ABSTRACT
We studied the developmental trajectories of satisfaction with work-family reconciliation (WFS) and their associations with family-related factors and quality of life measures among municipal employees. The study was based on the Helsinki Health Study of municipal employees of the City of Helsinki in 2001-02 and its follow-up surveys in 2007, 2012, and 2017. Employees aged 40-50 at baseline and working at all timepoints were analysed (n = 1681, 84% women). Growth Mixture Models were applied to identify trajectories of WFS (dissatisfied vs. satisfied). Associations of family-related and quality-of-life factors (physical functioning and emotional well-being) with the WFS trajectories were studied using log-binomial regression models, adjusting for sociodemographic and lifestyle variables. Two WFS trajectories, low (women 45%; men 53%) and high were identified. In a fully adjusted model among women, having ≥1 children aged 0-6 years was associated with increased odds of belonging to the low WFS trajectory (OR 1.52, 95% CI 1.19-1.95). Among men, having ≥1 children aged 7-18 was associated with decreased odds (0.39, 0.19-0.80). High emotional well-being was inversely associated with the low WFS trajectory among both genders (women 0.32, 0.23-0.45; men 0.20, 0.09-0.46). High physical functioning (0.59, 0.42-0.83) was inversely associated with the low WFS trajectory among women only. Less than half of the women and more than half of the men participants belonged to a low WFS trajectory, which associated with the age of children in the family and quality-of-life measures.
ABSTRACT
BACKGROUND: Active commuting, such as walking or cycling to work, can be beneficial for health. However, because within-individual studies on the association between change in active commuting and change in health are scarce, the previous results may have been biased due to unmeasured confounding. Additionally, prior studies have often lacked information about commuting distance. METHODS: We used two waves (2020, T1 and 2022, T2) of self-report data from the Finnish Public Sector study (N = 16,881; 80% female) to examine the within- and between associations (in a hybrid model) between active commuting and health. Exposure was measured by actively commuted kilometers per week, that is, by multiplying the number of walking or cycling days per week with the daily commuting distance. The primary outcome, self-rated health, was measured at T1 and T2. The secondary outcomes, psychological distress, and sleep problems were measured only at T2 and were therefore analyzed only in a between-individual design. RESULTS: After adjustment for potential time-varying confounders such as socioeconomic factors, body mass index, and health behaviors, an increase equivalent to 10 additional active commuting kilometers per week was associated with a small improvement in self-rated health (within-individual unstandardized beta = 0.01, 95% CI 0.01-0.02; between-individual unstandardized beta = 0.03, 95% CI 0.02-0.04). No associations were observed between changes in active commuting and psychological distress or sleep problems. CONCLUSIONS: An increase in active commuting may promote self-rated health. However, increase of tens of additional kilometers in commuting every day may be required to produce even a small effect on health.
Subject(s)
Public Sector , Sleep Wake Disorders , Humans , Female , Male , Finland , Walking , Bicycling , Transportation/methodsABSTRACT
BACKGROUND: . Decreased work ability due to mental disorders is a growing concern in Europe. We studied the role of work-family conflicts in association with long-term sickness absence due to mental disorders (LTSA-MD). METHODS: . Baseline data were extracted from the Helsinki Health Study for women aged 40 to 55 in full-time work in 2001 - 2002 (N = 2386). Questionnaire responses were linked with register data from the Social Insurance Institution of Finland on SA spells due to mental disorders during 2004-2010. We studied an overall question on satisfaction with combining work and family (WFS) and composite scores of work-to-family conflicts (WTFC) and family-to-work-conflicts (FTWC), and their components in association with the first certified SA spell (≥ 12 calendar days) due to a mental disorder during the follow-up. We performed Cox regression analyses with hazard ratios (HR) and their 95% confidence intervals (CI) adjusted for sociodemographic factors, work schedule, perceived mental and physical strenuousness at work, and self-rated health. First, we examined all participants, and second, only those who reported no prior mental disorder. RESULTS: . Poor work-family satisfaction (WFS) was associated with subsequent LTSA-MD, adjusting for all covariates (HR 1.60; 95% CI 1.10-2.16). Both high WTFC (1.64; 1.15-2.23), and high FTWC (1.43; 1.02-2.00) increased the probability of LTSA-MD in the full model. When participants with prior mental disorder were excluded, the association between poor WFS and WTFC with LTSA-MD retained while that between FTWC and LTSA-MD attenuated; however, two items of the FTWC were still associated with LTSA-MD: 'Family worries and problems distract you from your work' and 'Family matters prevent you from sleeping enough to do your job well'. Of the WTFC items, the following remained associated with LTSA-MD: 'Problems at work make you irritable at home' and 'Your job takes so much energy you do not feel up to doing things that need attention at home'. The experience of decreased time for work or family did not associate with LTSA-MD. CONCLUSIONS: . Among female municipal employees, dissatisfaction with combining work and family and both work-to-family and family-to-work conflicts were associated with subsequent long-term sickness absence due to mental disorders.
