2018-08-01 12:00 - Messages

Comparison of hemodynamic responses between normotensive and untreated hypertensive men under simulated long working hours

This study examined hemodynamic responses of normotensive and hypertensive participants under the simulated long working hours in an experimental laboratory. The findings showed that long working hours increases the blood pressure of individuals especially those with hypertension; suggesting that such individuals may suffer more severe damage related to long working hours.

Source: Ikeda, H., Liu, X., Oyama, F., Wakisaka, K. et Takahashi, M. (2018). Scandinavian journal of work, environment & health.

Summary of the evidence on the effectiveness of Mental Health First Aid (MHFA) training in the workplace

The Mental Health First Aid (MHFA) training programme was first developed to train the public in providing help to adults with mental ill-health problems. Recently there has been an increase in undertaking MHFA training in workplace settings.
As the regulator for workplace health and safety, the Health and Safety Executive (HSE) wishes to understand the strength of the available evidence on the effectiveness of MHFA in the workplace. A rapid scoping evidence review was undertaken that considered three research questions on the impact, influence and application of MHFA training in workplaces.
A number of knowledge gaps have been identified in this evidence review that mean it is not possible to state whether MHFA training is effective in a workplace setting. There is a lack of published occupationally-based studies, with limited evidence that the content of MHFA training has been considered for workplace settings. There is consistent evidence that MHFA training raises employees' awareness of mental ill health conditions. There is no evidence that the introduction of MHFA training in workplaces has resulted in sustained actions in those trained, or that it has improved the wider management of mental ill-health.

Source: http://www.hse.gov.uk/research/rrhtm/rr1135.htm

Aggression in mental health residential facilities

A systematic review and meta-analysis
Objectives: To estimate the prevalence of aggression exhibited by patients living in community residential facilities and to identify risk factors for such aggression.
Methods: A systematic review with meta-analysis was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) dataset (registration number: CRD42016042475). PubMed, Scopus and Web of Science were searched for studies published prior to February 21st 2017. Studies reporting the number of patients who perpetrated aggressive behavior in residential facilities were included. Methodological quality, publication bias, and the role of moderators were assessed. A pooled effect size was calculated for each outcome. Factors affecting between-study heterogeneity were analyzed using sub-groups and meta-regression analysis.
Results: Ten studies met the inclusion criteria, for a total sample of 3760 patients. The pooled prevalence of aggression in residential facilities was 29% (95% CI 0.17–0.42) with a high heterogeneity and variability among studies. History of violence, personality disorders, lifetime substance and alcohol misuse were found significantly associated with aggression.
Conclusion: Aggression in residential care services is common. Certain individual factors are associated to an increased risk for such aggression.

Source: Bulgari, V., Ferrari, C., Pagnini, F., de Girolamo, G. et Iozzino, L. (2018). Aggression and Violent Behavior.

Clustering of job strain, effort-reward imbalance, and organizational injustice and the risk of work disability: a cohort study

Objectives: The aim of this study was to examine the association between co-occurring work stressors and risk of disability pension.
Methods: The work stressors job strain,brffort−reward imbalance (ERI), and organizational injustice were measured by a survey in 2008 of 41 862 employees linked to national records of all-cause and cause-specific disability pensions until 2011. Co-occurring work stressors were examined as risk factors of work disability using Cox regression marginal models.
Results: Work stressors were clustered: 50.8% had no work stressors [observed-to-expected ratio (O/E)=1.2], 27.4% were exposed to one stressor (O/E=0.61–0.81), 17.7% to two stressors (O/E=0.91–1.73) and 6.4% to all three stressors (O/E=2.59). During a mean follow-up of 3.1 years, 976 disability pensions were granted. Compared to employees with no work stressors, those with (i) co-occurring strain and ERI or (ii) strain, ERI and injustice had a 1.9–2.1-fold [95% confidence interval (CI) 1.7–2.6] increased risk of disability retirement. The corresponding hazard ratios were 1.2 and 1.5 (95% CI 1.0–1.8) for strain and ERI alone. Risk of disability pension from depressive disorders was 4.4–4.7-fold (95% CI 2.4–8.0) for combinations of strain+ERI and strain+ERI+injustice, and 1.9–2.5-fold (95% CI 1.1–4.0) for strain and ERI alone. For musculoskeletal disorders, disability risk was 1.6–1.9-fold (95% CI 1.3–2.3) for strain+ERI and ERI+injustice combinations, and 1.3-fold (95% CI 1.0–1.7) for strain alone. Supplementary analyses with work stressors determined using work-unit aggregates supported these findings.
Conclusions: Work stressors tend to cluster in the same individuals. The highest risk of disability pension was observed among those with work stressor combinations strain+ERI or strain+ERI+injustice, rather than for those with single stressors.

