Cancer-work management: Hourly and salaried wage women's experiences managing the cancer-work interface following new breast cancer diagnosis.

OBJECTIVE: The purpose of this paper is to report the baseline characteristics of EMPOWER participants-a group of newly diagnosed breast cancer survivors-and describe differences in hourly and salaried wage women's experiences regarding cancer and work management in the three months following breast cancer diagnosis. DESIGN AND SETTING: The EMployment and Potential Outcomes of Working through canceER (EMPOWER) project is a prospective longitudinal, mixed methods pilot study designed to evaluate how employment influences treatment decisions among women diagnosed with breast cancer. Participants were women diagnosed with new breast cancer and treated at one of two clinical sites of the University of Maryland Medical System. Women were enrolled in the study within three months of first breast cancer diagnosis. Study visits occurred every three months for one year. This paper reports data from for the baseline and three-month visit which had been completed by all enrollees. METHODS: Trained research personnel collected demographic information, medical history and health status, social history, employment data, cancer-related data, psychosocial adjustment, and financial wellbeing at the baseline enrollment visit. A semi-structured qualitative interview was administered at the three-month study visit to assess employment decisions and the impact of job demands, cancer care, and cancer-work fit during the three months following diagnosis. RESULT: Fifty women with new, primary diagnosis of breast cancer were enrolled in the study. Mean age of participants was 51 years, and 46% identified their race as Black or other. The majority of women disclosed their diagnosis to their employer and nearly all maintained some level of employment during the first three to six months of treatment. Women with hourly wage jobs were similar to those with salaried wage jobs with respect to demographic and social characteristics. Women with hourly wage jobs were more likely to report working in physically demanding jobs and taking unpaid leave. They were also more likely to experience side effects that required physical restrictions at work, to leave their jobs due to demands of treatment, and to report managing cancer and work concurrently as very difficult. Women in salaried wage jobs were more likely to report falling behind or missing work and working remotely as a cancer-management strategy. Women in hourly jobs more often reported difficulty managing the competing demands of cancer and work. CONCLUSION: While further study is needed, these results suggest that women in hourly and salaried workers reported similar experiences managing cancer and work, with a few key exceptions. These exceptions pertain to the nature of hourly-wage work. Cancer survivors employed in hourly jobs may be more vulnerable to poor employment outcomes due to limited access to paid time off and workplace flexibility, and challenges related to managing physical aspects of cancer and employment.

Job category differences in the prevalence and associated factors of insomnia in steel workers in China.

OBJECTIVES: This study aimed to investigate the prevalence of insomnia and risk factors among different job categories of steel workers in China, in order to improve their quality of occupational life. MATERIAL AND METHODS: A cross-sectional face-to-face survey was conducted which involved 5834 steel workers from a large enterprise located in northern China, including front-line, maintenance and inspection, and other auxiliary workers. The Athens Insomnia Scale and the Job Content Questionnaire were used to assess the status of insomnia and job stress/social support, respectively. Multivariable logistic regression was used to identify factors influencing insomnia. RESULTS: The overall prevalence of insomnia was determined at 42.0% (95% confidence interval: 40.7%-43.2%). For front-line, maintenance and inspection, and other auxiliary workers, the prevalence was 42.3%, 39.8%, and 47.9% (p = 0.001), respectively. The participants with high stress and low support, and those who had experienced ≥2 major life events in the past 12 months, compared to those with low stress and high support, and those without major events, displayed an increased risk of insomnia among all 3 job categories (the adjusted odds ratio ranged 1.56-2.38 and 1.30-1.75, respectively). The educational level, shift work, alcohol consumption, and present illness were identified as influencing factors of insomnia for 1 or 2 job categories. CONCLUSIONS: The prevalence of insomnia was the highest in the group of other auxiliary steel workers among the 3 job categories of steel workers under consideration. While the influencing factors of insomnia differed among the groups, job stress and major life events were common risk factors of insomnia among the 3 categories of steel workers. Int J Occup Med Environ Health. 2020;33(2):215-33.

Prevalence of problem gambling in an employed population in Brittany, France.

Some employees may have recourse to gambling, notably as an adaptive strategy. Although many studies have been performed on specific occupational groups (i.e. gambling industry, transportation or teaching), none have been conducted with workers followed-up by Occupational Health Services (OHS). Our aim was to evaluate the prevalence of problem gambling in an employed population and its links with work. We performed a cross-sectional study between November 2016 and April 2017, in an OHS in France. We evaluated the prevalence of gambling using the Lie or Bet questionnaire and the Canadian Problem Gambling Index. Among the 410 employees included, 138 (33.7%) had gambled in the previous year, 12 (2.9%) considered their gambling experience to be work-related, 13 (3.2%) were identified as problem gamblers. The influence of colleagues and the workplace hierarchy and ease of access to gambling (in tobacco shops, bars…) could be risk factors. Screening for gambling behavior could be offered by occupational health services, using the Lie or Bet, especially for employees exposed to readily available gambling opportunities at their workplace.

