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.

Effects of the Labor Inspection Authority's regulatory tools on physician-certified sick leave and employee health in Norwegian home-care services - a cluster randomized controlled trial.

OBJECTIVE: This study aimed to determine the effects of the Labor Inspection Authority's regulatory tools on physician-certified sick leave and self-reported health outcomes among employees in municipal home-care services in Norway. METHODS: We conducted a cluster-randomized controlled trial in the home-care service sector, and 96 eligible municipalities were randomly assigned to one of three groups: (i) labor inspection visits, based on the Labor Inspection Authority's standard inspections; (ii) guidance-through-workshops, where participants from home-care services met with labor inspectors to receive information and discuss relevant topics; and (iii) the control group. Data on employee self-reported health (N=1669) were collected at baseline and 6 and 12 months after the interventions. Additionally, registry data (N=1202) on diagnosis specific physician-certified sick leave were collected for 18 months after the interventions. RESULTS: We found no statistically significant effects of either intervention on self-reported health outcomes. There was, for both interventions, a pattern of decrease in days and periods of physician-certified sick leave due to musculoskeletal diagnoses and increase in days and periods of physician-certified sick leave due to psychological diagnoses, but these were not statistically significant. CONCLUSION: Labor inspections and guidance-through-workshops had no statistically significant effect on self-reported health and physician-certified sick leave. The results should be interpreted with caution given the low response rate and subsequent attrition, and in the context of the COVID-19 pandemic. Future studies, in various industries, should further elucidate whether regulatory tools influence employee health and sick leave due to musculoskeletal and mental disorders.

The contribution of office design to the appraisal of job control: A longitudinal study.

The appraisal of control over work intensity and decisions at the workplace is a well-established determinant of health and well-being among employees. Building on job design theories, the overarching aim of this study was to determine office layout as a predictor of perceived job control. Specifically, we investigated between-group differences in control by contrasting employees in cellular offices with employees in shared/open offices, as well as effects on control among employees transitioning from one office design to another. This is a longitudinal study with three survey points across 48 months comprising 3,415 Norwegian office employees. Data were analyzed with latent growth curve analyses, adjusted for gender, age, leadership responsibility, and teleworking. Employees in cellular offices reported significantly higher control over work intensity and control over decisions when compared with employees in shared/open workspaces. Transitioning from a shared/open workspace to a cellular office led to a significant increase in perceived control regarding work intensity. As the experience of control may buffer the negative impact of job demands, organizations that rely on shared or open office solutions may benefit from identifying tools that can contribute to enhancing their employees' perceived control.

"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.

Do regulatory tools instigate measures to prevent work-related psychosocial and ergonomic risk factors? A process evaluation of a Labour inspection authority trial in the Norwegian home-care services.

OBJECTIVE: There is a research gap regarding the way managers and employee representatives respond to Labour Authority interventions targeting work-related psychosocial and ergonomic risk factors. The present study aimed to determine if (I) labour inspections and (II) guidance-through-workshops led by inspectors were perceived by the target audience as equally useful and educational; and to determine if utility and enhanced knowledge were associated with the implementation of measures to prevent work-related risk factors. Finally, it aimed to determine if the managers in the intervention groups to a greater extent than the controls reported implementing such measures. RESULTS: Managers and employee representatives in both intervention groups reported a high level of perceived utility as well as a high level of enhanced knowledge. Both utility (p < 0.05) and enhanced knowledge (p < 0.05) were significantly associated with the implementation of, or plans to soon implement, measures to improve working conditions. When compared to controls, implemented measures, or plans to implement measures, were reported significantly more frequently by managers in the inspection group (p < 0.05). Trial Registration ClinicalTrials.gov ID: NCT03855163 Registered on February 26, 2019.

Effects of the Labour Inspectorate Authority's regulatory tools on psychosocial and biomechanical work factors in Norwegian home care services: a cluster randomised controlled trial.

OBJECTIVES: This study aimed to determine the effects of the Labour Inspectorate Authority's (LIA's) regulatory tools on psychosocial and biomechanical work factors in the Norwegian municipal home care services. METHODS: A cluster-randomised controlled trial conducted in the home care services with employee questionnaire data on work factors at baseline, and 6 and 12 months after the interventions. In total, 96 eligible municipalities were randomly assigned to either the control group or one of two interventions: (1) labour inspection visits, based on the LIA's standard inspections; and (2) guidance-through-workshops, where the participating services highlighted issues and trained labour inspectors provided guidance based on existing labour laws and regulations. RESULTS: No favourable intervention effect was observed for the inspection intervention. No effects were observed for most of the variables in the guidance intervention, although an effect was observed for the following psychosocial factors: decision control, control over work intensity and empowering leadership. However, after adjusting for multiple testing, none of the observed effects were statistically significant. CONCLUSION: Labour inspections did not affect psychosocial and biomechanical work factors in the home care services. A favourable effect of the guidance intervention on psychosocial work factors was observed. However, this was not evident after adjusting for multiple testing. Further research is needed to elaborate on how labour inspections and other regulatory tools can impact psychosocial and biomechanical work factors. TRIAL REGISTRATION NUMBER: NCT03855163.

