Long working hours and cancer risk: a multi-cohort study.

BACKGROUND: Working longer than the maximum recommended hours is associated with an increased risk of cardiovascular disease, but the relationship of excess working hours with incident cancer is unclear. METHODS: This multi-cohort study examined the association between working hours and cancer risk in 116 462 men and women who were free of cancer at baseline. Incident cancers were ascertained from national cancer, hospitalisation and death registers; weekly working hours were self-reported. RESULTS: During median follow-up of 10.8 years, 4371 participants developed cancer (n colorectal cancer: 393; n lung cancer: 247; n breast cancer: 833; and n prostate cancer: 534). We found no clear evidence for an association between working hours and the overall cancer risk. Working hours were also unrelated the risk of incident colorectal, lung or prostate cancers. Working ⩾55 h per week was associated with 1.60-fold (95% confidence interval 1.12-2.29) increase in female breast cancer risk independently of age, socioeconomic position, shift- and night-time work and lifestyle factors, but this observation may have been influenced by residual confounding from parity. CONCLUSIONS: Our findings suggest that working long hours is unrelated to the overall cancer risk or the risk of lung, colorectal or prostate cancers. The observed association with breast cancer would warrant further research.

Burden of Sickness Absence Due to Chronic Disease in the Dutch Workforce from 2007 to 2011.

INTRODUCTION: Chronic diseases are associated with productivity loss costs due to sickness absence. It is not always clear, however, which chronic diseases in particular are involved with how many sickness days and associated costs. OBJECTIVE: To determine the prevalence, additional days of sickness absence, and associated costs of chronic diseases among the Dutch working population from 2007 to 2011. METHODS: Prevalence of chronic diseases and additional days of sickness absence were derived from the Netherlands Working Conditions Survey (NWCS) from 2007 to 2011. The cost of each sickness absence day was based on linked personal income data. We used multiple regression analysis to derive the unconfounded additional days of sickness absence due to each chronic disease. RESULTS: Annually, approximately 37 % of the Dutch working population reported some type of chronic physical or psychological disease. No clinically relevant changes in prevalence of specific chronic diseases were observed in the studied period, nor in the number of additional sickness absence days or associated costs. The national financial burden due to sickness absence associated with chronic musculoskeletal disorders amounted to €1.3 billion annually. CONCLUSIONS: Chronic diseases result in substantial productivity loss due to sickness absence. Given the ageing population, the proposed increase in the state pension age and an increase in sedentary lifestyle and obesity, the prevalence of chronic diseases may be expected to rise. Coordinated efforts to maintain and improve the health of the working population are necessary to minimize socioeconomic consequences.

Night work and breast cancer risk in a general population prospective cohort study in The Netherlands.

Experimental studies in animals indicate that disruption of the circadian rhythm is carcinogenic, and night work has been suggested to be a probable breast cancer cause in humans. Findings among humans, however are inconsistent, often gathered with retrospective study designs, and only based on specific populations, such as nurses. We used data on night work collected in the Dutch Labor Force Surveys of 1996 until 2009, and individually linked these with National registers on hospital admission. Among 285,723 women without breast cancer at baseline, 2,531 had a hospital admission for breast cancer during an average of 7 years of follow up in the registers. Occasional and regular night work were not associated with the risk of hospital admission for breast cancer (adjusted hazard ratios 1.04; 95 % confidence interval 0.85-1.27, and 0.87; 0.72-1.05, respectively). Working more hours per week, or more years in a job entailing night work did not show increased breast cancer risks. Hazard ratios neither differed between nurses and women with other occupations. Our results show no association of night work with incident breast cancer, and suggest that night work generally does not increase the risk of breast cancer among women in the Dutch working population.

Social Dialogue and Psychosocial Risk Management: Added Value of Manager and Employee Representative Agreement in Risk Perception and Awareness.

The present study aimed to explore the added value of managers' and employee representatives' agreement in risk perception and awareness in explaining the management of more 'subjective' psychosocial risks as compared to the more 'objective' traditional OSH risks. The general assumption tested was whether the added value of agreement in risk perception and awareness between these parties would be larger for psychosocial risk management as compared to traditional OSH risk management. European Survey of Enterprises on New and Emerging Risks (ESENER-1) data were used from 7226 enterprises in which both managers and employee representatives were interviewed. Answers by employee representatives and managers to mirror questions on risk perception and awareness were used as independent variables, and answers to questions on risk management by the manager were used as dependent variables. Polynomial regression with response surface analysis was used. Differences in risk perception and awareness between managers and employee representatives explained more variance in psychosocial risk management as compared to more traditional OSH risk management. The implications of these findings and the importance of 'social dialogue' particularly in the case of psychosocial risk management as opposed to general OSH management are discussed.

Effectiveness of physical training for self-employed persons with musculoskeletal disorders: a randomized controlled trial.