Subject(s)
Mental Disorders , Psychotic Disorders , Female , Humans , Follow-Up Studies , Family Conflict , Mental Disorders/epidemiology , CertificationABSTRACT
AIM: Although multisite pain (MSP) often threatens work ability (WA), some of those with MSP retain good WA. Our aim was to identify factors associated with good WA among subjects with MSP. METHODS: A nationally representative sample (the Health 2000-Study, response rate 87%) comprising 3884 occupationally active Finns aged 30-64 years. Data on WA, musculoskeletal pain, physical and psychosocial working conditions, chronic diseases, lifestyle and domestic situation were gathered by questionnaire, interview and clinical examination. Good current WA compared with the lifetime best was defined as ⩾9 on a 0-10 scale. Musculoskeletal pain in 18 body locations was combined into four sites, and thereafter pain in two or more sites was defined as MSP (N=1351). Poisson regression analysis was used to obtain prevalence rate ratios (PRR). RESULTS: Good WA was reported by 48% of the women and 37% of the men with MSP. In a multivariable model good WA was associated with younger age, female gender, physically non-strenuous work (PRR 1.3, 95% CI 1.1-1.5), low job strain (1.2, 1.0-1.4), high supervisor support (1.2, 1.0-1.4), and not having musculoskeletal diseases (1.3, 1.1-1.5), mental disorders (1.4, 1.1-1.9), daytime tiredness (1.4, 1.2-1.7) or economic troubles (1.5, 1.1-1.9). Age-stratified analyses revealed also associations with high coworker support (1.2, 1.0-1.4) and strenuous leisure-time physical exercise (1.2, 1.0-1.4) in those aged 30-44 and low alcohol consumption (1.8, 1.2-2.6) in the age-group 45-64. CONCLUSIONS: Several potentially modifiable factors related to health, work, and lifestyle were associated with good WA among occupationally active subjects with MSP.
Subject(s)
Musculoskeletal Pain/epidemiology , Work Capacity Evaluation , Adult , Cross-Sectional Studies , Female , Finland/epidemiology , Humans , Male , Middle Aged , Multivariate AnalysisABSTRACT
AIMS: Previously, among food industry workers, multisite pain predicted sickness absence (SA) only in those with low biomechanical workload. Here we studied among a wide range of occupations whether the relationship of pain with SA was modified by the level of physical or psychosocial workload. METHODS: A nationally representative sample (Health 2000 Survey) comprised 3420 occupationally active Finns aged 30-55 years. Baseline data on musculoskeletal pain during the preceding month, strenuous work history, current physical workload, job demands, job control, support at work, lifestyle, and chronic diseases were obtained in 2000/2001 by questionnaire, interview, and clinical examination. Musculoskeletal pain in 18 body locations was combined into four sites (neck, upper limbs, low back, and lower limbs) and classified as no pain, single-site pain, and multisite pain (2-4 sites). The data were linked with information from national registers on annual SA periods lasting ≥10 workdays for 2002-2008. Negative binomial regression analysis was used. RESULTS: At baseline, one-third of the study sample reported single-site and one-third multisite pain. Allowing for gender and age, the employees with multisite pain in strata with high physical workload and high job demands tended to have the highest risk of SA, but no statistically significant interactive effects between work factors and pain were observed. Further adjustment for health-related lifestyle and chronic diseases decreased the risk estimates in all strata. CONCLUSION: We did not find evidence for significant modification by physical or psychosocial workload of the relationship between musculoskeletal pain and SA periods lasting ≥10 workdays.