An Exploratory Study on the Physical Activity Health Paradox-Musculoskeletal Pain and Cardiovascular Load during Work and Leisure in Construction and Healthcare Workers.

Using a novel approach, this exploratory study investigated whether the physical activity (PA) paradox extends to cardiovascular load and musculoskeletal pain. At baseline, 1-2 days of 24 h heart rate was assessed in 72 workers from construction and healthcare. Workers then reported pain intensity in 9 body regions (scale 0-3) every 6 months for two years. The 2 year average of musculoskeletal pain (sum of 9 pain scores; scale 0-27) was regressed on time spent during work and leisure above three thresholds of percentage heart rate reserve (%HRR), i.e., ≥20 %HRR, ≥30 %HRR, and ≥40 %HRR, using a novel ilr structure in compositional data analysis. Analyses were stratified for several important variables. Workers spending more time in physical activity at work had higher pain, while workers with more time in physical activity during leisure had less pain (i.e., the PA paradox), but none of the associations were statistically significant. Higher aerobic capacity and lower body mass index lowered the pain score among those with higher physical activity at work. This exploratory study suggests that the PA paradox may apply to musculoskeletal pain and future studies with larger sample sizes and additional exposure analyses are needed to explain why this occurs.

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.

The Impact of a Workplace Terrorist Attack on the Psychosocial Work Environment: A Longitudinal Study From Pre- to Post-disaster.

The psychosocial work environment is of great importance for regaining health and productivity after a workplace disaster. Still, there is a lack of knowledge about the impact of a disaster on the psychosocial work environment. The purpose of this study was to examine whether employees' perceptions of role clarity, role conflicts, and predictability in their work situation changed from before to after a workplace terrorist attack. We combined data from two prospective work environment surveys of employees in three governmental ministries that were the target of the 2011 Oslo terrorist attack. A first two-wave survey was conducted 4-5 years and 2-3 years before the attack, and a second three-wave survey took place 10 months, 2 years, and 3 years after the attack. Of 504 individuals who were employed at the time of the bombing, 220 were employed in both pre- and post-disaster periods, participated in both the first and the second survey, and consented to the linking of data from the two surveys. We found no significant changes in levels of role clarity, role conflict, and predictability from before to after the terrorist attack. Adjusting for sex, age and education had no effect on the results. The findings suggest that perceptions of the psychosocial working environment are likely to be maintained at previous levels in the aftermath of a workplace disaster. Considering the importance of the psychosocial work environment for regaining health and productivity, the findings are important for the preparation for, and management of, future crises.

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.

Do intensity of pain alone or combined with pain duration best reflect clinical signs in the neck, shoulder and upper limb?

OBJECTIVES: It is important to validate self-reported musculoskeletal pain used in epidemiological studies for evaluation of pain outcome measures. The main objective of this paper was to assess the association between self-reported neck/shoulder/upper limb pain and clinical signs of disorders in the region, especially by comparing a measure that only used pain intensity with a measure that combined pain intensity and pain duration. METHODS: Four hundred and twenty technical school students of both genders were included with a median age of 17 years (16-28). The students stated the pain in four intensity grades and the pain duration in four period lengths within the preceding four weeks period. A pain severity index was calculated by multiplying the pain intensity (0-3) and the duration (1-4). A clinical examination was performed within a week after completing the form. The associations were evaluated by agreement, correlation and symmetric strength of association (contingency). RESULTS: The study found low correlation and low positive agreement for neck/shoulder and upper limb pain related to clinical signs of disorders in the region. However, the relationship showed high negative agreement and high contingency. The negative agreement increased for the neck/shoulder region with higher cut-off points for dichotomization, but not for the upper limb region. The index combining reports of pain intensity with pain duration, do not improve agreement, correlation or contingency with clinical signs compared to use of pain intensity alone. CONCLUSIONS: This study showed an association between self-reported neck/shoulder/upper limb pain intensity and clinical signs of musculoskeletal disorders of the region. An index combining pain intensity and duration (Pain Severity Index) did not increase this association. From the results we suggest using pain intensity reports alone and if dichotomizing is wanted, choosing a cut-off point at high pain levels, especially for neck and shoulder pain.

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.

The Influence of Affective State on Subjective-Report Measurements: Evidence From Experimental Manipulations of Mood.