BACKGROUND: Despite the fact that the population of self-employed persons is still growing and at risk for long term disability due to a number of risk factors, there is still a lack of information on the effectiveness of interventions for this specific group. METHODS: To determine the effectiveness of physical training without a cognitive behavioral component and workplace specific exercises (PT) and physical training with a cognitive behavioral component and workplace specific exercises (PTCBWE), we conducted a pragmatic Randomized Controlled Trial, stratified into two groups. Self-employed persons with a new work disability claim because of musculoskeletal disorders were randomized to PT (n = 53) or PTCBWE (n = 76), or to a corresponding usual care group (n = 50 and n = 75 respectively). Both types of training consisted of cardiovascular training, strengthening, relaxation and posture exercises and took place two or three times a week, for 1-1.5 hours, during three months, also if someone had already returned to work full-time. The primary outcome measure was claim duration (in days) during 12 months follow-up. Pain severity and functional status were secondary outcome measures. All data were assessed at baseline and at 6 and 12 months follow-up. The data with regard to claim duration were analyzed by survival analysis and Cox regression analysis. Secondary outcome measures were analyzed by means of linear regression analysis. RESULTS: After 12 months of follow-up there was no difference in claim duration between PT and usual care (Hazard Ratio 0.7; 95%CI, 0.4-1.1; p = 0.12) or PTCBWE and usual care (Hazard Ratio 0.9; 95%CI, 0.6-1.4; p = 0.72). Both types of physical training and usual care improved in pain and functional status over time, but there was only a statistically significant difference in favor of PT on pain improvement at 6 months. CONCLUSION: In this study, physical training with and without a cognitive behavioral component and workplace specific exercises for self-employed persons with musculoskeletal disorders was not shown to be effective on claim duration, pain severity and functional status at 12 months follow-up. TRIAL REGISTRATION: Current Controlled Trials ISRCTN67766245.

A new bricklayers' method for use in the construction industry.

OBJECTIVES: The aim of this study was to investigate the effect of raised bricklaying on physical workload, reported musculoskeletal disorders, sickness absence, and job satisfaction. METHODS: A controlled intervention study with a follow-up period of 10 months was performed among 202 bricklayers from 25 construction companies. RESULTS: The introduction of devices for raised bricklaying decreased the physical load on the lower back and, to a less extent, on the shoulders and upper extremities. Although raised bricklaying had no effect on the number of lifts, decreases in trunk bending lowered the biomechanical moment. The results showed no decrease in reported musculoskeletal symptoms as a result of the adoption of raised bricklaying. Irrespective of the reason(s), the percentage of bricklayers in the intervention group reporting sickness absence was significantly lower than the same percentage in the control group. The results also showed that, in general, the bricklayers in this study were very satisfied with the use of devices for raised bricklaying. CONCLUSIONS: Controlled intervention studies on ergonomic improvements are rare. This study shows that the introduction of an ergonomic improvement in the construction industry may reduce physical load and the incidence of sickness absence.

Vitality at work and its associations with lifestyle, self-determination, organizational culture, and with employees' performance and sustainable employability.

BACKGROUND: Vitality at work is an important factor for optimal functioning and sustainable employability. To date, knowledge on how to promote vitality at work is fragmented. OBJECTIVE: Contribute to knowledge on how to promote vitality at work. METHODS: Determinants of vitality at work are identified from three scientific fields, and used in a comprehensive model. Regression analyses on cross-sectional data from a Dutch dairy company (N= 629) are performed to examine the associations between these factors, vitality at work, and employees' perceived effective personal functioning and sustainable employability. RESULTS: Vitality at work is most strongly associated with basic psychological needs of self-determination, but also with healthy lifestyle behavior, having a balanced workstyle, and social capital. Vitality at work is also associated with effective personal functioning and with sustainable employability. CONCLUSIONS: The study confirms the multifactorial nature of vitality at work. Since organizational culture may support self-determination, and cultural aspects themselves are positively associated with vitality, organizational culture seems particular important in promoting vitality at work. Additionally, a healthy lifestyle appears important. The associations between vitality at work and effective personal functioning and sustainable employability endorse the combined health-based, business-related and societal importance of vitality at work.

Inducing a health-promoting change process within an organization: the effectiveness of a large-scale intervention on social capital, openness, and autonomous motivation toward health.

OBJECTIVE: To examine the effectiveness of an organizational large-scale intervention applied to induce a health-promoting organizational change process. DESIGN AND METHODS: A quasi-experimental, "as-treated" design was used. Regression analyses on data of employees of a Dutch dairy company (n = 324) were used to examine the effects on bonding social capital, openness, and autonomous motivation toward health and on employees' lifestyle, health, vitality, and sustainable employability. Also, the sensitivity of the intervention components was examined. RESULTS: Intervention effects were found for bonding social capital, openness toward health, smoking, healthy eating, and sustainable employability. The effects were primarily attributable to the intervention's dialogue component. CONCLUSIONS: The change process initiated by the large-scale intervention contributed to a social climate in the workplace that promoted health and ownership toward health. The study confirms the relevance of collective change processes for health promotion.