Subject(s)
Absenteeism , Musculoskeletal Pain/etiology , Occupational Diseases/etiology , Sick Leave/statistics & numerical data , Workload , Adult , Female , Finland , Health Surveys , Humans , Job Satisfaction , Life Style , Male , Middle Aged , Prospective Studies , Registries , Regression Analysis , Risk Factors , Social SupportABSTRACT
BACKGROUND: Existing research has mostly focused on themes related to returning to or staying at work and studied organizations' operational rather than strategic level actions to support work ability. Top managers' understanding of work ability management (WAM) may influence how work ability support processes are implemented in organizations. OBJECTIVE: To find out how top managers define WAM, what the aims of WAM were and whether the aims were on a strategic level. METHODS: Altogether 28 semi-structured interviews among Finnish social and health care top managers were conducted during the years 2019-2021 and analyzed inductively using qualitative thematic analysis. RESULTS: Top managers' definition of WAM was mainly multidimensional. Two main aims were identified, i.e., to support work ability 1) at the individual and 2) at the organizational level. The aims of the former were to anticipate the decrease of health and functional capacity, to support workers already decrease in these, to develop competence, and to manage the effects of changes on work ability. The aims at the organizational level were to improve labor availability and personnel retention, to ensure the flow of work, and to increase trust and create shared values. Top managers described the aims as being at a strategic level, but this was not yet realized in their organizations because the actions were reactive rather than proactive. CONCLUSION: Top managers' multidimensional perception of WAM, emphasizing proactive actions, and strategic level aims are crucial and require the commitment of the top managers for strategic WAM, especially during constant changes.
Subject(s)
Delivery of Health Care , Work Capacity Evaluation , Humans , Personnel Turnover , LeadershipABSTRACT
Repetitive strain injuriesof the upper extremities refer to pain in the forearm, wrist and hand, caused by excessive strain. Diagnoses include tenosynovitis, epicondylitis and carpal tunnel syndrome. Treatment is aimed at alleviating pain, restoring normal physical functioning and maintain ability to work. Preventive interventions have shown some attenuation of discomfort but no effects on disease prevalance or sick leave days. Return to work interventions seem to decrease length of sickness absences. Part time work has hastened return to work and decreased sickness absences in musculoskeletal disorders.
Subject(s)
Carpal Tunnel Syndrome/diagnosis , Carpal Tunnel Syndrome/therapy , Cumulative Trauma Disorders/diagnosis , Cumulative Trauma Disorders/therapy , Occupational Diseases/diagnosis , Occupational Diseases/therapy , Tennis Elbow/diagnosis , Tennis Elbow/therapy , Tenosynovitis/diagnosis , Tenosynovitis/therapy , Humans , Pain Management , Pain Measurement , Practice Guidelines as Topic , Recovery of Function , Risk FactorsABSTRACT
OBJECTIVES: The aim of this prospective study was to examine the role of physical workload, leisure-time physical activity, obesity and smoking in predicting the occurrence and course of multisite musculoskeletal pain (MSP). METHODS: Data on physical and psychosocial workload, lifestyle factors and MSP were based on questionnaire surveys of 385 Finnish female kitchen workers. MSP (defined as pain at three or more of seven sites) during the past 3 months was measured repeatedly at 3-month intervals over 2 years. Four different patterns (trajectories) in the course of MSP were identified. The authors analysed whether the determinants at baseline predicted the occurrence of MSP (1) at the 2-year follow-up and (2) over the total of nine measurements during the 2 years by exploiting the MSP trajectories. Logistic regression was used. RESULTS: High physical workload at baseline was an independent predictor of MSP at the 2-year follow-up (OR 3.8, 95% CI 1.7 to 8.5) in a model allowing for age, psychosocial factors at work and lifestyle. High physical workload (OR 2.0, 95% CI 1.0 to 4.0) and moderate (OR 2.4, 95% CI 1.2 to 4.9) or low (OR 2.3, 95% CI 1.1 to 4.7) physical activity predicted persistent MSP. Obesity (OR 2.8, 95% CI 1.0 to 7.8) predicted an increased, and not being obese (OR 3.7, 95% CI 1.1 to 12.7) a decreased, prevalence of MSP in models similarly including all covariates. Smoking had no effect. CONCLUSION: The results emphasise the importance of high physical workload, low to moderate physical activity and obesity as potential modifiable risk factors for the occurrence and course of MSP over time.
