Is new tech a pain in the neck? The impact of introducing new technologies in home-care on neck pain: a prospective study.

BACKGROUND: Home healthcare services are increasingly utilizing novel technologies to enhance quality and efficiency of caregiving, to reduce workloads and compensate for expected labor shortages in the future due to ageing populations. However, rapid, ongoing implementation of new technologies may demand considerable adaptation for employees. The objective of this study was to prospectively examine associations of newly introduced work technologies with neck pain complaints. METHODS: With a nationally representative prospective sample of home-care workers in Norway (N = 887), we estimated effects of 1) introducing new technologies and 2) the appraised quality of training during implementation on neck pain eight months after. RESULTS: A majority of employees reported new technologies having been introduced the previous 12 months (73.8%). This was not by itself associated with neck pain. However, perceived high quality of training was associated with less subsequent neck pain, also after adjustment for job demands and job control. The strongest effect was seen for "very good" versus "very poor" quality training (OR 0.35, 95% CI 0.17,0.71, in the fully adjusted model). Cross-lagged path analyses ruled out potential reverse causation stemming from the influence of pain on needs for or appraisals of training. CONCLUSION: The present findings suggest the introduction of new work technologies has a significant impact on home-care workers' health, depending on the quality of training during implementation. This highlights the need to include training programs in risk assessments when implementing new technologies.

Pain, Conflicted Feelings About Work, and Sickness Absence: A Prospective Study of the Effects of Number of Pain Sites and Role Conflicts on Medically Certified Sickness Absence.

We investigated associations between the number of pain sites (NPS) and role conflict with medically certified, pain-related sickness absence (SA) in employees of Norwegian enterprises (N = 5,654). Latent profile analyses identified exposure profiles based on 3 types of role conflict (work-role conflict, work-life conflict, and emotional dissonance). Multinomial logistic regressions estimated effects on absence (short-term absence of less than 56 days, long-term absence of more than 56 days) during 1 year after survey. Effects of the NPS on absence were compared across exposure profiles. Results suggested the NPS and all types of role conflict predicted absences separately. Mutually adjusted regressions revealed unique contributions of the NPS to the short-term and long-term absence (odds ratio [OR] 1.24, 95% confidence interval [CI] 1.18, 1.30 and OR 1.51, 95% CI 1.37, 1.66) and of work-role conflict to the short-term absence (OR 1.18, 95% CI 1.03, 1.35). Latent profile analyses identified 4 exposure profiles ("1 unconflicted," "2 dissonant, otherwise medium," "3 conflicted, medium dissonance," "4 conflicted and dissonant"). Profiles 3 and 4 exhibited elevated risk of SA, with the strongest baseline-adjusted effects for profile 4 (short-term absence OR 1.90, 95% CI 1.40, 2.57, long-term absence OR 1.95, 95% CI 1.15, 3.31). Effects of the NPS on short-term absence were stronger for profile 4 versus profile 1 (OR 1.38 vs 1.24, P < .001). Our findings suggest that addressing role conflicts may prevent pain-related absence, possibly also for individuals already experiencing pain. PERSPECTIVE: This article elucidates the connections between role conflicts associated with work roles, the NPS, and SA due to pain. This should help organizations prevent pain-related absences from work and improve working conditions for workers who remain occupationally active in spite of pain problems.

Stress-induced headache in the general working population is moderated by the NRCAM rs2300043 genotype.