Motivations for health and their associations with lifestyle, work style, health, vitality, and employee productivity.

OBJECTIVE: Investigate employees' underlying motivational regulatory styles toward healthy living and their associations with lifestyle, work style, health, vitality, and productivity. METHODS: Regression analyses on cross-sectional data from Dutch employees (n = 629), obtained as baseline measurement before a workplace health promotion project. RESULTS: Controlled regulation was not associated with smoking and alcohol use, and negatively associated with physical activity, healthy dietary habits, relaxation, and a balanced work style. Autonomous regulation was positively associated with physical activity, healthy dietary habits, and relaxation, and negatively associated with smoking and alcohol use. Healthy lifestyle and work style were associated with perceived health and vitality, which in turn were associated with employees' productivity (absenteeism and presenteeism). CONCLUSIONS: Internalization of the value of health is important to promote a healthy lifestyle and work style among employees, and has meaningful business implications.

[Contribution of lifestyle factors to cancer: secondary analysis of Dutch data over 2010 and a projection for 2020]. / Bijdrage van leefstijlfactoren aan kanker: secundaire analyse van Nederlandse gegevens voor 2010 met een voorspelling voor 2020.

OBJECTIVE: To calculate the proportion of cancer cases in the Netherlands in 2010 that were attributable to lifestyle factors by using the most recent data. DESIGN: Secondary analysis. METHOD: Lifestyle risk factors studied were tobacco smoking, alcohol consumption, overweight, lack of physical exercise, and six elements of diet (consumption of vegetables, fruit, processed meat and red meat, and calcium and fibre intake). The lifestyle factors were organised so that the group with the highest risk (e.g. smokers) could be compared with the groups with the lowest risk (e.g. ex-smokers, non-smokers). Cut-off points were in line with Dutch public health messages. We obtained prevalence data on risk factors from national databases. Relative risks for the relationship between lifestyle and cancer were based on the international literature. Incidence and mortality data for cancer in 2010 were obtained through the Netherlands Cancer Registry. We calculated percentages of new cancer cases and deaths for men and women and for each type of cancer individually; these were then summed. RESULTS: We estimated that of the 98,971 newly-diagnosed cases of cancer among persons aged ≥ 20 years in the Netherlands in 2010, 29,938 (30%) were attributable to the above-mentioned lifestyle factors. Smoking was the most important contributory risk factor (19% of all new cancer cases), followed by sub-optimal dietary habits (10%), overweight (4%), alcohol consumption (3%), and lack of physical activity (2%). Of cancer deaths in 2010, an estimated 38% were attributable to lifestyle factors. Projections for 2020 show that lack of exercise and consumption of alcohol and meat will contribute less to the development of cancer while overweight and a reduction in inadequate dietary fibre intake and inadequate fruit and vegetable consumption will contribute more. CONCLUSION: Almost one-third of all cases of cancer and almost 40% of deaths from cancer can be attributed to a less healthy lifestyle.

The associations between organizational social capital, perceived health, and employees' performance in two Dutch companies.

OBJECTIVE: To examine the associations between organizational (bonding, bridging, and linking) social capital, employees' health, and employees' performance. METHODS: Linear regression on cross-sectional data among 718 employees in two Dutch companies. RESULTS: Organizational social capital was significantly associated with perceived health (ß = 0.20; P < 0.001) and with emotional exhaustion (ß = -0.34; P < 0.001). Both the health indicators, in turn, were associated with absenteeism, presenteeism, and effective personal functioning in the presumed direction, that is, better health was associated with better functioning. Especially, bonding social capital was significantly associated with health (ß = 0.14; P < 0.01) and with emotional exhaustion (ß = -0.26; P < 0.001). Linking social capital was associated with emotional exhaustion as well (ß = -0.09; P < 0.05). CONCLUSIONS: Organizational social capital was found to be a resource for employees' health, with meaningful business implications.

Effects of a supportive-expressive group intervention on long-term psychosocial adjustment in HIV-infected gay men.

BACKGROUND: This study compared the effects of a supportive-expressive group intervention (GI) with an educational control condition (EC) on long-term psychosocial adjustment in gay men with HIV infection. METHOD: Subjects (n = 85) were randomized after stratification for disease stage and use of antiretroviral medication. GI consisted of 4 months of weekly group sessions followed by 5 monthly maintenance sessions plus written educational material, whereas the EC subjects received educational material only. RESULTS: There were no between-group differences in effects on distress, coping or social support in analyses examining 4 time points over 15 months. Both conditions decreased in distress over time on the Hopkins Symptom Checklist and Beck Depression Inventory. CONCLUSIONS: Several explanations are offered for the reason why no additional benefit of the GI was found on outcome measures studied when compared with the EC condition and recommendations are made for future psychosocial intervention research with HIV-infected persons.