Work-Related Outcomes in Self-Employed Cancer Survivors: A European Multi-country Study.

Purpose To describe: (i) patterns of self-employment and social welfare provisions for self-employed and salaried workers in several European countries; (ii) work-related outcomes after cancer in self-employed people and to compare these with the work-related outcomes of salaried survivors within each sample; and (iii) work-related outcomes for self-employed cancer survivors across countries. Methods Data from 11 samples from seven European countries were included. All samples had cross-sectional survey data on work outcomes in self-employed and salaried cancer survivors who were working at time of diagnosis (n = 22-261 self-employed/101-1871 salaried). The samples included different cancers and assessed different outcomes at different times post-diagnosis. Results Fewer self-employed cancer survivors took time off work due to cancer compared to salaried survivors. More self-employed than salaried survivors worked post-diagnosis in almost all countries. Among those working at the time of survey, self-employed survivors had made a larger reduction in working hours compared to pre-diagnosis, but they still worked more hours per week post-diagnosis than salaried survivors. The self-employed had received less financial compensation when absent from work post-cancer, and more self-employed, than salaried, survivors reported a negative financial change due to the cancer. There were differences between self-employed and salaried survivors in physical job demands, work ability and quality-of-life but the direction and magnitude of the differences differed across countries. Conclusion Despite sample differences, self-employed survivors more often continued working during treatment and had, in general, worse financial outcomes than salaried cancer survivors. Other work-related outcomes differed in different directions across countries.

Differences in Metabolic Syndrome Prevalence by Employment Type and Sex.

Workers may sometimes do the same work, but differ in their risk of health-related problems depending on whether the employment type is standard or non-standard. Furthermore, even with similar job and employment types, there may be differences in risk factors for health-related problems depending on sex. This study aimed to determine the prevalence of metabolic syndrome (MetS) by employment type and sex using data from the Fifth Korean National Health and Nutrition Examination Survey (KNHANES Ⅴ) (2010⁻2012) and KNHANES Ⅵ (2013⁻2015) conducted by the Korea Centers for Disease Control and Prevention. Overall, 9523 adult wage workers (5523 standard workers and 4000 non-standard workers) aged ≥ 19 years were analyzed. To determine MetS prevalence odds ratios according to employment type, logistic regression analysis was performed disaggregated by sex. The prevalence of MetS significantly increased with age (p < 0.001), being married (p < 0.05), current smoking status (p < 0.05), and high-risk drinking (p < 0.001) among male subjects. The prevalence of MetS significantly increased among female manual workers (p < 0.001), those with lower educational level and household income (p < 0.001). Non-standard workers of either sex showed higher MetS prevalence than standard workers; only females showed significant difference (p < 0.001). Female non-standard workers showed 1.44, 1.33, and 1.34 (all p < 0.001) times higher odds of MetS prevalence in Models 1, 2, and 3, respectively, compared to standard workers, suggesting a difference in risk factors of MetS according to sex. Also, that employment type affects MetS prevalence suggests that employment pattern is an important risk factor especially in females. Therefore, to manage MetS in female non-standard workers, individual health care as well as social effort may be necessary.

Foods, Dietary Patterns and Occupational Class and Leukocyte Telomere Length in the Male Population.

Telomeres contain TTAGGG repetitive sequences and are located at the end of human chromosomes. Telomere dysfunction is associated with some age-related and chronic diseases, but its relationship with foods, dietary patterns, and occupational class in the young male population is not yet known. In this cross-sectional study, 300 healthy men, residents of Tehran, aged 25-40 years were enrolled from January to December 2016. We employed a cross-sectional study of 300 healthy people, residents of Tehran, aged 25-40 years. A food frequency questionnaire was used to obtain food intakes of all participants and converted into actual food intake (g/day). The principal components analysis was used to determine dietary patterns and other demographic characteristics. Leukocyte telomere length (TL) was measured by quantitative real-time polymerase chain reaction (PCR) to measure number of telomere repeat copy number (T) to the relative number of 36B4 copies (S) (T/S ratio). T/S in office-workers, waste recyclers, and other workers were 1.22 ± 0.4, 1.08 ± 0.3, and 1.094 ± 0.34, respectively. The results of multivariate linear regression adjusted for age, body mass index (BMI), and smoking were showed that whole grains (ß = 0.02; p = .05), refined grains, fruits and vegetables, fish and dairy products were associated with an increase in log-T/S, but consumption of nuts and seeds (ß = -0.00072; p = .06), meats (ß = -0.00043; p = .9), produced meats (ß = -0.00238; p = .03), oils and solid fats (ß = -0.00146; p = .03) had a negative relationship with log-T/S in all studied occupational classes. A positive relationship was reported between the healthy (ß = 0.017; p = .2) and traditional dietary pattern (ß = 0.012; p = .4) with log-T/S, but western pattern identified negative relationship (ß = -0.004; p = .7). Adherence to a healthy (with consumption whole grains, refined grains, dairy, and cereals) and then traditional pattern with increased consumption of fruits, vegetables and whole grains, fish and dairy products are necessary to prevent TL destruction in all studied occupational classes.