Subject(s)
Exercise , Musculoskeletal Pain/etiology , Obesity/complications , Occupational Diseases/etiology , Occupations , Smoking , Workload , Adult , Female , Follow-Up Studies , Health Surveys , Humans , Industry , Leisure Activities , Life Style , Logistic Models , Middle Aged , Odds Ratio , Physical Exertion , Prospective Studies , Risk Factors , Surveys and Questionnaires , Young AdultABSTRACT
OBJECTIVES: Musculoskeletal pain often occurs at multiple sites concurrently. The aim of this study was to examine the associations between multi-site pain and self-rated work ability and retirement plans among actively working people. METHODS: The Health 2000 Survey was carried among a representative sample of Finnish adults. Musculoskeletal pain during the preceding month in the lower back, neck or shoulders, upper extremities, hips and lower extremities, and work ability and intentions to retire early were assessed. Subjects were also clinically examined. Analyses were restricted to 30-64-year-old subjects actively working during the preceding 12 months who provided information on work ability outcomes (population-weighted number of subjects=4087). Log-binomial regression was used to estimate prevalence ratios of reduced work ability. RESULTS: Single-site pain was reported by 33% of subjects, 20%, 9% and 4% reported pain in two, three and four sites, respectively, and 8%-15% reported poor work ability. Every fifth person had thought about retiring early. Age- and gender-adjusted risks of poor physical work ability and own prognosis of poor future work ability increased from 2 for single-site pain to 8 for pain at four sites. Risks remained considerably elevated after adjustment for various covariates, including clinical musculoskeletal disorders and functional capacity. Poor current work ability was most affected by multi-site pain at older age (50-64 years) and intentions to retire early at age 40-49 years. CONCLUSIONS: Co-occurring pain is a considerable threat to work ability. Workers with multi-site pain may benefit from targeted preventive measures to sustain their work ability. Future studies should also consider multi-site pain as an important risk factor for reduced work ability.
Subject(s)
Musculoskeletal Diseases/epidemiology , Occupational Diseases/epidemiology , Pain/epidemiology , Absenteeism , Adult , Data Interpretation, Statistical , Disability Evaluation , Female , Finland/epidemiology , Health Surveys , Humans , Male , Middle Aged , Musculoskeletal Diseases/economics , Musculoskeletal Diseases/prevention & control , Occupational Diseases/economics , Occupational Diseases/prevention & control , Pain/economics , Pain/psychology , Prevalence , Retirement , Risk Factors , Surveys and QuestionnairesABSTRACT
OBJECTIVES: To study the effect of a participatory ergonomics intervention on psychosocial factors among kitchen workers. DESIGN: A cluster randomised controlled trial. SETTING: Four cities in Finland, 2002-2005. PARTICIPANTS: 504 workers in 119 municipal kitchens. INTERVENTION: Kitchens were randomised to intervention (n=59) and control (n=60) groups. The intervention lasted 11-14 months and was based on the workers' active participation in work analysis, planning and implementing the ergonomic changes aimed at decreasing the physical and mental workload. MAIN OUTCOME MEASURES: Mental stress, mental strenuousness of work, hurry, job satisfaction, job control, skill discretion, co-worker relationships and supervisor support. Data were collected by questionnaire at baseline, at the end of the intervention, and at a 12-month follow-up (PI(12)). RESULTS: At the end of the intervention, the OR of job dissatisfaction for the intervention group as compared with the control group was 3.0 (95% CI 1.1 to 8.5), of mental stress 2.3 (1.2 to 4.7) and of poor co-worker relationships 2.3 (1.0 to 5.2). At the PI(12), the OR of job dissatisfaction was 3.0 (1.2 to 7.8). Analysis of the independent and joint effects of the intervention and unconnected organisational reforms showed that adverse changes were accentuated among those with exposure to both. CONCLUSIONS: No favourable effects on psychosocial factors at work were found. The adverse changes were due to a joint effect of the intervention and the unconnected organisational reforms. The findings do not support the usefulness of this kind of intervention in changing unsatisfactory psychosocial working conditions.
