Occupational risk of COVID-19 related hospital admission in Denmark 2020-2021: a follow-up study.

OBJECTIVE: Mounting evidence indicates increased risk of COVID-19 among healthcare personnel, but the evidence on risks in other occupations is limited. In this study, we quantify the occupational risk of COVID-19-related hospital admission in Denmark during 2020-2021. METHODS: The source population included 2.4 million employees age 20-69 years. All information was retrieved from public registers. The risk of COVID-19 related hospital admission was examined in 155 occupations with at least 2000 employees (at-risk, N=1 620 231) referenced to a group of mainly office workers defined by a COVID-19 job exposure matrix (N=369 341). Incidence rate ratios (IRR) were computed by Poisson regression. RESULTS: During 186 million person-weeks of follow-up, we observed 2944 COVID-19 related hospital admissions in at-risk occupations and 559 in referents. Adjusted risk of such admission was elevated in several occupations within healthcare (including health care assistants, nurses, medical practitioners and laboratory technicians but not physiotherapists or midwives), social care (daycare assistants for children aged 4-7, and nursing aides in institutions and private homes, but not family daycare workers) and transportation (bus drivers, but not lorry drivers). Most IRR in these at-risk occupations were in the range of 1.5-3. Employees in education, retail sales and various service occupations seemed not to be at risk. CONCLUSION: Employees in several occupations within and outside healthcare are at substantially increased risk of COVID-19. There is a need to revisit safety measures and precautions to mitigate viral transmission in the workplace during the current and forthcoming pandemics.

Past, Present, and Future Labor Market Participation Among Patients Admitted to Hospital With Concurrent Substance Use and Mental Health Disorder, and What We Can Learn From It.

OBJECTIVE: The aim of the study is to investigate the labor market participation of patients with concurrent substance use and mental health disorder before treatment, as well as the strength of the barriers to re-enter the labor market. METHODS: The study population is composed of individuals with concurrent substance use and mental health disorder at a psychiatric unit in 1996, 2001, 2006, 2011, and 2016. The number of self-supported years 20 years back in time, as well as present and subsequent employment, was calculated. RESULTS: From 1996 to 2016, there was a decrease by 43.8% in self-supported years before treatment and by 36.4% in the fraction of patients working at the time of admission. CONCLUSIONS: The results point to increasing difficulties with regard to labor market attachment among individuals with mental illnesses.

Occupational risk of COVID-19 across pandemic waves: a two-year national follow-up study of hospital admissions.

OBJECTIVE: Assuming that preventive measures to mitigate viral transmission of SARS-CoV-2 at the workplace may have been improved in the course of the COVID-19 pandemic, we examined the occupational risk of COVID-19 related hospital admission across the four pandemic waves in Denmark between week 8, 2020, and week 50, 2021. METHODS: The study included 4416 cases of COVID-19 related hospital admissions among 2.4 million Danish employees aged 20-69 with follow-up in 2020 through 2021. At-risk industrial sectors and a reference population were defined a priory by a job-exposure matrix on occupational risk for COVID-19. Incidence rate ratios (IRR) and potential effect modification by pandemic wave were computed with Poisson regression adjusted for demographic, social and health factors including completed COVID-19 vaccination. RESULTS: We observed an overall elevated relative risk in four of six at-risk industrial sectors, but the pandemic wave only modified the risk among healthcare employees, where the excess risk from a high initial level declined to background levels during the latest waves in models not adjusting for COVID-19 vaccination. In social care, education and transport, the elevated risk was not modified by pandemic wave. CONCLUSION: Danish healthcare employees were to some extent protected against occupational transmission of SARS-CoV-2 during the two last pandemic waves even though the absolute risk conferred by occupation may not have been eliminated. Early vaccination of this group seems not to be the only explanation. The risk in other sectors remained elevated indicating a need to revisit preventive measures.

The effect on work ability of a tailored ergonomic learning program.

BACKGROUND: The physical working conditions and the musculoskeletal health of industrial workers have an effect on their work ability. OBJECTIVE: The paper evaluates the effectiveness of an ergonomic learning program focused on the development of low strain working techniques. The project is evaluated in regard to its capacity to improve and sustain the work ability of industrial workers with high physical work demands. METHOD: 249 employees at an industrial work site were followed over 2½ years. About one third of the employees were selected into differentiated courses according to the severity of musculoskeletal disorders. The reference group consisted of the departments that did not participate. The project was evaluated by using questionnaires and interviews. RESULTS: The evaluation of the project only showed minor, non-significant increases in the work ability of the group of employees participating in the most intensive activities. Self- reported productivity increased in all departments, with the largest improvement found among the employees in the department, where everyone participated in a course (8.6% , p = 0.003). CONCLUSIONS: Work ability is composed of many different factors, physiological, physical as well as psycho-social and this may explain the only limited results even of the extensive project activities in the present study. However, the evaluation indicated that job rotation in combination with more healthy work methods could sustain the work ability of employees with more severe musculoskeletal disorders.