Source: Juvani, A., Oksanen, T., Virtanen, M., Salo, P., Pentti, J., Kivimäki, M. et Vahtera, J. (2018). Scandinavian journal of work, environment & health.

New perspectives on psychosocial safety climate in healthcare

A mixed methods approach
The psychological safety of frontline healthcare workers receives less attention in policy and from management than either physical safety or productivity goals. In other industries, Psychosocial Safety Climate (PSC) has been used to better understand how management values shape job design and the health and wellbeing of workers. Our study looks at how PSC theory manifests in healthcare on a day-to-day basis, aiming to explore the factors shaping that climate from the perspective of the frontline worker. A grounded theory approach was used in content analysis of semi-structured interviews with staff from three government hospitals (N?=?27), including nursing, medical, allied health, and administrative employees. Findings suggest that PSC theory might at a broad level be applicable to a wide range of industries, such as through key themes like ‘Communication' and ‘Group Expectations'. However it is important to acknowledge industry-specific factors in how PSC is manifested, such as the major role that PSC plays in the management of systemic risks in healthcare like balancing the ‘Conflicting Pressures' of staff personal safety versus delivering quality patient care. In addition, practical implications of our study include three methods by which management and Australian policy makers can mitigate psychosocial risks, enacting a positive change in safety climates that better value frontline worker psychological health.

Source: McLinton, S. S., Dollard, M. F. et Tuckey, M. M. (2018). Safety Science, 109, 236-245.

Content and quality of workplace guidelines developed to prevent mental health problems

Results from a systematic review
Objectives: A wide range of guidelines have been developed to prevent work-related mental health problems (MHP), but little is known about the quality of such guidelines. We systematically reviewed the content and quality of workplace guidelines aiming to prevent, detect, and/or manage work-related MHP.
Methods: We conducted systematic online and database searches (MEDLINE; Web of Science; PsychNET; occupational safety and health databases) to identify guidelines. Eligibility criteria included guidelines recommending primary, secondary, or tertiary preventive interventions to be implemented at the workplace by employers, employees or organizational staff. A minimum of minimum three independent reviewers assessed the quality of guidelines using the Guidelines for Research and Evaluation (AGREE II). Guidelines rated ≥65% with regards to domain I, II, and III were considered to be of good developmental quality.
Results: Seventeen guidelines were quality assessed. Guidelines mainly targeted employers: eight guidelines recommended primary preventive interventions (eg, reduction of psychosocial hazards by risk management procedures), three recommended tertiary (eg, stay at work or return to work procedures for management), and six recommended a combination of primary, secondary and tertiary interventions (eg, facilitate return to work by increasing mental health literacy of all staff and coordination of sick-listed employees). Four guidelines had developed recommendations of good quality, but the evidence of two guidelines was outdated and studies documenting the effect of implementation were not yet available.
Conclusions: Few guidelines have been developed with sufficient rigor to help employers prevent or manage work-related MHP and evidence of their effectiveness remains scarce.

Source: Nexø, M. A., Kristensen, J. V., Grønvad, M. T., Kristiansen, J. et Poulsen, O. M. (2018). Scandinavian journal of work, environment & health.