Subject(s)
Ergonomics , Food Handling , Occupational Diseases/prevention & control , Stress, Psychological/prevention & control , Adult , Female , Finland , Humans , Interpersonal Relations , Job Satisfaction , Male , Middle Aged , Occupational Health , Program Evaluation , Workload/psychology , Workplace/psychology , Young AdultABSTRACT
The contribution of physically demanding work to the developmental trajectories of sickness absence (SA) has seldom been examined. We analyzed the associations of 12 physical work exposures, individually and in combination, with SA trajectories among the occupationally active in the Finnish nationally representative Health 2000 survey. We included 3814 participants aged 30-59 years at baseline, when exposure history to work-related factors was reported. The survey and interview responses were linked with the annual number of medically confirmed SA spells through 2002-2008 from national registries. Trajectory analyses identified three SA subgroups: 1 = low (54.6%), 2 = slowly increasing (33.7%), and 3 = high (11.7%). After adjustments, sitting or use of keyboard >1 year was inversely associated with the high SA trajectory (odds ratio, OR, 0.57; 95% 95% confidence interval, CI, 0.43-0.77). The odds of belonging to the trajectory of high SA increased with an increasing number of risk factors, and was highest for those with ≥4 physical workload factors (OR 2.71; 95% CI 1.99-3.69). In conclusion, these findings highlight the need to find ways to better maintain the work ability of those in physically loading work, particularly when there occurs exposure to several workload factors.
Subject(s)
Sick Leave/statistics & numerical data , Workload , Adult , Female , Finland , Follow-Up Studies , Health Surveys , Humans , Male , Middle Aged , Odds Ratio , Registries , Risk Factors , WorkplaceABSTRACT
Objective This study aimed to develop and validate a risk screening tool using a points system to assess the risk of future disability retirement due to musculoskeletal disorders (MSD). Methods The development population, the Health 2000 Survey, consisted of a nationally representative sample of Finnish employees aged 30-60 years (N=3676) and the validation population, the Helsinki Health Study, consisted of employees of the City of Helsinki aged 40-60 years (N=6391). Both surveys were linked to data on disability retirement awards due to MSD from national register for an 11-year follow-up. Results The discriminative ability of the model with seven predictors was good (Gönen and Heller's K concordance statistic=0.821). We gave points to seven predictors: sex-dependent age, level of education, pain limiting daily activities, multisite musculoskeletal pain, history of arthritis, and surgery for a spinal disorder or carpal tunnel syndrome. A score of 3 or higher out of 7 (top 30% of the index) had good sensitivity (83%) and specificity (70%). Individuals at the top 30% of the risk index were at 29 [95% confidence interval (CI) 15-55) times higher risk of disability retirement due to MSD than those at the bottom 40%. Conclusion This easy-to-use screening tool based on self-reported risk factor profiles can help identify individuals at high risk for disability retirement due to MSD.