OBJECTIVES: Earlier findings suggest that social stress such as abusive supervision may promote pain. In the present study we examine the possible moderating role of genetic variability in the NRCAM gene in this process. METHODS: The data were collected through a national survey drawn from the National Central Employee Register by Statistics Norway. A total of 1,205 individuals returned both the questionnaire and the saliva kit. Abusive supervision was scored by a 5-item version of the Tepper's 2,000 scale. Headache was measured on a four-category scale; 'not bothered,' 'a little bothered,' 'considerably bothered', 'seriously bothered'. Genotyping with regards to NRCAM rs2300043 was carried out using Taqman assay. Ordinal logistic regression was used to analyse the data. RESULTS: For males exposed to abusive supervision, those carrying the rs2300043 CC genotype reported the highest levels of headache. Women showed a trend towards the opposite pattern. Women with the rs2300043 CC genotype seem to have a weaker effect of abusive supervision regarding reported headache than their male counterparts with the CC genotype when exposed to abusive supervision. CONCLUSIONS: The present results indicated that the association between abusive supervision and headache in men with the NRCAM rs2300043 C allele was stronger than in other men. This suggests that the NRCAM genotype in men is important for the tolerance of social stress e.g., repeated negative acts from a superior. In contrast, a trend, though non-significant, towards the opposite pattern was observed in women. Our result suggests that the NRCAM genotype in men manifestly affects stress-induced pain such as headache.

"I'm too old for this!": A prospective, multilevel study of job characteristics, age, and turnover intention.

Introduction: Deciding to leave a job is often foreshadowed by burgeoning job dissatisfaction, which is in turn often attributed to characteristics of the job and work environment. However, while we know that job characteristics influence job satisfaction, health, and motivation, their associations with turnover intention is less clear. Moreover, despite aging workforces, an understanding of how working conditions influence workers across the lifespan is lacking. Therefore, drawing on job design theories and bridging turnover- and aging research, we studied 15 specific job characteristics to determine whether they predicted turnover intentions, and whether the predictive value was modified by age. Methods: Data were collected from various public and private enterprises in Norway. Moderated multilevel regressions were conducted cross-sectionally (N = 12,485) and prospectively over 2 years (N = 5,504). Results: Most work factors were associated with turnover intention at both the individual and work unit levels. A social climate of support, trust, and encouragement was most strongly inversely associated with turnover intentions, while role conflict was most strongly positively associated with turnover intentions. Organizational climate, leadership styles, and job control were more important with age while job demands, predictability and role stressors were more important to younger workers. Ten individual level- and four work-unit level factors predicted turnover intentions prospectively, suggesting turnover intentions due to poor working conditions persisted in employees that did not quit. Discussion: Our results highlight several specific, modifiable job characteristics that are likely to affect turnover intentions, and the impact of certain factors specifically for older workers.

Mapping of pituitary stress-induced gene regulation connects Nrcam to negative emotions.

Environmental stressors such as repeated social defeat may initiate powerful activation of subconscious parts of the brain. Here, we examine the consequences of such stress (induced by resident-intruder paradigm) on the pituitary gland. In male stressed vs. control rats, by RNA- and bisulfite DNA sequencing, we found regulation of genes involved in neuron morphogenesis and communication. Among these, Neuronal cell adhesion molecule (Nrcam) showed reduced transcription and reduced DNA methylation in a region corresponding to intron 1 in human NRCAM. Also, genetic variability in this area was associated with altered stress response in male humans exposed to repeated social defeat in the form of abusive supervision. Thus, our data show that the pituitary gene expression may be affected by social stress and that genetic variability in NRCAM intron 1 region influences stress-induced negative emotions. We hope our shared datasets will facilitate further exploration of the motions triggered by social stressors.

The relationship between telework from home and the psychosocial work environment: a systematic review.

OBJECTIVE: Telework from home (TWFH) has become routine for many, yet research on how this may affect the psychosocial work environment is sparse. To understand the effects that TWFH may have on the psychosocial work environment, this systematic literature review identified, evaluated, and summarized findings on the association of TWFH with factors of the psychosocial work environment. METHODS: Searches were conducted in MEDLINE, Embase, Amed, PsycINFO, and PubMed. The topic of the study reflected TWFH, and subjects should be office workers employed at a company. Outcomes should reflect psychosocial work environment factors. Inclusion criteria stated that studies should be primary, quantitative, and published in a peer-reviewed journal. English language publications dating from January 2010 to February 2021 were included. Risk of bias was assessed using the Newcastle-Ottawa scale (NOS) and quality of overall evidence using Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS: Searches resulted in 3354 publications, and after screening rounds 43 peer-reviewed original studies satisfying predetermined inclusion and exclusion criteria were included. Fourteen individual psychosocial work environment outcome categories were studied. Limited overall evidence to support effects of TWFH on the included work environment outcomes, with evidence being rated either of low or very low quality. Flexibility and autonomy are discussed as potential mediating variables in the relationship between TWFH and the psychosocial work environment. CONCLUSION: There is a lack of high-quality research investigating effects of TWFH on the psychosocial work environment. To suggest TWFH guidelines or recommendations, there is a need for research with high-quality longitudinal designs, precise measures of time use and location of work, and validated measures of factors known to be of importance. PROSPERO registration number CRD42021233796.