Job burnout: The contribution of emotional stability and emotional self-efficacy beliefs

Consistent with insights from both trait and social cognitive theories, this study presents a theoretical model positing emotional self-efficacy beliefs in managing negative emotions at work as a key mechanism that contributes to mediate the negative relationship between emotional stability – a trait highly associated with positive affect and mental health – and job burnout. To test this assertion, a two-wave study using a representative sample of 416 new military cadets of an Italian military academy was designed. Military cadets were involved in the study 2 months after their entrance into the academy and then again, a year later. Results from structural equation modelling supported the hypothesized model. As predicted, self-efficacy beliefs in managing negative emotions at work significantly mediated the longitudinal relation between emotional stability and job burnout, even after controlling for the effect of the other Big Five traits, education, previous experience in military contexts, gender, and age. Practical implications and directions for future research are discussed. In conclusion, our study demonstrates that self-efficacy in managing negative emotions at work represents an important mechanism linking emotional stability level to burnout symptoms.

Source: Alessandri, G., Perinelli, E., De Longis, E., Schaufeli, W. B., Theodorou, A., Borgogni, L., ... et Cinque, L. (2018). Journal of Occupational and Organizational Psychology.

Effectiveness of training workplace managers to understand and support the mental health needs of employees

A systematic review and meta-analysis
Managers are in an influential position to make decisions that can impact on the mental health and well-being of their employees. As a result, there is an increasing trend for organisations to provide managers with training in how to reduce work-based mental health risk factors for their employees. A systematic search of the literature was conducted to identify workplace interventions for managers with an emphasis on the mental health of employees reporting directing to them. A meta-analysis was performed to calculate pooled effect sizes using the random effects model for both manager and employee outcomes. Ten controlled trials were identified as relevant for this review. Outcomes evaluating managers' mental health knowledge (standardised mean difference (SMD)=0.73; 95% CI 0.43 to 1.03; p<0.001), non-stigmatising attitudes towards mental health (SMD=0.36; 95% CI 0.18 to 0.53; p<0.001) and improving behaviour in supporting employees experiencing mental health problems (SMD=0.59; 95% CI 0.14 to 1.03; p=0.01) were found to have significant pooled effect sizes favouring the intervention. A significant pooled effect was not found for the small number of studies evaluating psychological symptoms in employees (p=0.28). Our meta-analysis indicates that training managers in workplace mental health can improve their knowledge, attitudes and self-reported behaviour in supporting employees experiencing mental health problems. At present, any findings regarding the impact of manager training on levels of psychological distress among employees remain preliminary as only a very limited amount of research evaluating employee outcomes is available. Our review suggests that in order to understand the effectiveness of manager training on employees, an increase in collection of employee level data is required.

Source: Gayed, A., Milligan-Saville, J. S., Nicholas, J., Bryan, B. T., LaMontagne, A. D., Milner, A., ... et Glozier, N. (2018). Occup Environ Med, 75(6), 462-470.

Do age and gender contribute to workers’ burnout symptoms?

Background: Despite mounting evidence on the association between work stress and burnout, there is limited knowledge about the extent to which workers' age and gender are associated with burnout.
Aims: To evaluate the relationship between age, gender and their interaction with burnout in a sample of Canadian workers.
Methods: Data were collected in 2009–12 from a sample of 2073 Canadian workers from 63 workplaces in the province of Quebec. Data were analysed with multilevel regression models to test for linear and non-linear relationships between age and burnout. Analyses adjusted for marital status, parental status, educational level and number of working hours were conducted on the total sample and stratified by gender.
Results: Data were collected from a sample of 2073 Canadian workers (response rate 73%). Age followed a non-linear relationship with emotional exhaustion and total burnout, while it was linearly related to cynicism and reduced professional efficacy. Burnout level reduced with increasing age in men, but the association was bimodal in women, with women aged between 20–35 and over 55 years showing the highest burnout level.
Conclusions: These results suggest that burnout symptoms varied greatly according to different life stages of working men and women. Younger men, and women aged between 20–35 and 55 years and over are particularly susceptible and should be targeted for programmes to reduce risk of burnout.

Source: Marchand, A., Blanc, M. E. et Beauregard, N. (2018). Occupational Medicine.