A substantial portion of the knowledge base of psychology is based on subjective reports with a risk of information bias. The objective of the present study was to elucidate one contextual source of variance and potential bias in subjective reports: the influence of affective state at the time of responding to questionnaires. Employees (N = 67, abstaining from stimulants and activities that may influence emotional and physiological state) were subjected to mood-induction procedures in the laboratory. Neutral, positive, and negative moods were induced by combinations of pictures from the international affective picture set (IAPS) and music. The subjects responded to questions on visual analog scales (VAS) in order to optimize sensitivity and attenuate short-term memory effects. Most subjects exhibited significant affective-state inductions with no change in arousal. The analyses took affective response to the manipulation into account. Only four of 20 questions were somewhat influenced by induced affective state: job overload, social support from co-workers, satisfaction with getting to develop personally, and an item measuring agreeableness. In general, responding to questions of work that were phrased for valence was little or insignificantly influenced by induced affective state.

Associations of objectively measured total duration and maximum bout length of standing at work with lower-extremity pain intensity: a 2-year follow-up of construction and healthcare workers.

BACKGROUND: Musculoskeletal disorders are among the major reasons for years lived with disability. Approximately one third of the European working population report lower-extremity discomfort and many attribute these discomforts to work-related factors. Employees in the healthcare and construction sectors reports high levels of lower-extremity pain and commonly relate the pain to their profession. These workers spend a large part of their workday standing. Periods of prolonged standing is suggested to increase lower-extremity symptoms, but this cannot be concluded on, since limited evidence is available from longitudinal studies using objective measures. This study aimed to determine possible associations between objectively measured total duration and maximum bout length of static- and dynamic standing at work and lower-extremity pain intensity (LEPi) among Norwegian construction- and healthcare workers. METHODS: One-hundred and twenty-three construction and healthcare workers wore two accelerometers for up to four consecutive days, to establish standing behavior at baseline. The participants reported LEPi (Likert scale 0-9) for the preceding 4 weeks at baseline and after 6, 12, 18, and 24 months. We investigated associations between standing at work and average and change in LEPi using linear mixed models with significance level p ≤ 0.05. RESULTS: Total duration of static- and dynamic standing showed weak associations with average LEPi, for the total sample and for construction workers. Maximum bout of static- and dynamic standing was associated with average LEPi in construction workers, but not in healthcare workers. Furthermore, we found no associations between standing and change in LEPi over the 2-year follow-up in any of our analyses. CONCLUSIONS: This study indicate that objectively measured standing is associated with average LEPi over 2-years follow-up in construction workers, and that maximal bout of standing have a stronger association to LEPi than total duration. For every 10 min added to the maximal length of continuous standing during an average workday, we found approximately one unit increase in pain on a 0-9 scale. The lack of significant findings in analyses on healthcare workers suggest that the association between standing and LEPi depend on work-tasks, gender and/or other sector-specific factors.

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.

Office design as a risk factor for disability retirement: A prospective registry study of Norwegian employees.

Objectives This aim of this study was to (i) examine differences in risk of subsequent disability retirement between employees working in cellular, shared, and open-plan offices and (ii) determine the contribution of gender, skill-level, work ability, medically certified sickness absence, leadership position, and personality traits (extroversion, agreeableness, conscientiousness, neuroticism, and openness) as confounders. Methods Survey data on predictor variables combined with official objective registry data on disability retirement and sickness absence were extracted from a large Norwegian occupational cohort of office workers (N=6779, 53.5% women). Questionnaire data included the respondents' office designs, comparing cellular, shared, and open-plan offices, demographic characteristics, workability, and personality factors. Objective data on disability retirement and medically certified sickness absence were extracted from the sickness and disability benefit register of the Norwegian Labor and Welfare Administration. Results In the final fully adjusted model, employees working in shared [hazard rato (HR) 1.52, 95% confidence interval (CI) 1.08-2.16] and open-plan (HR 1.95, 95% CI 1.31-2.90) offices had significantly higher risk of subsequent disability retirement compared to employees in cellular offices. Gender, work ability, medically certified sickness absence, and conscientiousness had independent direct effects on risk of disability retirement. Conclusion This study shows that open and shared workspace designs have detrimental effects by increasing risk of disability retirement among office workers, even when taking other known predictive factors into account.

Can a metric combining arm elevation and trapezius muscle activity predict neck/shoulder pain? A prospective cohort study in construction and healthcare.