Domestic Job Shortage or Job Maldistribution? A Geographic Analysis of the Current Radiation Oncology Job Market.

PURPOSE: To examine whether permanent radiation oncologist (RO) employment opportunities vary based on geography. METHODS AND MATERIALS: A database of full-time RO jobs was created by use of American Society for Radiation Oncology (ASTRO) Career Center website posts between March 28, 2016, and March 31, 2017. Jobs were first classified by region based on US Census Bureau data. Jobs were further categorized as academic or nonacademic depending on the employer. The prevalence of job openings per 10 million population was calculated to account for regional population differences. The χ2 test was implemented to compare position type across regions. The number and locations of graduating RO during our study period was calculated using National Resident Matching Program data. The χ2 goodness-of-fit test was then used to compare a set of observed proportions of jobs with a corresponding set of hypothesized proportions of jobs based on the proportions of graduates per region. RESULTS: A total of 211 unique jobs were recorded. The highest and lowest percentages of jobs were seen in the South (31.8%) and Northeast (18.5%), respectively. Of the total jobs, 82 (38.9%) were academic; the South had the highest percentage of overall academic jobs (35.4%), while the West had the lowest (14.6%). Regionally, the Northeast had the highest percentage of academic jobs (56.4%), while the West had the lowest (26.7%). A statistically significant difference was noted between regional academic and nonacademic job availability (P=.021). After we accounted for unit population, the Midwest had the highest number of total jobs per 10 million (9.0) while the South had the lowest (5.9). A significant difference was also observed in the proportion of RO graduates versus actual jobs per region (P=.003), with a surplus of trainees seen in the Northeast. CONCLUSIONS: This study presents a quantitative analysis of the RO job market. We found a disproportionately small number of opportunities compared with graduates trained in the Northeast, as well as a significant regional imbalance of academic versus nonacademic jobs. Long-term monitoring is required to confirm these results.

Combined analysis of job and task benzene air exposures among workers at four US refinery operations.

Workplace air samples analyzed for benzene at four US refineries from 1976 to 2007 were pooled into a single dataset to characterize similarities and differences between job titles, tasks and refineries, and to provide a robust dataset for exposure reconstruction. Approximately 12,000 non-task (>180 min) personal samples associated with 50 job titles and 4000 task (<180 min) samples characterizing 24 tasks were evaluated. Personal air sample data from four individual refineries were pooled based on a number of factors including (1) the consistent sampling approach used by refinery industrial hygienists over time, (2) the use of similar exposure controls, (3) the comparability of benzene content of process streams and end products, (4) the ability to assign uniform job titles and task codes across all four refineries, and (5) our analysis of variance (ANOVA) of the distribution of benzene air concentrations for select jobs/tasks across all four refineries. The jobs and tasks most frequently sampled included those with highest potential contact with refinery product streams containing benzene, which reflected the targeted sampling approach utilized by the facility industrial hygienists. Task and non-task data were analyzed to identify and account for significant differences within job-area, task-job, and task-area categories. This analysis demonstrated that in general, areas with benzene containing process streams were associated with greater benzene air concentrations compared to areas with process streams containing little to no benzene. For several job titles and tasks analyzed, there was a statistically significant decrease in benzene air concentration after 1990. This study provides a job and task-focused analysis of occupational exposure to benzene during refinery operations, and it should be useful for reconstructing refinery workers' exposures to benzene over the past 30 years.