Indoor, outdoor, and night work and blood concentrations of vitamin D and parathyroid hormone

Objectives: The aim of this study was to examine blood concentrations of 25-hydroxyvitamin D (25OHD) and parathyroid hormone (PTH) among indoor, outdoor, permanent and rotating night workers and the association with hours spent outdoors on and off work days.
Methods: Blood samples were collected from 425 workers (162 indoor, 112 outdoor, 118 rotating night and 33 permanent night workers) throughout all seasons. Serum concentrations of 25-hydroxyvitamin D (25OHD) and parathyroid hormone (PTH) were analyzed by isotope dilution liquid chromatography-tandem mass spectrometry (LC MS/MS) and an automated immune analyzer, respectively. Personal light exposure levels were continuously recorded and used to estimate hours spent outdoors (all workers).
Results: Permanent night workers had 25.3% (95% CI 11.9–36.6) lower 25OHD concentration, 4.55 (95% CI 1.39–14.94) higher odds of vitamin D insufficiency (<50 nmol/L) and 14.5% [95% confidence interval (CI)
0.1–31.1] higher PTH concentration than indoor workers. Outdoor workers had similar 25OHD concentrations but 7.5% (95% CI -0.5–14.9) lower PTH concentration compared to indoor workers. Rotating night workers
25OHD and PTH concentrations did not differ from indoor workers. Concentration of 25OHD increased by 5.2% (95% CI 1.1–9.5) per hour spent outdoor at workdays in the summer.
Conclusion: Clinicians should be aware that vitamin D insufficiency may be more prevalent among permanent night workers and human resources should consider the positive effect of allowing workers to spend time outdoors during work hours.

Source: Daugaard, S., Garde, A. H., Hansen, Å. M., Vistisen, H. T., Rejnmark, L. et Kolstad, H. A. (2018). Scandinavian journal of work, environment & health.

Adverse effect of long work hours on incident diabetes in 7065 Ontario workers followed for 12 years

Objective: According to the International Diabetes Federation, the most important challenge for prevention is now to identify social and environmental modifiable risk factors of diabetes. In this regard, long work hours have recently been linked with diabetes, but more high-quality prospective studies are needed. We evaluated the relationship between long work hours and the incidence of diabetes among 7065 workers over a 12-year period in Ontario, Canada.
Research: design and methods Data from Ontario respondents (35–74 years of age) to the 2003 Canadian Community Health Survey were prospectively linked to the Ontario Health Insurance Plan database for physician services and the Canadian Institute for Health Information Discharge Abstract Database for hospital admissions. Our sample consisted of actively employed participants with no previous diagnoses of diabetes. Cox proportional hazard regression models were then performed to evaluate the relationship between long work hours (≥45 hours per week) and the incidence of diabetes.
Results: Long work hours did not increase the risk of developing diabetes among men. However, among women, those usually working 45 hours or more per week had a significantly higher risk of diabetes than women working between 35 and 40 hours per week (HR: 1.63 (95% CI 1.04 to 2.57)). The effect was slightly attenuated when adjusted for the potentially mediating factors which are smoking, leisure time physical activity, alcohol consumption and body mass index.
Conclusion: Working 45 hours or more per week was associated with an increased incidence of diabetes among women, but not men. Identifying modifiable risk factors such as long work hours is of major importance to improve prevention strategies and orient policy making.

Source: Gilbert-Ouimet, M., Ma, H., Glazier, R., Brisson, C., Mustard, C. et Smith, P. M. (2018). BMJ Open Diabetes Research and Care, 6(1).

Night work and risk of common mental disorders

Analyzing observational data as a non-randomized pseudo trial
Finnish night workers had higher odds of developing common mental disorders (CMD) compared with day workers and they showed higher recovery rates from CMD when moving back to day work. Awareness should therefore be raised promoting the importance of good sleep hygiene. However, workplace policies should take into account the degree of individual resilience to adverse health effects of night work.

Source: Beltagy, M. S., Pentti, J., Vahtera, J. et Kivimäki, M. (2018). Scandinavian journal of work, environment & health.

