Informal caregiving and self-reported mental and physical health: results from the Gazel Cohort Study.

OBJECTIVES: We investigated whether, and under what conditions, informal caregiving is associated with improved self-reported physical and mental health, most notably in terms of cognitive functioning. METHODS: We performed a cross-sectional analysis of 2008 data from the Gazel Cohort Study, which involved 10 687 men and women aged 54 to 70 years. Multivariate linear and logistic regression models were used to estimate the associations between self-reported health and caregiving status and burden. RESULTS: Regular caregivers with the highest burden scores reported significantly worse health status than did noncaregivers for almost all of the physical and mental outcomes evaluated after adjustment for potential confounding factors. In particular, they reported more cognitive complaints (odds ratio [OR] = 1.44; 95% confidence interval [CI] = 1.21, 1.73). Conversely, caregivers with the lowest burden scores reported better perceived health status, less physical and mental tiredness, and fewer depressive symptoms (OR = 0.50; 95% CI = 0.37, 0.68) than did noncaregivers; however, they did not report decreases in cognitive difficulties (OR = 0.98; 95% CI = 0.81, 1.18). CONCLUSIONS: Our findings support the hypothesis that caregiving can have positive effects on health, provided that caregiving activities themselves are not too heavy a burden.

Post-retirement surveillance of workers exposed to asbestos or wood dust: first results of the French national SPIRALE Program.

OBJECTIVES: In France, 15 000-20 000 cancers attributable to occupational exposure occur each year. These cancers appear most often after the worker has retired. Since 1995, a system of post-retirement medical surveillance (PRMS) has been set up for former workers, but it remains largely underused. DESIGN: The SPIRALE program is a public health intervention aimed at identifying the former workers having been exposed to asbestos or wood dust during their working life and to propose them a PRMS. Additionally, it is also an epidemiologic research on the longterm effects of occupational exposure.We report the results of first years of the program conducted in 2006-2008, in 13 districts. SETTING AND PARTICIPANTS: a self-administered questionnaire was sent to 50 000 newly retired men, to identify potential past occupational carcinogen exposure. For respondents detected as possibly exposed, exposure was assessed in Health Screening Centres and a PRMS was recommended if necessary. MAIN OUTCOME MEASURES: Participation rate, rate of confirmed exposure, increased rate of PRMS, satisfaction about the program. RESULTS: The participation rate was 24%. From 12 002 questionnaires analysed, 72% of respondents were identified as possibly exposed: 3%to wood dust, 50%to asbestos and 19%to both exposures. Exposure to asbestos was confirmed for 73.4%, and according to the level of exposure, PRMS was recommended for 47.1%. Wood dust exposure was confirmed for 56.7%. In these districts, PRMS for asbestos increased by 45% and for wood dust by 600%. Additional surveys showed that participants showed a high degree of satisfaction about the program. CONCLUSIONS: The results are positive in terms of detection, information and medical surveillance of exposed workers.

Organizational downsizing and depressive symptoms in the European recession: the experience of workers in France, Hungary, Sweden and the United kingdom.

BACKGROUND: Organizational downsizing has become highly common during the global recession of the late 2000s with severe repercussions on employment. We examine whether the severity of the downsizing process is associated with a greater likelihood of depressive symptoms among displaced workers, internally redeployed workers and lay-off survivors. METHODS: A cross-sectional survey involving telephone interviews was carried out in France, Hungary, Sweden and the United Kingdom. The study analyzes data from 758 workers affected by medium- and large-scale downsizing, using multiple logistic regression. MAIN RESULTS: Both unemployment and surviving layoffs were significantly associated with depressive symptoms, as compared to reemployment, but the perceived procedural justice of a socially responsible downsizing process considerably mitigated the odds of symptoms. Perception of high versus low justice was assessed along several downsizing dimensions. In the overall sample, chances to have depressive symptoms were significantly reduced if respondents perceived the process as transparent and understandable, fair and unbiased, well planned and democratic; if they trusted the employer's veracity and agreed with the necessity for downsizing. The burden of symptoms was significantly greater if the process was perceived to be chaotic. We further tested whether perceived justice differently affects the likelihood of depressive symptoms among distinct groups of workers. Findings were that the odds of symptoms largely followed the same patterns of effects across all groups of workers. Redeploying and supporting surplus employees through the career change process-rather than forcing them to become unemployed-makes a substantial difference as to whether they will suffer from depressive symptoms. CONCLUSIONS: While depressive symptoms affect both unemployed and survivors, a just and socially responsible downsizing process is important for the emotional health of workers.

Informal caregiving and the risk for coronary heart disease: the Whitehall II study.

BACKGROUND: The stress associated with informal caregiving has been shown to be associated with poor health, including coronary heart disease (CHD). However, it is unclear if the risk of CHD is attributable to caregiving or prior poor health of the caregiver. METHODS: We used data from the Whitehall II cohort study. Caregiving and caregiver's health (using 3 measures: self-rated health, mental health using the General Health Questionnaire, and physical component score of the SF-36) were assessed in 1991-1993 among 5,468 men and 2,457 women aged 39-63 years. CHD (fatal CHD, clinically verified nonfatal myocardial infarction, and definite angina) incidence was recorded for a mean 17 years; sociodemographic variables, health behaviors, and cardiovascular risk factors were included as covariates. RESULTS: Cox regression showed the risk of CHD in caregivers not to be higher (hazard ratio = 1.18; 95% CI: 0.96, 1.45) compared with noncaregivers. Analyses stratified by health status showed that compared with noncaregivers in good health, caregivers with poor self-rated (hazard ratio = 2.00; 95% CI: 1.44, 2.78), mental (hazard ratio = 1.63; 95% CI: 1.16, 2.30), or physical (hazard ratio =1.87; 95% CI: 1.34, 2.62) health had greater risk of CHD. A similar elevated risk was observed in noncaregivers with poor health; no excess risk was observed among caregivers reporting good health, and the combined effect of poor health and caregiving did not exceed their independent effects. CONCLUSIONS: Caregiving in midlife is not in itself associated with greater risk of CHD, but it is associated with increased risk for CHD among caregivers who report being in poor health.