Análisis de los determinantes próximos e impacto de la ocupación en la fertilidad de mujeres peruanas / Analysis of proximate determinants and impact of type of employment on fertility in peruvian women

RESUMEN Objetivo Estimar la capacidad predictiva de los determinantes próximos y el trabajo en la disminución de la fertilidad en mujeres peruanas en edad fértil. Métodos Análisis secundario de la Encuesta Demográfica y de Salud Familiar (ENDES) de 2014 de Perú. La muestra fue de 20 396 mujeres entre 15 y 49 años de edad con actividad sexual en las cuatro semanas previas a la entrevista realizada. La variable dependiente fue el número total de hijos nacidos vivos y las variables independientes principales incluidas, trabajo, número ideal de hijos, máximo nivel educativo alcanzado y quintiles de riqueza. Se calcularon odds ratios (OR) para estimar la fuerza de las asociaciones entre los determinantes próximos y la ocupación y la fertilidad mediante modelos de regresión logística. Se estimó la bondad de ajuste de los modelos con la prueba de Hosmer-Lemeshow y su capacidad discriminante, con curvas ROC. Resultados La fertilidad deseada (2,5 hijos por mujer) fue más alta que la real (2,1). Los principales factores asociados con la reducción de la fertilidad fueron el nivel educativo superior (OR = 0,03; IC95%: 0,02–0,04), el número ideal de hijos entre 0 y 2 (OR = 0,13; IC95%: 0,11–0,15), y el trabajo dependiente (OR = 0,31; IC95%: 0,28–0,34). El área bajo la curva de los modelos fue 0,908 (IC95%: 0,898–0,917) y 0,91 (IC95%:0,891–0,928), respectivamente. Conclusión La acción de los determinantes directos (edad de inicio de las relaciones sexuales y del matrimonio) retrasa el comienzo de la maternidad, mientras que los determinantes indirectos (mayor nivel educativo y pertenencia al quintil superior de riqueza) suponen una mayor autonomía económica, que, a su vez, se asocia con niveles bajos de fertilidad. Asimismo, cuanto mayor es la dependencia en el trabajo, menor es la fertilidad de las mujeres encuestadas.

ABSTRACT Objective To estimate the predictive capacity of proximate determinants and type of employment with respect to reduced fertility in Peruvian women of childbearing age. Methods Secondary analysis of Peru’s Demographic and Family Health Survey (ENDES) for 2014. The sample consisted of 20 396 women aged 15 to 49 years who had been sexually active during the four-week period immediately before the interview. The dependent variable was the total number of live births, and the main independent variables were type of employment, ideal number of offspring, highest educational level attained, and wealth quintile. Odds ratios (OR) were used to estimate the strength of the associations between proximate determinants and type of employment on the one hand and fertility on the other in logistic regression models. The goodness of fit of the models was estimated using the Hosmer-Lemeshow test and its discriminatory capacity, based on receiver operating characteristic curves. Results Desired fertility (2.5 children per woman) was higher than actual fertility (2.1). The factors most strongly associated with reduced fertility were higher educational attainment (OR = 0.03; 95% CI: 0.02-0.04); ideal number of offspring between 0 and 2 (OR = 0.13; 95% CI: 0.11-0.15); and dependent employment (OR = 0.31; 95% CI: 0.28–0.34). The models’ areas under the curve were 0.908 (95% CI: 0.898-0.917) and 0.91 (95% CI: 0.891-0.928), respectively. Conclusion Older age at first sexual intercourse and older age when first married (direct determinants) delay childbearing, whereas higher educational level and belonging to the highest wealth quintile (indirect determinants) indicate greater economic autonomy, which, in turn, is associated with low fertility. Similarly, the more dependent the work, the lower the fertility of the women surveyed.

New market labor and obesity: A nation-wide Italian cross-sectional study.

OBJECTIVES: To investigate the prevalence of obesity among different types of employment status in the Italian working population, and to examine associated risk factors. MATERIAL AND METHODS: Cross-sectional survey of 36 814 people that declared to have been occupied with the same type of contract for at least 5 years was analyzed. Multivariable logistic regression models were built considering workers' sex, age, education, family body mass index (BMI) category, leisure time and occupational physical activity, weight control habits, smoking habit, use of drugs, number of working hours per week, and type of working contract. RESULTS: After adjusting for covariates, the importance of temporary-employment was confirmed by multivariate analysis, with odds ratio (OR) = 1.32 for obesity (95% confidence interval (CI): 1.07-1.63) with respect to employed persons; the association was even more important in workers occupied for more than 40 h/week (OR = 1.69, 95% CI: 1.07-2.66); moreover, shiftwork was confirmed as a risk factor for obesity in workers (OR = 1.06, 95% CI: 0.94-1.2). Dealing with different occupational group, some categories were associated with obesity; in particular, this phenomenon involved people employed in agriculture (OR = 1.44, 95% CI: 1.22-1.7), transportation (OR = 1.53, 95% CI: 1.26-1.85), and public administration (OR = 1.31, 95% CI: 1.1-1.55). CONCLUSIONS: Our analysis suggest that obesity is strongly correlated with temporary employment. Maybe the way out this pathway to obesity in the future might be working better, choosing organizational flexibility rather than fixed term. Int J Occup Med Environ Health 2016;29(6):903-914.