The relationship between telework from home and employee health: a systematic review.

BACKGROUND: Globalization and technological progress have made telework arrangements such as telework from home (TWFH) well-established in modern economies. TWFH was rapidly and widely implemented to reduce virus spread during the Coronavirus disease (COVID-19) pandemic, and will probably be widespread also post-pandemic. How such work arrangements affect employee health is largely unknown. Main objective of this review was to assess the evidence on the relationship between TWFH and employee health. METHODS: We conducted electronic searches in MEDLINE, Embase, Amed, PsycINFO, PubMed, and Scopus for peer-reviewed, original research with quantitative design published from January 2010 to February 2021. Our aim was to assess the evidence for associations between TWFH and health-related outcomes in employed office workers. Risk of bias in each study was evaluated by the Newcastle-Ottawa Scale and the collected body of evidence was evaluated using the the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS: We included 14 relevant studies (22,919 participants) reporting on 28 outcomes, which were sorted into six outcome categories (general health, pain, well-being, stress, exhaustion & burnout, and satisfaction with overall life & leisure). Few studies, with many having suboptimal designs and/or other methodological issues, investigating a limited number of outcomes, resulted in the body of evidence for the detected outcome categories being GRADED either as low or very low. CONCLUSIONS: The consisting evidence on the relationship between TWFH and employee health is scarce. The non-existence of studies on many relevant and important health outcomes indicates a vast knowledge gap that is crucial to fill when determining how to implement TWFH in the future working life. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO registration ID # CRD42021233796 .

Working at home and expectations of being available: effects on perceived work environment, turnover intentions, and health.

OBJECTIVES: The aim of this study was to determine if (i) working at home and (ii) expectations of being available to the employer in their spare time influences employees' perceptions of their work environment and well-being, health, organizational commitment, or intention to leave. METHODS: We conducted cross-sectional analyses of survey data from 7861 office workers reporting hours worked at home and 3146 reporting frequency of expectations of being available to the employer in spare time (availability expectations). Prospective analyses (two-year follow up) comprised 5258 and 2082, respectively. Dependent variables were work factors previously associated with health complaints, mental distress, positive affect, work-private life conflict, commitment, and intention to leave. Random intercept linear and logistic regressions controlled for time worked (in addition to regular hours), age, gender, and skill level. RESULTS: "Hours working at home" was cross-sectionally associated with higher levels of demands, role ambiguity, role conflicts, decision control, empowering leadership, human resource primacy, commitment, work-private life conflict, and lower support from co-workers. "Availability expectations" was associated with higher levels of demands, role conflicts, neck pain, mental distress, thinking that work was not finished when going to bed, sleep problems, work-private life conflict, intentions to leave and with lower levels of superior support, co-worker support, fair leadership, and commitment. There were no prospective associations. CONCLUSIONS: Working at home was associated with both positive and negative factors. Specific factors pertaining to role expectations and support from co-workers pose challenges. Availability expectations was associated with potentially negative work factors and health, organizational commitment, and intentions to leave. There were no long-term effects.

Patterns of pain complaints and insomnia symptoms are associated with abusive supervision in the Norwegian working population: a latent class analysis.

