked night shifts is relatively modest and we cannot exclude the possibility that there is no cancer risk. If a causal association exists, the most likely mechanism is night time suppression of the production of the hormone melatonin. However, the observed increased risk of breast cancer amongst night shift workers may be due to higher prevalence of obesity and other lifestyle risks in this group of women. Current health and safety policies for shift work generally do not address cancer risks. Employers should develop a workplace policy for night work that informs workers about the potential cancer risks and possible strategies to minimize risks. Employers should also help reduce the cancer risk for shift workers through health promotion initiatives and encouraging access to cancer screening programmes. We summarize the evidence and recommendations in an infographic.

Source: Cherrie, J. W., Crawford, J. O., Davis, A., Dixon, K., Alexander, C., Cowie, H., & McElvenny, D. M. (2017). Policy and Practice in Health and Safety, 1-7.

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