Examining differences in physical activity levels by employment status and/or job activity level: Gender-specific comparisons between the United States and Sweden.

OBJECTIVES: The aim of the study was to examine the relationship between employment status and job activity level with physical activity (PA) and sedentary time, stratified by gender and country. DESIGN: Cross-sectional study design. METHODS: Data from working age adults (18-65 years) from two cross-sectional studies, the Swedish 2001-2002 and 2007-2008 Attitude Behavior and Change Study (ABC; n=1165) and the 2003-2006 US National Health and Nutrition Examination Survey (NHANES; n=4201), were stratified by employment status (employed and not employed) and job activity level (active, sedentary and mixed). PA in counts×min(-1) and time spent in sedentary, low and moderate or higher intensity were measured with accelerometers. Analyses were conducted in 2012-2013. RESULTS: In NHANES, the employed had significantly higher counts×min(-1) and spent more time in moderate or higher intensity PA than those not employed. In ABC, no significant differences were observed between employed and unemployed. Adults with active versus sedentary occupations had higher counts×min(-1) and less sedentary time in both the USA and Sweden and in both men and women. For example, counts×min(-1) were 20-40% greater in active versus sedentary jobs. CONCLUSIONS: Employment status is related to PA and sedentary time among men and women in the USA but not in Sweden. Among the employed, occupational PA is associated with total PA and sedentary time for both genders and in both countries. Comparisons of PA levels based on objective measurements can refine understanding of country differences in activity.

Health Status of Older US Workers and Nonworkers, National Health Interview Survey, 1997-2011.

INTRODUCTION: Many US workers are increasingly delaying retirement from work, which may be leading to an increase in chronic disease at the workplace. We examined the association of older adults' health status with their employment/occupation and other characteristics. METHODS: National Health Interview Survey data from 1997 through 2011 were pooled for adults aged 65 or older (n = 83,338; mean age, 74.6 y). Multivariable logistic regression modeling was used to estimate the association of socioeconomic factors and health behaviors with 4 health status measures: 1) self-rated health (fair/poor vs good/very good/excellent); 2) multimorbidity (≤1 vs ≥2 chronic conditions); 3) multiple functional limitations (≤1 vs ≥2); and 4) Health and Activities Limitation Index (HALex) (below vs above 20th percentile). Analyses were stratified by sex and age (young-old vs old-old) where interactions with occupation were significant. RESULTS: Employed older adults had better health outcomes than unemployed older adults. Physically demanding occupations had the lowest risk of poor health outcomes, suggesting a stronger healthy worker effect: service workers were at lowest risk of multiple functional limitations (odds ratio [OR], 0.82; 95% confidence interval [CI], 0.71-0.95); and blue-collar workers were at lowest risk of multimorbidity (OR, 0.84; 95% CI, 0.74-0.97) and multiple functional limitation (OR, 0.84; 95% CI, 0.72-0.98). Hispanics were more likely than non-Hispanic whites to report fair/poor health (OR, 1.62; 95% CI, 1.52-1.73) and lowest HALex quintile (OR, 1.21; 95% CI, 1.13-1.30); however, they were less likely to report multimorbidity (OR, 0.78; 95% CI, 0.73-0.83) or multiple functional limitations (OR, 0.82; 95% CI, 0.77-0.88). CONCLUSION: A strong association exists between employment and health status in older adults beyond what can be explained by socioeconomic factors (eg, education, income) or health behaviors (eg, smoking). Disability accommodations in the workplace could encourage employment among older adults with limitations.

The influence of neighbourhood-level socioeconomic deprivation on cardiovascular disease mortality in older age: longitudinal multilevel analyses from a cohort of older British men.

BACKGROUND: Evidence from longitudinal studies on the influence of neighbourhood socioeconomic factors in older age on cardiovascular disease (CVD) mortality is limited. We aimed to investigate the prospective association of neighbourhood-level deprivation in later life with CVD mortality, and assess the underlying role of established cardiovascular risk factors. METHODS: A socially representative cohort of 3924 men, aged 60-79 years in 1998-2000, from 24 British towns, was followed up until 2012 for CVD mortality. Quintiles of the national Index of Multiple Deprivation (IMD), a composite score of neighbourhood-level factors (including income, employment, education, housing and living environment) were used. Multilevel logistic regression with discrete-time models (stratifying follow-up time into months) were used. RESULTS: Over 12 years, 1545 deaths occurred, including 580 from CVD. The risk of CVD mortality showed a graded increase from IMD quintile 1 (least deprived) to 5 (most deprived). Compared to quintile 1, the age-adjusted odds of CVD mortality in quintile 5 were 1.71 (95% CI 1.32 to 2.21), and 1.62 (95% CI 1.23 to 2.13) on further adjustment for individual social class, which was attenuated slightly to 1.44 (95% CI 1.09 to 1.89), but remained statistically significant after adjustment for smoking, body mass index, physical activity and use of alcohol. Further adjustment for blood pressure, high-density lipoprotein cholesterol and prevalent diabetes made little difference. CONCLUSIONS: Neighbourhood-level deprivation was associated with an increased risk of CVD mortality in older people independent of individual-level social class and cardiovascular risk factors. The role of other specific neighbourhood-level factors merits further research.