OBJECTIVES: Previous findings suggest that abusive supervision, i.e., subordinates' perceptions of their supervisor's behaviours as hostile (excluding physical aggression), may increase the risk of health complaints. In addition, recent data suggest that the FKBP5 genotype rs9470080 important in the regulation of cortisol release, influences the same outcome. Adding to this complexity, different health complaints often co-occur. The present study aimed to (1) uncover patterns of pain complaints and insomnia symptoms by using latent class analysis, (2) determine whether abusive supervision or FKBP5 rs9470080 was associated with these patterns, and (3) examine the interaction between abusive supervision and FKBP5 genotype regarding pain and insomnia symptoms. METHODS: The data was collected through a national probability survey of 5,000 employees drawn from the National Central Employee Register by Statistics Norway. Abusive supervision was measured by a 5-item version of the Tepper's 2000 scale. Pain and insomnia symptoms were measured by 5 items reflecting pain and 3 items reflecting insomnia. The FKBP5 rs9470080 genotyping was carried out using TaqMan assay. RESULTS: A total of 1,226 participants returned the questionnaire and the saliva kit sample. Based on these the latent class analyses revealed four classes based on response patterns of pain and insomnia symptoms. In the regression analysis, abusive supervision was a significant predictor for the response patterns. However, neither the FKBP5 nor the interaction between abusive supervision and FKBP5 showed significant contributions. CONCLUSIONS: In conclusion, awareness of the association between abusive supervision and the revealed four pain- and insomnia subgroups, and what separates them, may be important for prognosis and an optimal follow-up for those affected.

Spinal pain in employees exposed to abusive supervision: Evidence of a sex and CRHR1 CTC haplotype interaction.

Previous findings suggest that exposure to social stress in the form of abusive supervision may increase the risk of musculoskeletal disorders. In the present study, we examined the link between abusive supervision, the CRHR1 genotype and spinal pain. The data were collected through a national survey drawn from the National Central Employee Register by Statistics Norway. A total of 1226 individuals returned both the questionnaire and the saliva kit. Abusive supervision was measured by a 5-item version of the Tepper's 2000 scale. Spinal pain was measured by 3 items (neck-, upper and low back pain). Genotyping with regard to CRHR1 rs242941, rs242939 and rs1876828 was carried out using Taqman assay, and Phase v.2.1.1 was used to define the CRHR1 allele combinations. The analyses revealed that abusive supervision was associated with spinal pain. In particular, we observed a strong effect of abusive supervision on spinal pain in female +CTC/+CTC carriers (p = 0.002). Moreover, using +CTC/+CTC as a reference, +CTC/-CTC and -CTC/-CTC both showed protective effects (p = 0.024, p = 0.002, respectively). Also, our data demonstrated a clear sex and CRHR1 CTC haplotype interaction (p = 0.013). No such gene-environment interaction was seen in men. Our data demonstrated that the CRHR1 CTC haplotype may exacerbate the effect of abusive supervision on spinal pain in female employees. Hence, the present study supports the theory that both gender and the CRHR1 genotype, may moderate the pain responses to social stressors.

Working at home and alcohol use.

Working at home has become a frequent work arrangement following the COVID-19 pandemic. However, little is known about how working at home influence alcohol use among employees. This study examines associations between working at home at least 15 h per week and alcohol consumption using data from a pre-COVID-19 sample. Self-reported questionnaire data on working at home and alcohol use from a large cross-sectional sample of Norwegian employees (N = 14,728). Data were collected between 2004 and 2019 and were analyzed by ordinal logistic regressions. Working at home for >15 h per week was significantly associated with alcohol use (OR 1.67, 95% CI: 1.30 - 2.16). The association remained significant after adjusting for age, gender, leadership position, and educational level. Working at home may facilitate alcohol use that otherwise would not happen. Organizations must ensure that policies and procedures are in place to prevent alcohol use during working hours among employees working at home.

Safety incidents associated with extended working hours. A systematic review and meta-analysis.