Predicting long-term sickness absence and early retirement pension from self-reported work ability.

OBJECTIVE: The aim of this paper is to examine the relationship between self-reported work ability and long-term term of sickness absence or early retirement from the labour market. METHODS: Data on work ability were retrieved from a representative cohort study of Danish wage earners and linked with a register of social payment transfers. In all, 4.743 individuals were followed from 2001 to 2005. Cox regression was used for the analyses. RESULTS: A one point decrease in perceived work ability, on a 10 point scale, was associated with an increased risk of long-term sickness absence (LTSA) of 15.1% (95% CI 12-19%, P < 0.0001) and an increased risk of early retirement from the labour market of 33% (95% CI 20-48%, P < 0.0001). CONCLUSIONS: Reports of reduced work ability were significantly associated with both an increased risk of onset of LTSA and early retirement from the labour market, after adjustment for socio-demographic characteristics and lifestyle variables.

High-fat petrolatum-based moisturizers and prevention of work-related skin problems in wet-work occupations.

The study presented is a randomized, controlled intervention study with the purpose of implementing an evidence-based skin disease prevention programme. The hypothesis explored in this article is whether a high-fat petrolatum-based moisturizer can be an alternative to protective gloves in wet-work occupations. The study population was all gut cleaners in Danish swine slaughterhouses, and data were collected by telephone interviews using a standardized questionnaire - The Nordic Occupational Skin Questionnaire (NOSQ-2002). At baseline, 644 (88%) gut cleaners responded and at 1-year follow-up 622 (72%). 135 gut cleaners in the intervention and 277 in the comparison group responded at both telephone interviews. In the intervention group, the eczema frequency was reduced significantly. Detailed analyses revealed that protective gloves are the overall most effective protective means and did not indicate that a high-fat moisturizer could be an alternative. Furthermore, the most extensive improvements could not be explained by combinations of protective behaviour but was found among those who had received information on, and was having discussions on prevention of skin problems. This only applied to the intervention group. A continuous focus on prevention of skin problems with information and discussions on the shop floor therefore seemed to be most important for reducing skin problems.

A study of the implementation process of an intervention to prevent work-related skin problems in wet-work occupations.

OBJECTIVES: The objective of the present implementation study is to document how an intervention to reduce work-related skin problems by means of implementing an evidence-based skin protection programme in six gut-cleaning departments in swine slaughterhouses was understood, accepted and carried out. The association between the degree of implementation and the reduction of work-related skin problems in each department is examined. The intervention included a top-down strategy with establishment of a management system focusing on skin risks and a bottom-up strategy with participation of a selected group of shop floor workers and the safety representative, as change agents, as well as an empowerment-based educational programme, where the middle management and representatives from the top management also participated. METHODS: The study design was a randomized controlled intervention study with a 1-year study period. The outcome of the intervention was evaluated by telephone interviews. Data on the implementation process consisted of self-administered questionnaires, focus interviews and compiled written materials. Four indexes referring to the management system and the change agents' intervention activities were constructed. Finally, the Pearson correlation coefficient was used to test the correlation between the degree of implementation and the eczema frequency at 1-year follow-up. RESULTS: There was a statistically significant association (p < 0.05) between both the index for the combined implementation method and the eczema frequency after 1 year of intervention, and between the activities of the change agents and the eczema frequency. In contrast to this there was only a weak association between the establishment of a formal management system alone and the outcome. CONCLUSION: The study evidences that a combination of a top-down and a bottom-up implementation method is effective to reduce work-related skin problems, and that the process of implementation is a significant determinant of the overall results.

Implementation of an occupational skin disease prevention programme in Danish cheese dairies.

The purpose of this study was to implement an evidence-based prevention programme to reduce occupational skin diseases in a wet work occupation by educational activities and elements from an occupational health-management system. The effects were studied by telephone interviews using a standardized questionnaire (NOSQ-2002) with trade-modified questions on work and exposure. The study population consisted of all employees at 5 cheese dairies. At baseline, October 2002, a total of 557 answered (83.8%). At follow up 1 year later, a total of 650 current and former employees answered (81.8%). At 4 of the 5 dairies, the eczema frequency at baseline was relatively low (11.8% and 5.9% at intervention dairies; 7.0%, 10.4% and 33.3% at comparison dairies). On all the studied dairies, about one-third of the workers reported having 2 or more skin symptoms at baseline. At follow up, skin symptoms were reduced significantly on all dairies. Effects restricted to the intervention dairies included significant increases in the use of gloves and moisturizers. The comparison dairy with high eczema frequency at baseline introduced skin-care products, changed hand soap and mowed employees with skin problems, away from adverse working areas during the intervention period, and the frequency of eczema was significantly reduced at follow up.