Cancer risk by education in Iceland; a census-based cohort study.

UNLABELLED: Earlier studies have shown that cancer risk is related to educational level in many countries. The relationship between education and cancer risk has not been studied in the small, but ethnically homogenous, Icelandic population postulated to be outstanding as regards social equity. MATERIAL AND METHODS: We conducted a follow-up study of a cohort of 60,194 males and 58,505 females aged 20-64 at census 1981 in Iceland. Information on education from the census was classified into three educational groups and linked with the population-based Icelandic Cancer Registry. Standardized incidence ratios (SIRs) were calculated for the period 1982 to 2004. RESULTS: We found a significant association between educational level and cancer risk. Among males with academic education, the SIR was elevated for prostate cancer (SIR=1.17, 95% CI 1.05-1.30) and melanoma (SIR=1.41, 95% CI 1.00-1.93) and lowered for cancers of the lung (SIR=0.72, 95% CI 0.59-0.87) and stomach (SIR=0.67, 95% CI 0.48-0.90). Women with academic education had an increased risk of breast cancer (SIR=1.19, 95% CI 1.07-1.33) and a decreased risk of lung cancer (SIR=0.49, 95% CI 0.36-0.65). Increasing educational level was associated with a lowered risk of cervical cancer (p trend=0.017). DISCUSSION: The association between education and cancer incidence seen in this study resembles observations from other countries and probably reflects concordance between social status and certain risk factors for cancer. Our study confirms health-related socioeconomic differences in Iceland and must be taken into account when programmes for health promotion are planned.

Predictors of self-assessed physical and mental health of Icelandic nurses: results from a national survey.

BACKGROUND: Recent health care organizational changes have been associated with stress and musculoskeletal disorders in nurses. However, studies are lacking on what factors are the most important predictors of poor self-assessed health among nurses. OBJECTIVES: To describe and identify the self-assessed predictors of physical and mental health of nurses. PARTICIPANTS AND DESIGN: A cross-sectional design was used with a sample of 394 nurses, drawn from the registry of the Icelandic Nurses' Association, representing 17% of the workforce of Icelandic nurses. METHODS: Data were collected with a self-administered questionnaire, addressing symptoms, illness and treatment, lifestyle and sleep, work and working environment, family and quality of family life. Data were analysed according to nurses' assessment of their physical and mental health (very good/good; poor/very poor) by use of analysis of variance, chi-square and stepwise multiple linear regression. RESULTS: 21.7% of participants assessed their physical health as poor or very poor and 14.3% assessed their mental health as such. Those who assess their physical or mental health poor/very poor, as compared to the others, reported more symptoms in general, less regular exercise, as well as more use of medication, more visits to physicians, trouble with sleeping, conflicts between work and family life, work absence, and they experience their work as more strenuous. Experiencing symptoms is an important predictor of both physical and mental health of nurses. CONCLUSION: Various factors, including work-, family- and socio-cultural environment, play a role in how nurses assesses their health. During our present time of nurse shortage it is imperative that the authorities take special measures in order to improve the work environment of nurses.

Lifestyle, harassment at work and self-assessed health of female flight attendants, nurses and teachers.

Health-related lifestyle, harassment at work, and self-assessed health of female flight attendants in comparison to that of female nurses and female primary school teachers were surveyed. A higher proportion of flight attendants than nurses or teachers were smokers, 26% vs. 15% and 17% respectively; and consumed alcohol at least once a week, 40% vs. 21% and 16%. Repeated sexual harassment at work was more common among the flight attendants, 31% vs. 8% and 4%; whereas bullying, physical violence and threats were less prevalent among the flight attendants (12%) than among nurses (19%). Flight attendants were on average somewhat taller, but weighed on average less, 63.8 kg vs. 72.4 kg and 72.7 kg respectively. Repeated exposure to sexual harassment, bullying, violence and threats was related to less physical and psychological well-being in all the groups. Teachers scored on average significantly lower than did the flight attendants on general health and physical well-being, while nurses did not.

Mortality among female industrial workers in Iceland.

AIMS: The aim was to describe the mortality pattern among unskilled female industrial workers with the hypothesis that they were disadvantaged compared to other women and that smoking-related causes of death were in excess among them. METHODS: The study group comprised 13349 women who had contributed at any time to a pension fund for unskilled industrial workers in Reykjavik during the time period 1970-1995. The follow-up was from 1975 to 1995. The death rate of the study group was compared to that of women in the general population during the time period 1981-1995. The study group was studied with regard to selected causes of death, by age at first entrance into the pension fund, different lag-time, and by employment-time. RESULTS: Results showed an excess of external causes but a deficit of most other causes of death, among those smoking related diseases. The high mortality by external causes was consistent in all the analyses. Standardised mortality ratio (SMR) for external causes in the total group was 1.79 (95% CI 1.45-2.19), for lung cancer 1.04 (95% CI 0.80-1.34) and for ischemic heart disease 0.77 (95% CI 0.65-0.91). Mortality was highest among those who started to pay in the pension fund at younger ages. CONCLUSIONS: The notable excess of external causes in the group needs further exploration. The results did not confirm the hypothesis that smoking-related causes of death were in excess in the group. Methodological problems related to studies on women workers are discussed.

Well-being and self-assessed health among different groups of female personnel in geriatric care.