OBJECTIVE: We performed a systematic review to assess potential consequences of extended working hours on accidents, near-accidents, safety incidents and injuries (incidents) by considering the overall certainty of evidence. METHODS: We searched five databases systematically (Medline, Embase, PsycINFO, Web of Science, and Proquest Health and safety Science Abstract) and identified 10072 studies published until December 2020. Twenty-two studies met the inclusion criteria. We followed a systematic approach to evaluate risk of bias and synthesize results in a meta-analysis. The certainty of evidence was determined by a modified version of The Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS: Our analyses indicated an association between working >12 hours/day (RR: 1.24, 95%CI: 1.11, 1.40), or working >55 hours/week (RR: 1.24, 95%CI: 0.98, 1.57), and elevated risk of incidents. The certainty of evidence evaluated as low. Weak or no associations were observed for other exposure contrasts: working >8 hours/day (RR: 0.93, 95%CI: 0.72, 1.19), or working overtime (RR: 1.08, 95%CI: 0.75, 1.55), working 41-48 hours/week (RR: 1.02, 95%CI: 0.92, 1.13) or 49-54 hours/week (RR: 1.02, 95%CI: 0.97, 1.07). The certainty of evidence was evaluated as low (very low for 41-48 hours/week). CONCLUSIONS: Daily working hours >12 hours and weekly working hours exceeding 55 hours was associated and increased risk of incidents. The level of evidence was low. Hence, further high-quality research is warranted to elucidate these associations.

Shift work, low-grade inflammation, and chronic pain: a 7-year prospective study.

OBJECTIVES: We investigated prospective associations of shift work with chronic pain and C-reactive protein (CRP), an indicator of inflammation. Furthermore, we elucidated CRP as a possible mediator and/or moderator of effects of shift work on pain. METHODS: Data from a 7 years follow-up study were analyzed (N = 2323). Shift work and chronic pain of "neck/shoulder", "arm/hand", "upper back", "low back", "hip/leg/feet", and "other regions" were measured by questionnaires. "Chronic widespread pain", "number of chronic pain sites", and "any chronic pain" were computed. CRP was measured in serum samples. Logistic and Poisson regressions were conducted. Mediation was assessed by casual mediation analyses and moderation by the Relative Excess Risk due to Interaction (RERI). RESULTS: Shift work was not associated with any chronic pain variable and no mediation was detected. CRP was associated with low back pain, hip/leg pain, and "number of pain sites", and also with the combination of shift work and CRP of 1-2.99 mg/L (compared to: no shiftwork and CRP < 1). Additionally, shiftwork and CRP 1-2.99 mg/L was associated with risk of "any chronic pain" (OR: 1.76, 95% CI: 1.12, 2.85), which was not associated with CRP alone. Moderation analyses suggested the risks for "any chronic pain" and "number of pain regions" increased when individuals with elevated CRP worked shifts-beyond what the separate effects of CRP and shift would suggest. CONCLUSIONS: We found no evidence of shift work in general affecting CRP or chronic pain. However, shift work and elevated CRP combined may influence chronic pain.

Adverse social behaviour at the workplace and subsequent physician certified sick leave: a three-wave prospective study of the general working population in Norway.

OBJECTIVES: We aimed to provide an integrated picture of the relationship between different facets of adverse social behaviour (ASB) at the workplace and sick leave. METHODS: Data from a randomly drawn prospective cohort of the general working population. Eligible respondents were interviewed in 2009, 2013 or 2016, and were registered with an employee relationship of at least 50 working days in the national register the year following the survey interviews (n=21 674 observations/13 470 respondents). We investigated the prospective associations of self-reported exposure to ASB, including threats/acts of violence, bullying and sexual harassment, with physician-certified sick leave of 1-16 days (ie, low level of sick leave (LLSL)) and >16 days (ie, high level of sick leave (HLSL)) by means of mixed effects logistic regression. RESULTS: The prevalence of sick leave was 18.4% (n=3986 observations) for LLSL and 16.1% (n=3492 observations) for HLSL. The different facets of ASB were independently associated with higher odds of sick leave, with stronger associations for HLSL than for LLSL. Adjusted for sex, age, education level, occupation, previous sickness absence level, OR (95% CI) for HLSL was 1.97 (1.61 to 2.35) for threats/acts of violence, 1.97 (1.53 to 2.54) for bullying and 1.41 (1.10 to 1.79) for sexual harassment. The population risks of LLSL and HLSL attributable to ASB were 5.27 (95% CI 1.85 to 8.81) and 8.27% (95% CI 4.01 to 12.48), respectively. CONCLUSIONS: Threats/acts of violence, bullying and sexual harassment were all independent predictors of sick leave, with threats/acts of violence appearing as the single most important factor.