Toxicological profile of deltamethrin in Triatoma brasiliensis (Hemiptera: Reduviidae) in State of Ceará, Northeastern Brazil

INTRODUCTION: Triatoma brasiliensis is the species of greatest epidemiological relevance in the semi-arid region of Brazil. This species is predominantly found in domestic environments, and it has the ability to build large colonies with high levels of natural infection via Trypanosoma cruzi. Thus, T. brasiliensis is one of the most efficient transmitters of Chagas disease (CD) to humans. Despite household spraying with residual insecticides, many areas report persistent reinfestations for reasons that remain poorly understood. Therefore, this study sought to characterize the toxicological profile of deltamethrin in T. brasiliensis from areas with persistent reinfestation in State of Ceará, Brazil. METHODS: The susceptibility reference lineage (SRL) was derived from Umari. Serial dilutions of deltamethrin were prepared and applied to the dorsal abdomen of first instar nymphs. The control group received only pure acetone. Mortality was evaluated after 72h. Qualitative tests assessed mortality in response to a diagnostic dose of 1xLD99 (0.851 nanograms of active ingredient per treated nymph) of the SRL. RESULTS: The susceptibility profile characterization of the T. brasiliensis populations revealed 50% resistance ratios (RR50) that ranged from 0.32 to 1.21. The percentage of mortality in response to the diagnostic dose was 100%. CONCLUSIONS: We demonstrated that T. brasiliensis was highly susceptible to deltamethrin. The control difficulties found might be related to the recolonization of the triatomines originating from neighboring environments and the possible operational failures related to the process of spraying that enabled specimens less susceptible to deltamethrin to survive. .

Clase social, factores de riesgo psicosocial en el trabajo y su asociación con la salud autopercibida y mental en Chile / Social class, psychosocial occupational risk factors, and the association with self-rated health and mental health in Chile / Classe social, fatores psicossociais de risco ocupacional e sua associação com saúde autopercebida e mental no Chile

El objetivo fue examinar la relación entre clase social, riesgo psicosocial laboral y la salud autopercibida y mental en Chile. Se trata de un estudio transversal con los datos de la Primera Encuesta Nacional de Condiciones de Empleo, Trabajo, Calidad de Vida y Salud de los Trabajadores y Trabajadoras en Chile (N = 9.503). Las variables dependientes son: salud mental y salud autopercibida. Las variables explicativas son: clase social neo-marxista, factores de riesgo psicosocial y privación material. Se realizaron análisis descriptivos y de regresión logística. Existen desigualdades en la distribución de los factores exposición laboral a riesgos psicosociales, según clase social y sexo. Además, la clase social y los factores de riesgo psicosocial en el trabajo están asociados a una distribución desigual de la salud autopercibida y salud mental entre la población trabajadora en Chile. Las intervenciones en el área de la salud de los trabajadores deben considerar la clase social y los factores de riesgo psicosocial a que están expuestos los trabajadores.

The objective of this study was to analyze the association between social class and psychosocial occupational risk factors and self-rated health and mental health in a Chilean population. A cross-sectional study analyzed data from the First National Survey on Employment, Work, Quality of Life, and Male and Female Workers in Chile (N = 9,503). The dependent variables were self-rated health status and mental health. The independent variables were social class (neo-Marxist), psychosocial occupational risk factors, and material deprivation. Descriptive and logistic regression analyses were performed. There were inequalities in the distribution of psychosocial occupational risk factors by social class and sex. Furthermore, social class and psychosocial occupational risk factors were associated with unequal distribution of self-rated health and mental health among the working population in Chile. Occupational health interventions should consider workers’ exposure to socioeconomic and psychosocial risk factors.