OBJECTIVE: To determine whether a composite metric of arm elevation and trapezius activity (i.e. neck/shoulder load) is more strongly associated with the 2-year course of neck and shoulder pain intensity (NSPi) among construction and healthcare workers than each exposure separately. METHODS: Dominant arm elevation and upper trapezius muscle activity were estimated in construction and healthcare employees (n = 118) at baseline, using accelerometry and normalized surface electromyography (%MVE), respectively. At baseline and every 6 months for 2 years, workers reported NSPi (score 0-3). Compositions of working time were determined for arm elevation (< 30°; 30-60°; > 60°), trapezius activity (< 0.5%; 0.5-7.0%; > 7.0%MVE), and a composite metric "neck/shoulder load" (restitution, low, medium, and high load). Associations between each of these three compositions and the 2-year course of NSPi were determined using linear mixed models. RESULTS: Associations between exposure compositions and the course of NSPi were all weak and in general uncertain. Time spent in 0.5-7.0%MVE showed the largest and most certain association with changes in NSPi during follow-up (ß = - 0.13; p = 0.037; corresponding to a -0.01 change in NPSi every 6 months). Among pain-free workers at baseline, medium (ß = - 0.23; p = 0.039) and high (ß = 0.15; p = 0.031) neck/shoulder load contributed the most to explaining changes in NSPi. CONCLUSION: The composite metric of neck/shoulder load did not show a stronger association with the course of NSPi than arm elevation or trapezius activity alone in the entire population, while some indications of a stronger association were found among those who were pain-free at baseline.

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.

Effects of exposure to workplace terrorism on subsequent doctor certified sickness absence, and the modifying role of psychological and social work factors: a combined survey and register study.

BACKGROUND: Studies have shown that terrorist attacks affect the mental and physical health of persons exposed to terrorism. When terror strikes at the workplace where people spend much time, and should feel safe, the health consequences for those affected might be severe. The aim of the study was to determine whether psychological and social work factors moderates effects of exposure to a workplace terrorist attack on subsequent doctor-certified sickness absence. METHODS: The study design combined survey data with register data on sickness absence. Data on exposure to the attack, and psychosocial working conditions were collected by a web-based questionnaire 10 months after the attack. Survey data was linked to registry data on doctor-certified sickness absence over the one-year time period following baseline. The survey response rate was 56% (n = 1974), where 80.6% (1591) gave consent to link survey data to data on sickness absence. Exposure to the attack was assessed as "Directly-", or "Indirectly exposed". Psychological and social work factors were measured by the General Questionnaire for Psychological and Social factors at Work (QPSNordic). Data were analyzed with negative binominal hurdle regressions. RESULTS: Direct exposure to the attack increased the odds of becoming sick-listed if role clarity was average (OR = 1.50) or high (OR = 2.13), but not if low (OR = 1.17). Direct exposure was associated with higher sickness absence rates if control over work pace was low (RR = 1.61). Role conflict, support from co-workers, and -superior showed weaker evidence of moderating effects of exposure on sickness absence. CONCLUSIONS: Exposure to the bomb explosion, as well as psychosocial working conditions affect the risk of employee sickness absence. Psychosocial working conditions seems to moderate effects of exposure to workplace terrorism on subsequent sickness absence. Organizations would benefit from striving for good psychological and social working conditions both as preventions against illness and sickness absence, and as measures in the aftermath of a workplace terrorist attack.

How leadership behaviors influence the effects of job predictability and perceived employability on employee mental health - a multilevel, prospective study.

Objectives This study aimed to elucidate the potential moderating effect of fair-, empowering-, and supportive-leadership behaviors on the relationship between job predictability, future employability, and subsequent clinically relevant mental distress. Method The study had a full panel, prospective design, utilizing online, self-administered questionnaire data collected at two time points, two years apart. Fair-, empowering-, and supportive-leadership behaviors, job predictability and future employability were measured by the General Nordic Questionnaire for Psychological and Social Factors at Work (QPSNordic). Mental health was measured using the 10-item Hopkins Symptom Checklist (HSCL-10), with cut-off set to >1.85 to identify clinically relevant cases. As data were nested within work units, a multilevel analytic approach was chosen. Results Individual-level direct effects: (i) higher levels of job predictability [odds ratio (OR) 0.83, 95% confidence interval (CI) 0.70-0.98], (ii) future employability (OR 0.83, 95% CI 0.74-0.93), (iii) fair- (OR 0.78, 95% CI 0.68-0.91), empowering- (OR 0.77, 95% CI 0.67-0.87), and supportive- (OR 0.71, 95% CI 0.61-0.81) leadership behavior, and (iv) the combination "quality of leadership" (OR 0.69, 95% CI 0.59-0.81) were significantly associated with a lower risk of reporting subsequent mental distress. Work-unit level direct effects: higher work-unit levels of fair- (OR 0.52, 95% CI 0.34-0.80) and empowering- (OR 0.61, 95% CI 0.40-0.94) leadership behaviors and quality of leadership (OR 0.54, 95% CI 0.34-0.87) were significantly associated with a lowered risk of subsequent mental distress. Cross-level interactions: No cross-level interaction effects were shown. Conclusions Leadership behaviors did not moderate the effects of job predictability and future employability on mental health. However, employees embedded within work-units characterized by fair, empowering and supportive leadership behaviors had a lower risk of subsequent mental distress.