Prevalence and correlates of psychological distress in a large and diverse public sector workforce: baseline results from Partnering Healthy@Work.

BACKGROUND: Depressive and anxiety disorders are common among working adults and costly to employers and individuals. Mental health screening is often an important initial strategy, but the resultant data are often of unknown representativeness and difficult to interpret. In a public sector workforce, this study used a brief screener for depression/anxiety to: a) compare prevalence of high psychological distress obtained from a researcher survey with an employer survey and population norms and b) verify whether expected correlates were observed in a screening setting. METHODS: Participants were public servants working for an Australian state government. High psychological distress (Kessler-10 ≥22) stratified by age and sex was compared for a random weighted sample researcher survey (n = 3406) and an anonymous volunteer employer survey (n = 7715). Prevalence ratios (PR) were estimated from log binomial regression. RESULTS: Referencing the researcher survey, prevalence of high psychological distress was greater by age and sex in the employer survey but was only dependably higher for men when compared with population norms. Modelling suggested this may be due to work stress (effort-reward imbalance) (PR = 3.19, 95% CI 1.45-7.01) and casual/fixed-term employment (PR 2.64, 95% CI 1.26-5.56). CONCLUSIONS: Depression and anxiety screening using typical employer survey methods could overestimate prevalence but expected correlates are observed in a screening setting. Guidance for employers on screening and interpretation should be provided to encourage engagement with mental health prevention and treatment programs in the workplace.

Improved iodine status in Tasmanian schoolchildren after fortification of bread: a recipe for national success.

OBJECTIVES: To examine population iodine status in Tasmania after mandatory iodine fortification of bread and assess the magnitude of difference compared with results from a period of voluntary iodine fortification. DESIGN AND SETTING: A cross-sectional urinary iodine survey of schoolchildren from classes that included fourth-grade students was conducted in Tasmania in 2011. Results were compared with surveys conducted before fortification and during a period of voluntary fortification. PARTICIPANTS: Three hundred and twenty students aged 8-13 2013s from 37 participating school classes. MAIN OUTCOME MEASURES: Median urinary iodine concentration (UIC) and proportion of UIC results < 50 µg/L. RESULTS: Median UIC in 2011 was 129 µg/L, and 3.4% of samples had a UIC under 50µg/L. This was significantly higher than during the period of voluntary fortification (129 µg/L v 108 µg/L) (P> < 0.001), which was significantly higher than before fortification (108 µg/L v 73 µg/L) (P < 0.001). There was a reduction in the proportion of samples with UIC under 50 µg/L after mandatory fortification (3.4%) compared with results from the period of voluntary fortification (9.6%) (P = 0.01), which was a further reduction compared with results from the prefortification period (17.7%) (P < 0.001). CONCLUSIONS: Iodine status in Tasmania can now be considered optimal. Mandatory iodine fortification has achieved significantly greater improvements in population iodine status compared with voluntary fortification. However, surveys of schoolchildren cannot be generalised to pregnant and breastfeeding women, who have higher iodine requirements. Measurement of iodine status in population surveys is warranted for ongoing monitoring and to justify the appropriate level of fortification of the food supply into the future.

Folate status and socio-demographic predictors of folate status, among a national cohort of women aged 26-36 in Australia, 2004-2006.

OBJECTIVE: To describe serum folate status and the socio-demographic correlates of serum folate status in a national sample of women aged 26-36 years in Australia, 2004-2006. METHODS: Stored serum samples from 1,046 women, collected as part of the Childhood Determinants of Adult Health study, were analysed for serum folate. RESULTS: Median (IQR) serum folate was 27.1 nmol/L (18.8-35.0 nmol/L) with only 7.0% of samples below 11 nmol/L. Serum folate was positively associated with supplement use, educational level, occupational status and urban dwelling. CONCLUSIONS: In this population-based sample, most women had folate levels in the normal range with few having low serum folate. Those of lower socioeconomic position or with poorer health behaviours had lower folate levels, though most were still within the normal range. IMPLICATIONS: In the absence of comprehensive national survey data on the folate status of women of child-bearing age, these data provide a valuable baseline for evaluating the impact of mandatory folic acid fortification in Australia, which commenced in 2009. It is likely that mandatory fortification of the food supply with folic acid will reduce the disparities in folate status between socioeconomic groups and in people with poorer health behaviours.