O objetivo foi analisar a associação entre classe social, fatores psicossociais de risco laboral e saúde autopercebida e saúde mental entre a população trabalhadora chilena. Estudo transversal com os dados da Primera Encuesta Nacional de Condiciones de Empleo, Trabajo, Calidad de Vida y Salud de los trabajadores y trabajadoras en Chile (N = 9.503). As variáveis dependentes são: saúde autopercebida e saúde mental. As variáveis explicativas são a classe social (neo-marxista), os fatores psicossociais de risco laboral e privação material. Foram realizadas análises descritivas e de regressão logística. Existem desigualdades na distribuição dos fatores psicossociais de risco laboral segundo classe social e sexo. Além disso, a classe social e os fatores de risco psicossociais no trabalho estão associados a uma distribuição desigual da saúde autopercebida e saúde mental. As intervenções na área da saúde dos trabalhadores devem considerar a classe social e fatores de risco psicossociais a que os trabalhadores estão expostos.

Precarious employment and the risk of serious psychological distress: a population-based cohort study in Japan.

OBJECTIVES: This study examines whether precarious employment increases the risk of serious psychological distress (SPD) in a nationally representative cohort of Japanese middle-aged people. METHODS: From 2005-2009, we followed 8486 male and 6736 female participants (aged 50-59 years) in the Longitudinal Survey of Middle-aged and Elderly Persons. All individuals were employed and free of SPD, cardiovascular disease, and cancer at baseline. The participants were classified into two groups based on their baseline employment contract: precarious and full-time permanent work. SPD was assessed at each year during the study, using the K6 scale, a self-rated 6-item scale that screens for mood or anxiety disorders. We used discrete-time survival analysis, with a complementary log-log link, to examine the effect of precarious employment on SPD incidence. RESULTS: During a maximum follow-up period of four years, 374 men and 364 women developed SPD. Male precarious employees were more likely to develop SPD than male full-time permanent employees (hazard ratio 1.79, 95% confidence interval 1.28-2.51) in the full model, after adjusting for sociodemographic and occupational factors, cardiovascular disease risk, and K6 scores at baseline. By contrast, no significant association was observed among female employees. However, an analysis stratified by marital status revealed an association similar to that found among men but only among unmarried women. CONCLUSIONS: The findings suggest that precarious employment is associated with double the risk of SPD incidence among middle-aged Japanese men and - when stratified by marital status - among unmarried women. This highlights a major gender difference in the association between precarious employment and risk of SPD.

Self-employment in joinery: an occupational risk facor?

OBJECTIVES: Only a few studies have analyzed the health of self-employed workers. This cross-sectional study is the first to compare health status among craftsmen joiners and paid joiners. MATERIAL AND METHODS: Clinical and paraclinical data for self-employed craftsmen and employees were collected by occupational health doctors according to a standardized protocol and compared. Health data and professional status relationships were analyzed by logistic regression. RESULTS: A total of 171 craftsmen and 196 paid workers were included. Craftsmen had more dermatologic pathologies (odds ratio (OR) = 2.67, p < 0.05), ear/nose/throat symptoms (OR = 3.38, p < 0.001), pulmonary symptoms (OR = 2.46, p < 0.05), musculoskeletal symptoms (OR = 3.09, p < 0.001), and abnormal audiogram (OR = 3.50, p < 0.001). The FEV1 was significantly lower among craftsmen (p < 0.01), independently of tobacco smoke exposure. CONCLUSIONS: This survey high-lights a high morbidity rate among self-employed craftsmen, suggesting that among woodworkers, professional status can be a risk factor for health. The preventive medical system for craftsmen has to be rethought to guarantee better safety for this population.

The impact of breast cancer on employment among Japanese women.

OBJECTIVES: Breast cancer (BC) is a cancer that affects working age women in Japan. The aim of this study was to examine the impact that BC has on the work-related life of Japanese women and identify factors that correlate with job resignation. METHODS: A cross-sectional Internet survey of cancer survivors in Japan was conducted from December 2011 to February 2012. The questionnaire included questions regarding demographic characteristics, impact of cancer diagnosis and treatment on job resignation and consultation behavior of respondents regarding work-related issues. This study reports results obtained from 105 respondents with BC. RESULTS: The mean age of respondents at diagnosis was 42.5 ± 6.4 years, and the median time since diagnosis was 40 months. Thirty-one respondents (29.5%) lost their jobs, and 12 could not find another job after BC diagnosis. Nearly half of the respondents (47.6%) reported a decrease in personal income after diagnosis. Multiple logistic regression analysis revealed that contract or part time workers were significantly more likely to lose their jobs compared with regular, full time workers (odds ratio, 2.52; 95% confidence interval, 1.39 to 4.55; p<0.001). Seventy-nine respondents (75.2%) consulted someone regarding work-related issues. The most frequently consulted person was the boss at the workplace. CONCLUSIONS: Our findings suggest that women with BC experience various job-related problems. In order to create a supportive work environment for BC survivors, focus should be placed on facilitating communication and coordination between BC survivors, healthcare providers and coworkers.