Subject(s)
Disabled Persons/statistics & numerical data , Musculoskeletal Diseases/epidemiology , Retirement , Surveys and Questionnaires/standards , Adult , Age Factors , Finland/epidemiology , Humans , Male , Middle Aged , Occupational Diseases/epidemiology , Registries , Retirement/statistics & numerical data , Risk Factors , Sex FactorsABSTRACT
We identified factors protective of all-cause sickness absence (SA) among subjects with multisite musculoskeletal pain (MSP). The nationally representative source sample comprised 3420 actively working Finns aged 30 to 55 in year 2000 and alive at follow-up. Pain in 18 body locations was combined into four sites (neck, low back, upper limbs, and lower limbs). The baseline prevalence of MSP (pain in ≥ 2 sites) was 32%. Baseline data on sociodemographic factors, work ability, work, health, and lifestyle were gathered by questionnaire, interview, and clinical examination and linked with national registers on all-cause SA (periods lasting ≥10 workdays) for 2002 to 2008. Based on trajectory analysis, 74% of those with MSP had a low and 26% a high probability of SA. In logistic regression analysis, younger age, male sex, and professional occupational group were inversely associated with SA. Allowing for these, good physician-assessed work ability, physically light work, possibility to adjust workday length, encouraging workplace atmosphere, no problems with working community or mental stress, normal weight, and no sleep disorders were predictive of lower SA rates (odds ratios between 0.47 and 0.70). In a final stepwise model adjusted for age, sex, and occupational group, no exposure to lifting (odds ratio 0.58, 95% confidence interval 0.39-0.85) and to repetitive hand movements (0.57, 0.39-0.83), possibility to adjust workday length (0.73, 0.53-0.99), and normal weight (0.59, 0.40-0.87) were inversely associated with SA. In conclusion, several modifiable factors related to work and lifestyle were found as predictive of lower rates of longer SA among occupationally active subjects with MSP.
Subject(s)
Absenteeism , Musculoskeletal Pain/epidemiology , Musculoskeletal Pain/psychology , Occupational Diseases/epidemiology , Sick Leave/statistics & numerical data , Adult , Female , Finland , Humans , Job Satisfaction , Life Style , Longitudinal Studies , Male , Middle Aged , Occupational Diseases/psychology , Retrospective Studies , WorkloadABSTRACT
INTRODUCTION: Previous research suggests that work with a suitable workload may promote health and work retention in people with disability. This study will examine whether temporary work modifications at the early stage of work disability are effective in enhancing return to work (RTW) or staying at work among workers with musculoskeletal or depressive symptoms. METHODS AND ANALYSIS: A single-centre controlled trial with modified stepped wedge design will be carried out in eight enterprises and their occupational health services (OHSs) in nine cities in Finland. Patients seeking medical advice due to musculoskeletal pain (≥4 on a scale from 0-10) or depressive symptoms (≥1 positive response to 2 screening questions) and fulfilling other inclusion criteria are eligible. The study involves an educational intervention among occupational physicians to enhance the initiation of work modifications. Primary outcomes are sustained RTW (≥4â weeks at work without a new sickness absence (SA)) and the total number of SA days during a 12-month follow-up. Secondary outcomes are intensity of musculoskeletal pain (scale 0-10), pain interference with work or sleep (scale 0-10) and severity of depressive symptoms (Patient Health Questionnaire, PHQ-9), inquired via online questionnaires at baseline and 3, 6, 9 and 12â months after recruitment. Information on SA days will be collected from the medical records of the OHSs over 12â months, before and after recruitment. The findings will give new information about the possibilities of training physicians to initiate work modifications and their effects on RTW in employees with work disability due to musculoskeletal pain or depressive symptoms. ETHICS AND DISSEMINATION: The Coordinating Ethics Committee of Hospital District of Helsinki and Uusimaa has granted approval for this study. The results will be published in peer-reviewed journals. TRIAL REGISTRATION NUMBER: ISRCTN74743666.