Iodine status of Tasmanians following voluntary fortification of bread with iodine.

OBJECTIVE: To describe changes in the iodine status of Tasmanians following voluntary fortification of bread with iodine in October 2001. DESIGN AND SETTING: Post-intervention, cross-sectional urinary iodine surveys of Tasmanian schoolchildren aged 8-11 years were used to assess population iodine status. Participants were selected using a one-stage cluster sampling method. The sampling frame comprised classes containing fourth-grade children from all Tasmanian government, Catholic and independent schools. Results were compared with pre-intervention survey results. MAIN OUTCOME MEASURES: Median urinary iodine concentration (UIC) and percentage of UIC < 50 microg/L ascertained from spot urine samples. RESULTS: Median UIC was 75 microg/L in 1998, 72 microg/L in 2000, 105 microg/L in 2003, 109 microg/L in 2004 and 105 microg/L in 2005. Median UIC in post-intervention years (2003-2005) was significantly higher than in pre-intervention years. The percentage of UIC results < 50 microg/L was 16.9% in 1998, 18.7% in 2000, 10.1% in 2003, 10.0% in 2004 and 10.5% in 2005. CONCLUSION: Despite methodological differences between the pre- and post-intervention surveys, switching to iodised salt in bread appears to have resulted in a significant improvement in iodine status in Tasmania. Given iodine deficiency has been identified in other parts of Australia and in New Zealand, mandatory iodine fortification of the food supply in both countries is worthy of consideration. As voluntary fortification relies on industry goodwill, mandating fortification could be expected to enhance population reach and give a greater guarantee of sustainability in Tasmania.

Meningococcal vaccine failure in conjunction with an unusual meningococcal cluster in southern Tasmania.

The following is a report of an unusual family cluster of group C invasive meningococcal disease in Tasmania. This unusual case cluster raises several important issues of public health significance regarding vaccine failure and nucleic acid amplification testing use in the setting of invasive meningococcal disease.

Public health surveillance for Australian bat lyssavirus in Queensland, Australia, 2000-2001.

From February 1, 2000, to December 4, 2001, a total of 119 bats (85 Megachiroptera and 34 Microchiroptera) were tested for Australian bat lyssavirus (ABLV) infection. Eight Megachiroptera were positive by immunofluorescence assay that used cross-reactive ntibodies to rabies nucleocapsid protein. A case study of cross-species transmission of ABLV supports the conclusion that a bat reservoir exists for ABLV in which the virus circulates across Megachiroptera species within mixed communities.

A multi-jurisdictional outbreak of hepatitis A related to a youth camp--implications for catering operations and mass gatherings.

In June 2003, Australian state and territory health departments were notified of an outbreak of Hepatitis A in people who had attended a five-day youth camp. Approximately 350 people attended the event in Central Australia between 24 and 28 April 2003. The public health investigation comprised of case identification, food handler interviews, an environmental health investigation of the campground and associated food premises, laboratory analysis of blood specimens and food/water samples, and an epidemiological study. Twenty-one cases fitted the case definition for the outbreak. A retrospective cohort study involving four states was conducted, with 213 people interviewed. Coleslaw and cordial were significantly associated with illness, however when the two exposures were adjusted for each other to account for confounding, only coleslaw remained significantly associated with illness (adjusted RR 2.5, 95% CI 1.09 - 5.77). The investigation highlighted a number of food hygiene and safety issues relating to the catering of mass gatherings. Implementation of food safety programs in these settings are likely to reduce the occurrence of such outbreaks. The recent proposal by Food Standards Australia New Zealand to mandate food safety programs for catering operations is supported.