UNLABELLED: Educational qualifications are reliable predictors of women's self-assessed health. AIMS: To study possible inequalities in health among women with different educational backgrounds working in geriatric care and to find groups that might need special public health measures. METHODS: In this cross-sectional questionnaire reaching throughout Iceland, the participants were employees in 62 geriatric nursing homes and geriatric hospital wards with 10 or more employees. A total of 1886 questionnaires were distributed. The 84-item questionnaire included questions on demographic and work-related factors, health and life style. Age-adjusted odds ratios (OR) were calculated for work-related psychosocial, physical and health factors, and confidence intervals were set at 95% (95% CI). Registered nurses were taken as a reference category. RESULTS: The response rate was 80%. Registered nurses accounted for 16%, practical nurses 21%, unskilled attendants 44%, cleaning personnel 8% and others 12%. The practical nurses, unskilled attendants and cleaning personnel assessed work as more physically difficult, and more monotonous both physically and mentally, than did the registered nurses, who enjoyed more physical and mental well-being than the others. However, the registered nurses visited doctors as often as the other groups did. CONCLUSIONS: Personnel groups in geriatric care have different physical and psychosocial workloads. The results provide opportunities to guide public health measures for people employed in geriatric care and possibly in other settings, such as hospitals and health care institutions.

Work organization, well-being and health in geriatric care.

The objective of the present study was to explore the connection between the organization of work in geriatric care and factors which have been connected to job stress and burnout, i.e. exhaustion, mental workload, job satisfaction and communication. We also analyzed how these factors were related to employee visits to doctors during the previous 12 months due to various medical conditions. The study was a cross-sectional questionnaire distributed to all employees within nursing homes and geriatric hospital wards with 10 employees or more throughout Iceland. The total response rate was 80%. The majority of respondents, or 96%, were women (n = 1432), and the results are based on their answers. Our data show that there is a high correlation between mental exhaustion and the unsatisfactory organization of work. Mental exhaustion upon completing work shifts was more closely connected to the health outcomes studied than were the other work-related factors studied. This is especially true for chronic fatigue, depression and sleeping disorders. It is important that employers and managers notice the mismatches between work and workers that this study manifests. Employers and managers must also consider the organizational factors that are influential.

Employment participation and work experience of male cancer survivors: a NOCWO study.

OBJECTIVE: To investigate whether employment status and work experiences, assessed in terms of job resources (organizational culture and superiors' and co-workers' support), commitment to organization, work motives, and experiences of discrimination, differ between survivors of prostate or testicular cancer or lymphoma and cancer-free reference subjects. METHODS: Questionnaires were sent to 1349 male cancer survivors and 2666 referents in Denmark, Finland, Iceland, and Norway. Valid responses were 59% and 45%, respectively. Odds ratios (OR) and 95% confidence intervals (CI) were estimated with logistic regression models. RESULTS: Compared to the referents, survivors of lymphoma and prostate cancer were less likely to be employed (OR=0.53; CI: 0.30-0.95 and OR=0.50; CI: 0.35-0.73, respectively), but decreased employment was not evident among testicular cancer survivors. Testicular cancer survivors experienced less discrimination at work than did the referents, for example, testicular cancer survivors were less likely to report that their colleagues doubted their ability to carry out their work tasks (OR=0.38; CI: 0.17-0.83). Lymphoma survivors were less likely than the referents to praise their workplace as an enjoyable place to work (OR=0.48; CI: 0.26-0.88). The prostate cancer survivors were more likely than the referents to find the organizational climate competitive, distrustful, and suspicious. CONCLUSIONS: Employment participation and work experiences of male cancer survivors varied substantially according to type of cancer. Occupational therapists and other health care personnel should keep this in mind when assisting cancer survivors in identifying their strengths and limitations at work.

[Work strain and well being among different groups of female personnel in geriatric care.].

OBJECTIVE: To study possible inequalities in work strain and well-being among women working in geriatric care and to find out if some groups might need special public health measures. MATERIAL AND METHODS: In this cross-sectional questionnaire reaching throughout Iceland, the participants were employees in 62 geriatric nursing homes and geriatric hospital wards with 10 or more employees. A total of 1886 questionnaires were distributed. The 84-item questionnaire included questions on demographic and work-related factors, health and life style. Age-adjusted odds ratios (OR) were calculated and confidence intervals were set at 95% (95% CI). Registered nurses were taken as a reference category. RESULTS: The response rate was 80%. Registered nurses accounted for 16%, practical nurses 21%, unskilled attendants 44%, cleaning personnel 8% and others 12% of the total group. Men were 4.5% of the group. The practical nurses, unskilled attendants and cleaning personnel assessed work as more physically difficult, and more monotonous both physically and mentally, than did the registered nurses, who enjoyed somewhat more physical and mental well-being than the others. Little difference was found as to visits to doctors. CONCLUSIONS: Various personnel groups of women in geriatric care have different physical and psychosocial workload that is reflected in their well being. The results provide opportunities to guide public health measures for people employed in geriatric care.

Psychosocial risk factors for musculoskeletal symptoms among women working in geriatric care.

BACKGROUND: Nursing is a stressful, physically demanding occupation and a rush setting for musculoskeletal problems. The aim of this study is to explore the extent of the association between psychosocial work characteristics and musculoskeletal symptoms among women working in geriatric care. METHODS: The participants were female employees of all geriatric nursing homes and geriatric hospital wards in Iceland having a staff of 10 or more. A total of 1,886 questionnaires were distributed. The response rate was 80%. RESULTS: Finding the job mentally difficult, mental exhaustion after one's shift, dissatisfaction with supervisors or the flow of information, insufficient influence at work, dissatisfaction with the hierarchy, intense time pressure, lack of solidarity, dissatisfaction with the job, harassment, violence or threats at work; all of the aforementioned gave crude odds ratios (OR) two or above for one or more musculoskeletal symptoms. Mental exhaustion and harassment, violence, and threats were the factors connected with symptoms from all the body regions studied. CONCLUSIONS: The extent of the association of work-related psychosocial factors and musculoskeletal symptoms among the geriatric female nursing staff is substantial and needs to be taken into account by occupational health services and others involved in preventive work. Am. J. Ind. Med. 44:679-684, 2003.