Psychometric properties and validation of the Brief NORSCI safety perceptions and climate inventory in the Norwegian waste management industry.

A valid, standardized tool for assessing workplace safety can help organizations and employers to detect potential safety risks. This is crucial to improve safety and protect employees and production against accidents and injuries. As no such tool has so far been developed for the waste management industry, this study aimed to establish the psychometric properties and the concurrent validity of the 11-item Brief Norwegian Safety Climate Inventory (Brief NORSCI). A cross-sectional questionnaire study was conducted with 543 workers from the formal Norwegian waste management industry. Exploratory and confirmatory factor analyses showed that the Brief NORSCI exhibited good psychometric properties. Replicating previous validation studies of the inventory, the findings suggested a three-factor structure reflecting Individual intention and motivation, Management's prioritization of safety, and Safety routines. The three first-order factors of the inventory could be combined in a composite second-order safety climate factor. Both the overall composite score and the three subscales correlated in the expected directions with measures of job characteristics (i.e., job demands and resources), leadership, social climate, and severe accidents, thus indicating high concurrent validity. This study supported the validity and reliability of the Brief NORSCI as an assessment tool to measure both individual safety perceptions and group level safety climate among waste management workers. The findings suggest that application of the Brief NORSCI as a safety assessment tool may contribute to the development of a stronger safety profile among organizations and companies in waste management.

Leadership Style, Headache, and Neck Pain: The Moderating Role of the Catechol-O-Methyltransferase (COMT) Genotype.

OBJECTIVE: Leadership styles can influence subordinates' health. We investigated how the gene encoding the Catechol-O-Methyltransferase (COMT) enzyme (ie, COMT rs4680 Val158Met) influenced effects of abusive supervision and transformational leadership on subordinates' headache and neck pain. METHODS: Multiple group structural equation modeling (SEM) was employed to test associations of leadership with subordinates' pain 6 months after in a representative sample of the Norwegian working population (n = 996). Genotyping was performed by TaqMan technology. RESULTS: Abusive supervision was associated with increased risk, and transformational leadership with decreased risk, of headache and neck pain. Both leadership styles exhibited more pronounced effects in individuals with the Met/Met genotype. CONCLUSION: Met/Met employees were relatively vulnerable to adversity, but also relatively responsive to constructive leadership. Many workers may benefit more from constructive leadership than population-averaged associations might suggest.

The influence of age, gender and the FKBP5 genotype on subjective health complaints in the Norwegian working population.

OBJECTIVE: In the present study we examined the potential association between age, gender, the genetic variant FKBP5 rs9470080 and subjective health complaints. METHODS: The data were collected through a three-wave nationally representative survey of 1060 Norwegian employees drawn from the Norwegian Central Employee Register by Statistics Norway. The follow-up period was six months. Subjective health complaints were scored by eight items reflecting; headache, neck pain, mid- and low back pain, stomach cramps or intestinal discomfort, problems with sleep onset or maintenance and early morning awakening. Genotyping with regard to FKBP5 rs9470080, previously linked to cortisol sensitivity, was carried out using Taqman assay. RESULTS: The baseline data showed that in women, levels of subjective health complaints were highest among those above 50 years of age. Moreover, in women the rs9470080 CC variant at baseline was associated with higher levels of subjective health complaints. However, the effect size was not large, and no relationships were demonstrated between age or genotype and subjective health complaints in men. Also, the study variables were not related to any changes in the levels of subjective health complaints during the follow-up period. CONCLUSION: We conclude that our biology such as age and sex, but also single genetic variants found in non-sex chromosomes, may be important in understanding the mechanisms underlying subjective health complaints in the general working population.