Long work hours and obesity in Korean adult workers.

OBJECTIVES: The present study was designed to identify the association between work hours and obesity in Korean adult manual and nonmanual workers, and to determine whether there is a gender difference in this association. METHODS: The study was conducted using Korean National Health and Nutrition Examination Survey data collected between 2007 and 2010. Individuals aged below 25 or over 64 years, pregnant women, part-time workers, soldiers, housewives and students were excluded. The total number of individuals included in the analysis was 8,889 (5,241 male and 3,648 female subjects). The outcome variable was obesity, defined as body mass index ≥25 kg/m(2). Variables considered in the model were age, education, income, marital status, alcohol drinking, smoking, daily energy intake, physical activity, sleep hours per day, the type of job, work hours, and work schedule. Work hours were categorized as <40, 40-48 (reference), 49-60, and >60 hours per week. RESULTS: In the multiple SURVEYLOGISTIC regression analyses, the adjusted odds ratio of obesity for long work hours (>60 hours per week) in male manual workers was 1.647 (95% confidence interval 1.262-2.151). Long work hours did not significantly increase the odds ratio for obesity in male nonmanual workers and female manual and nonmanual workers. CONCLUSIONS: More than 60 work hours per week increased the risk of obesity in Korean male manual workers. This result might be helpful in preventing obesity in Korean adult workers, especially male manual workers.

Desigualdades no acesso e uso dos serviços de saúde entre trabalhadores informais e desempregados: análise da PNAD 2008, Brasil / Inequalities in health services access and use among formal, informal, and unemployed workers, based on data from the Brazilian National Household Sample Survey, 2008 / Desigualdades en el acceso y uso de los servicios de salud entre los trabajadores informales y desempleados: análisis de la PNAD 2008, Brasil

O objetivo do estudo foi analisar se o tipo de vínculo de trabalho está associado a diferenças no acesso e utilização dos serviços de saúde. Utilizando os microdados da Pesquisa Nacional por Amostra de Domicílios (PNAD/2008) foram estudados trabalhadores de 18 a 64 anos (N = 152.233), de ambos os sexos. Foram calculadas prevalências e razões de prevalência brutas e ajustadas das características de saúde dos trabalhadores por meio de regressão de Poisson. Em relação aos formais (n = 76.246), os informais (n = 62.612) e desempregados (n = 13.375) apresentaram menor escolaridade, menor renda mensal, pior estado de saúde autorreferido, maior frequência de "acamado nas duas últimas semanas", maior dificuldade de acesso e menor procura e uso dos serviços de saúde, mesmo após ajuste para sexo, faixa etária, região, escolaridade e informante. Há necessidade de políticas de saúde que diminuam a desigualdade no acesso aos serviços de saúde pelos trabalhadores informais e desempregados.

The aim of this study was to analyze whether job market status is associated with differences in health services access and use. Data from the Brazilian National Household Sample Survey (PNAD/2008) were used to study workers 18 to 64 years of age, both men and women (N = 152,233). Prevalence and crude and adjusted prevalence ratios for the worker's health characteristics were calculated using Poisson regression. When compared to formal workers (n = 76,246), informal workers (n = 62,612) and unemployed (n = 13,375) showed less schooling, lower monthly income, worse self-reported health status, more frequent reporting of have been "bedridden in the previous two weeks", greater difficulty in accessing health services, and lower health services seeking, even after controlling for sex, age bracket, region, schooling, and respondent. Health policies are needed to reduce inequalities in access to health services by informal workers and the unemployed.

El objetivo del estudio fue analizar si el tipo de situación en el empleo se asocia con diferencias en el acceso y utilización de los servicios de salud. Utilizando datos microeconómicos de la Encuesta Nacional por Muestra de Domicilio (PNAD/2008) se estudiaron trabajadores de 18 a 64 años (N = 152.233) de ambos sexos. Se calcularon prevalencias y razones de prevalencia ajustadas y características manifiestas de los trabajadores de la salud a través de regresión de Poisson. En situaciones de relación formal (n = 76.246), informal (n = 62.612) y desempleo (n = 13.375) contaban con menor educación; menores ingresos; peor percepción del estado de salud, una mayor incidencia de "postrado en cama las últimas dos semanas", de mayor dificultad de acceso y de disminución en la demanda y utilización de servicios de salud, incluso después de realizar ajustes por sexo, edad, región, educación, e informante. No es necesario que las políticas de salud reduzcan la desigualdad en el acceso a los servicios de salud para los trabajadores desempleados e informales.