School environment as predictor of teacher sick leave: data-linked prospective cohort study.

BACKGROUND: Poor indoor air quality (IAQ) and psychosocial problems are common in schools worldwide, yet longitudinal research on the issue is scarce. We examined whether the level of or a change in pupil-reported school environment (IAQ, school satisfaction, and bullying) predicts recorded sick leaves among teachers. METHODS: Changes in the school environment were assessed using pupil surveys at two time points (2001/02 and 2004/05) in 92 secondary schools in Finland. Variables indicating change were based on median values at baseline. We linked these data to individual-level records of teachers' (n = 1678) sick leaves in 2001-02 and in 2004-05. RESULTS: Multilevel multinomial logistic regression models adjusted for baseline sick leave and covariates showed a decreased risk for short-term (one to three days) sick leaves among teachers working in schools with good perceived IAQ at both times (OR = 0.6, 95% CI: 0.5-0.9), and for those with a positive change in IAQ (OR = 0.6, 95% CI: 0.4-0.9), compared to teachers in schools where IAQ was constantly poor. Negative changes in pupil school satisfaction (OR = 1.8, 95% CI: 1.1-2.8) and bullying (OR = 1.5, 95% CI: 1.0-2.3) increased the risk for short-term leaves among teachers when compared to teachers in schools where the level of satisfaction and bullying had remained stable. School environment factors were not associated with long-term sick leaves. CONCLUSIONS: Good and improved IAQ are associated with decreased teacher absenteeism. While pupil-related psychosocial factors also contribute to sick leaves, no effect modification or mediation of psychosocial factors on the association between IAQ and sick leave was observed.

Effects of implementing an ergonomic work schedule on heart rate variability in shift-working nurses.

OBJECTIVES: The aim of this study was to compare the psychophysiological strain related to a conventional shift schedule and new ergonomically improved two- and three-shift schedules using heart rate variability (HRV) analysis. The specific aim was to determine whether the introduced ergonomic shift arrangement had any positive effects on the psychophysiological strain such as increased HRV or decrease in the sympathovagal balance of the autonomic nervous system (ANS). METHODS: Questionnaire data and 24-hour HRV recordings were gathered from 48 female shift-working nurses once while working the conventional shift schedule (baseline) and again after one year working an ergonomic shift schedule during the morning shift. RESULTS: Comparisons between conventional and ergonomic shift schedules (baseline and follow-up, respectively) revealed significant differences in frequency-domain parameters. Implementing an ergonomic shift schedule resulted in decreased normalized low frequency (LF) power, increased normalized high frequency (HF) power, and decreased LF/HF ratio at the beginning of the shift. Furthermore, at baseline, mean RR interval, root mean square of successive RR interval differences (RMSSD) and normalized HF power were increased at the end of the shift compared with the values at the beginning of the morning shift. In contrast, at the follow-up, LF power was increased between the end and beginning of the morning shift. CONCLUSIONS: The psychophysiological strain measured by HRV analysis was lower at the beginning of the work shift for the ergonomic shift schedules compared with the conventional schedule. This indicates that an ergonomic shift schedule may have a positive effect on the ANS recovery occurring between successive work shifts.

Pupils with special educational needs in basic education schools and teachers' sickness absences--a register-linkage study.

OBJECTIVES: We examined whether having a high percentage of pupils with special educational needs (SEN) in basic education schools increases the risk of sickness absence among teachers and whether this risk is dependent on the pupil-teacher ratio (PTR), an indicator of teacher resources at school. METHODS: We obtained register data on 8089 teachers working in 404 schools in 10 municipalities in Finland during the school year 2004-2005. We used multilevel multinomial regression models to examine the risk of teachers' short- and long-term sickness absence in relation to the percentage of SEN pupils and the PTR at school. We tested the equality of trends in groups with high and low PTR using PTR × SEN interaction term. RESULTS: After adjustment for teacher and school characteristics, the risk for long-term absences was higher among teachers at schools with a high percentage of SEN pupils than among teachers at schools with a low percentage of SEN pupils [odds ratio (OR) 1.5, 95% confidence interval (95% CI) 1.2-1.8). This was also the case for short-term absences (OR 1.4, 95% CI 1.2-1.7). In analyses stratified by the PTR levels, the association between the percentage of SEN pupils and long-term absences was 15% higher among teachers with a high PTR than among those with a low PTR (P for interaction=0.10). CONCLUSIONS: Teachers' sickness absenteeism seems to increase with a higher percentage of SEN pupils, especially when the PTR is high. Teacher resources at schools that have a high percentage of SEN pupils should be well maintained to ensure the health of teachers.

Less quick returns--greater well-being.

The aim of this study was to design ergonomically improved shift schedules for nurses in primary health care shift work in order to enhance their health and well-being. The main change made was the reduction of quick returns (i.e., no more morning shifts immediately after an evening shift) in order to ensure more recovery time between work shifts. Six municipal hospital units participated in the intervention. Our aim was to maintain or improve the well-being and work ability of aged workers. The subjects (n=75) were divided into three age groups: 20-40, 41-52, and 53-62 yr. The introduction of more recovery time between evening and morning shifts significantly improved the subjects' sleep and alertness, well-being at work, perceived health, and leisure-time activities independently of their age. The effect on social and family life was also positive. Working in shifts was the most disruptive for the youngest group of nurses. The Work Ability Index score depended on the age group: it was lowest among the oldest age group, and did not change during the intervention. Ergonomic working time arrangements show positive effects on the well-being of health care workers of all ages.