Subject(s)
Depression , Musculoskeletal Pain , Program Evaluation , Return to Work , Sick Leave , Unemployment , Workload , Adult , Disabled Persons , Female , Finland , Humans , Male , Research Design , Surveys and Questionnaires , Work Capacity EvaluationABSTRACT
OBJECTIVE: We studied predictors of sickness absences (SA) due to musculoskeletal pain over two years among 386 municipal female kitchen workers. METHODS: Pain and SA periods (no/yes) due to pain in seven sites during the past three months were assessed at 3-month intervals over two years by questionnaire. Age, musculoskeletal pain, multisite pain (pain in ≥3 sites), musculoskeletal and other somatic diseases, depressive symptoms, physical and psychosocial workload, body mass index, smoking, and leisure-time physical activity (LTPA) at baseline were considered as predictors. Trajectory analysis and multinomial logistic regression were used. RESULTS: Three trajectories of SA emerged, labelled as "none" (41% of the subjects), "intermediate" (48%), and "high" (11%). With the "none" trajectory (no SA) as reference, pain in all musculoskeletal sites excepting the low back predicted belonging to the "intermediate" [odds ratio (OR) 1.82-2.48] or "high" (OR 2.56-3.74) trajectory adjusted for age; multisite pain predicted membership of the "intermediate" [OR 2.15, 95% confidence interval (95% CI) 1.38-3.34] or "high" (OR 4.66, 95% CI 2.10-10.3) trajectories. In a mutually adjusted final model, smoking (OR 2.12, 95% CI 1.22-3.69), multisite pain (OR 1.87, 95% CI 1.15-3.02), and overweight/obesity (OR 1.71, 95% CI 1.08-2.72) predicted belonging to the "intermediate" trajectory, while depressive symptoms (OR 3.57, 95% CI 1.57-8.10), musculoskeletal diseases (OR 3.18, 95% CI 1.37-7.37), and multisite pain (OR 2.72, 95% CI 1.15-6.40) were associated with the "high" trajectory. CONCLUSION: Along with the number of pain sites and musculoskeletal diseases, attention to depressive symptoms, smoking, and overweight/obesity is needed to tackle SA related to musculoskeletal pain.
Subject(s)
Absenteeism , Cooking , Musculoskeletal Pain/physiopathology , Occupational Diseases/physiopathology , Adult , Body Mass Index , Depression , Female , Follow-Up Studies , Humans , Longitudinal Studies , Male , Middle Aged , Motor Activity , Musculoskeletal Pain/psychology , Occupational Diseases/psychology , Smoking , WorkloadABSTRACT
BACKGROUND: The contribution of common mental disorders (CMD) co-occurring with chronic musculoskeletal disorders (MSD) to disability retirement is not known. METHODS: A nationally representative sample (the Health 2000 survey) comprised 3943 occupationally active Finns aged 30-63. MSD and other chronic disorders were assessed by a physician in a standardized clinical examination, and CMD using the Composite International Diagnostic Interview. Disability pension data for 2000-2011 was retrieved from national pension records. Cox regression was used with censoring for death and pension other than that for disability. Covariate information was based on an interview. RESULTS: The baseline prevalence of CMD was 9.4% and of MSD 31.1%. CMD co-occurred with MSD in 3.3% of participants. The risks inflicted by CMD and MSD were additive. Thirty-eight per cent of the co-morbid subjects, 18% of those with CMD and 19% of those with MSD retired prematurely during the average follow-up of 8.6 years. Compared with those with neither type of disorder, the hazard ratio (HR) for disability pension was 2.4 (95% CI 1.7-2.7) for CMD only, 2.2 (1.8-2.7) for MSD only, and 4.1 (2.9-5.7) for the occurrence of both, allowing for age, gender, other chronic disorders, working conditions, and socio-economic and lifestyle factors. No synergistic or antagonistic interactive effects were observed. LIMITATIONS: The determinants were measured only once and we had no information on incident disorders during the follow-up. CONCLUSIONS: It is important to identify subjects with both mental and musculoskeletal complaints in order to efficiently support their work ability.
Subject(s)
Disabled Persons/statistics & numerical data , Mental Disorders/epidemiology , Musculoskeletal Diseases/epidemiology , Retirement , Adult , Female , Finland/epidemiology , Health Surveys , Humans , Male , Middle Aged , Pensions , PrevalenceABSTRACT
We studied the number of musculoskeletal pain sites as a predictor of sickness absence during a 7-year follow-up among a nationally representative sample (the Health 2000 survey) of occupationally active Finns 30 to 55years of age (3420 subjects who did not retire or die during the follow-up). Baseline data (questionnaire, interview, clinical examination by a physician) were gathered in 2000 to 2001 and linked with information from national registers on annual compensated sickness absence periods (⩾10workdays) covering the years 2002 to 2008. Pain during the preceding month in 18 body locations was inquired and combined into 4 sites (neck, upper limbs, low back, lower limbs). Demographic factors, BMI, smoking, leisure-time physical activity, sleep disorders, physical and psychosocial workload, and chronic diseases were assessed. Four distinct sickness absence trajectories emerged, labeled as Low (59% of the subjects), Ascending (21%), Mixed (11%), and High (9%). In multinomial logistic regression, the odds ratios (ORs) for belonging to the High vs. the Low trajectory increased with the number of pain sites, being 2.1 for single-site pain, 2.6 for 2 pain sites, 2.9 for 3 pain sites, and 4.1 for 4 pain sites, after adjustment for chronic diseases, demographic and lifestyle factors, and workload. The confidence intervals of the ORs did not include unity. The adjusted ORs for belonging to the Ascending trajectory were 1.1, 1.3, 1.7, and 1.7, respectively. As the number of pain sites was a strong independent predictor of work absenteeism, early screening of workers with multisite pain and interventions to support work ability seem warranted.