Pain complaints after consecutive nights and quick returns in Norwegian nurses working three-shift rotation: an observational study.

OBJECTIVES: To determine whether nurses working consecutive night shifts, or short transitions between shifts (quick returns (QRs)), yielded higher risk for pain complaints when compared with regular morning shifts. Sleep duration was tested as a potential mediator. DESIGN: Observational diary study. SETTING: Random hospitals. PARTICIPANTS: Nurses with three-shift rotation (morning, evening and night), n=679, 22-63 years old. OUTCOMES MEASURES: Daily ratings of working hours, sleep and subjective pain complaints in six anatomical regions (head, neck/shoulder/upper back, upper extremity, low back, lower extremity and abdomen) for 28 days. In addition, we assessed demographics, habitual sleep and pain complaints, work and lifestyle factors. It was tested (1) whether the risk for pain complaints was higher after workday 3 versus after workday 2, and whether the difference was larger for consecutive night shifts versus consecutive morning shifts, and (2) whether the risk for pain complaints was higher after QRs versus after two morning shifts. Risk for pain complaints refers to combined increased risk for any pain and risk for increased intensity. RESULTS: Adjusted analyses showed no shift type by workday interaction for pain complaints in the neck/shoulder/upper back, upper extremities, low back, lower extremities or abdomen. For headache, a strong trend indicated that the risk was higher on workday 3 compared with workday 2 for night shifts (OR 1.13, 95% CI 0.99 to 1.28). The risk was lowered if sleep duration was taken into account (OR 0.37, 95% CI 0.17 to 0.81). No conclusive support was found for the risk for pain complaints being higher after QRs, compared with after morning shifts. CONCLUSIONS: For five of six pain complaints, the hypotheses were not supported by the current data. For headache, we found potential support for a sleep-relieving effect on headache after working several nights in a row. Pain complaints were not instigated or exacerbated by an evening-to-morning transition between shifts.

Organizational Prevention and Management Strategies for Workplace Aggression Among Child Protection Workers: A Project Protocol for the Oslo Workplace Aggression Survey (OWAS).

BACKGROUND: Previous research has established exposure to workplace aggression as a significant risk factor for employee functioning, well-being, and health. However, less is known about effective prevention and management strategies. The main objectives of the current project were to determine the impact of physical and psychological aggression on the well-being, health, and work ability of employees in the child welfare service and to establish whether a strong psychosocial safety climate and an ethical infrastructure are effective with regard to protecting employees against aggression. This project may help identify the specific risks child welfare workers are exposed to, the impact of workplace aggression on their health and well-being, and the most effective strategies to manage the problem. Furthermore, the findings should be central for developing laws and regulations and to any political decision on measures to tackle aggression in the workplace. METHODS: The study will employ two prospective data collections. Firstly, a three-wave longitudinal survey with a 6-month time lag between measurement points will be conducted among all 1,500 employees in the child welfare services in Oslo Municipality, Norway. Data will have a multilevel structure and will be linked to registry data on sickness absence. Secondly, a quantitative daily diary study over a 14-day period will include 150 of the respondents from the main survey study. The survey questionnaires mainly comprise well-established and psychometrically validated indicators of workplace aggression, health and well-being, psychosocial safety climate, ethical infrastructure, and other relevant factors. The Regional Committees for Medical and Health Research Ethics (REC) in Norway (REC South East) have approved this project (project no. 28496). DISCUSSION: This project will identify the impact of workplace aggression on child protection workers as well as provide information on how organizations can actively manage exposure to workplace aggression. The findings may serve as a starting point for intervention studies as well as the development of policies and guidelines on how to handle workplace aggression.