Implications of work effort and discretion for employee well-being and career-related outcomes

An integrative assessment
How does work effort affect employee outcomes? The authors bridge distinct literatures on the well-being versus career-related implications of work effort by analyzing the relation of overtime work and work intensity to both types of outcomes. They also extend examination of the role of discretion in modifying the effects of work effort from well-being to career-related outcomes. Using data from the fifth and sixth European Working Conditions Surveys, the authors show that greater work effort relates strongly to reduced well-being and modestly to inferior career-related outcomes, while discretion may attenuate these adverse implications. Even with discretion, work intensity generally is a stronger predictor of unfavorable outcomes than overtime work. Implications include the need for employees to become aware of the broader limitations of excessive work effort, for employers to give discretion when viable, and for public policy to devise strategies that help limit the adverse consequences of work intensity.

Source: Avgoustaki, A. et Frankort, J. (2018). Industrial and Labor Relations Review.

La prévention des risques : un atout pour la performance de l'entreprise

La question de la contribution de la prévention à la performance des entreprises prend une place de plus en plus importante dans le débat public. Souvent perçue comme une contrainte, voire un coût, la prévention peut, si elle est intégrée à la marche de l'entreprise, contribuer à l'amélioration de sa productivité et de sa performance.
La performance de l'entreprise repose en effet en grande partie sur les compétences et l'implication des hommes et des femmes qui la composent et qui sont l'objet même de la prévention des risques professionnels. Ce dossier, à travers différents concepts, approches, points de vue et exemples d'actions, apporte des arguments permettant d'objectiver la participation naturelle de la prévention à la performance durable de l'entreprise.

Source: Canetto, P. (2018). Hygiène et sécurité au travail (251), 22-50.

Characteristics and determinants of recurrent occupational accidents

Recurrent occupational accidents provide valuable information for prevention purposes. Characteristics of recurrent occupational accidents were studied using a dataset of a Finnish insurance company including 21,580 subjects having at least two compensated workplace accidents with the same working process. For more than two thirds (70%) of the subjects, the circumstances and causes of the first accident did not reoccur in the second accident but their recurrence was substantial, typically around 30%. Working process and characteristics of the first accident affected the reoccurrence. In services, the violence-related accidents reoccurred for every second subject but losing control of machine only for every eighth subject. Moreover, the latter accidents were more severe than the former accidents. On average, two times more days were lost in the second than in the first accident.
The determinants of recurrent occupational accidents were examined for a small subset of 41 victims who had answered to a health-related questionnaire. Compared to age-matched controls with only one occupational accident, the subjects with at least two accidents were 3.2 times more likely to exercise less frequently, 3.2 times more likely to have relatives with diabetes and 2.6 times more likely to have symptoms of health problems.
The substantial reoccurrence of occupational accidents emphasizes the importance of assessing the prevention policies after each accident. Occupational accidents are related to work conditions and organizational practices but analysis of more in-depth data e.g. questionnaires may promote the means to improve the prevention policies of occupational accidents (e.g. violence-related) currently being difficult to prevent.

Source: Pietilä, J., Räsänen, T., Reiman, A., Ratilainen, H. et Helander, E. (2018). Safety science, 108, 269-277.

Knowledge and practice of waste management among hospital cleaners

Background: Poor knowledge and practice of waste management among hospital cleaners is a significant occupational and public health risk which could be improved by better training.
Aims: To assess private hospital cleaners' knowledge and practice of hospital waste management and the association with training.
Methods: A cross-sectional study using an interviewer-administered structured questionnaire was undertaken. The questionnaire was designed to record demographics, assess knowledge and assess self-reported practice and training by private hospital cleaners in Etiosa in Nigeria. Results were analysed with SPSS20 using chi-squared tests.
Results: Ninety-eight hospital cleaners out of 135 participated (response rate 73%), of whom 81% reported that they had received training. Forty-nine per cent had good knowledge, while 90% self-reported good practice. Statistical analysis showed a significant negative association between training and knowledge (χ2 = 11.1, P < 0.01). There was no significant association between knowledge and practice.
Conclusions: This group of cleaners reported good practice but knowledge was negatively associated with training. This may be related to the nature of training. The study found a knowledge gap, exposing these hospital cleaners to occupational risks which appropriate training has the potential to prevent. Collaboration to produce effective training programmes is recommended.

Source: Nwankwo, C. (2018). Occupational Medicine.

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