Subject(s)
Musculoskeletal Pain/epidemiology , Occupational Diseases/epidemiology , Sick Leave/statistics & numerical data , Adult , Female , Finland , Health Surveys , Humans , Life Style , Male , Middle Aged , Musculoskeletal Pain/psychology , Occupational Diseases/psychology , Prospective Studies , Surveys and QuestionnairesABSTRACT
Among 385 female kitchen workers, we examined (1) whether mental stress and psychosocial factors at work (job control, skill discretion, supervisor support, co-worker relationships, and hurry) predict multiple-site musculoskeletal pain (MSP; defined as pain at ≥ 3 of seven sites) and (2) reversedly, whether MSP predicts these psychosocial factors. Data were collected by questionnaire at 3-month intervals during 2 years. Trajectory analysis was applied. Four trajectories of MSP prevalence emerged: Low, Descending, Ascending, and High. For the psychosocial factors, a two-trajectory model (Ascending or High vs. Low) yielded the best fit. In logistic regression analysis, with the Low MSP trajectory as reference, poor co-worker relationships (odds ratio [OR] 3.9), mental stress (3.1) and hurry (2.1) at baseline predicted belonging to the High MSP trajectory. Also MSP at baseline predicted the trajectories (Ascending vs. Low) of low job control (2.2) and mental stress (3.2). Adverse changes in most psychosocial factors were associated with belonging to the High (ORs between 2.3 and 8.6) and Ascending (2.7-5.5) MSP trajectories. In generalized estimating equations, time-lagged by 3 months, all psychosocial factors but two predicted MSP (1.4-2.1), allowing, e.g. for MSP at baseline, and vice versa, MSP predicted low job control, low supervisor support, and mental stress (1.4-2.0), after adjustment for e.g. the relevant psychosocial factor at baseline. In conclusion, we found that several psychosocial factors predicted MSP and that MSP predicted several psychosocial factors. The results suggest a cumulative process in which adverse psychosocial factors and MSP influence each other.
Subject(s)
Food Industry , Musculoskeletal Diseases/psychology , Occupational Diseases/psychology , Pain/psychology , Social Environment , Stress, Psychological/psychology , Workplace/psychology , Adult , Bayes Theorem , Data Interpretation, Statistical , Ergonomics , Female , Finland , Humans , Logistic Models , Longitudinal Studies , Musculoskeletal Diseases/epidemiology , Occupational Diseases/epidemiology , Odds Ratio , Pain/epidemiology , Prognosis , Prospective Studies , Socioeconomic Factors , Stress, Psychological/epidemiology , Work/psychologyABSTRACT
We evaluated a participatory ergonomic intervention process applied in 59 municipal kitchens. In groups of three to five kitchens, the workers participated in eight workshops, and generated and evaluated solutions to optimize musculoskeletal load in their work. An ergonomist initiated and supported the process. By the end, 402 changes were implemented. Evaluative data were collected using research diaries, questionnaires, and focus group interviews. The intervention model proved feasible and the participatory approach was mostly experienced as motivating. The workers' knowledge and awareness of ergonomics increased, which improved their ability to tackle ergonomic problems by themselves. The changes in ergonomics were perceived to decrease physical load and improve musculoskeletal health. As hindering factors for implementation, lack of time and motivation, and insufficient financial resources were mentioned. In addition, the workers expressed a wish for more support from the management, technical staff, and ergonomists.