Pain Among Latvian Workers: General Prevalence vs. Registered Occupational Diseases.

The problem of painful and disabling work-related musculoskeletal disorders (MSDs) is increasing in many employment sectors of Latvia. Official statistics may underestimate the proportion of affected employees, causing delays in preventive interventions, ineffective rehabilitation, and a reduction of the workforce. This study investigated the prevalence of painful health conditions among Latvian workers by analyzing survey data and comparing these to official statistics on registered occupational diseases (ODs). A total of 2,446 workers participated in the state-level "Work conditions and risks in Latvia, 2017-2018" survey that included questions about pain lasting longer than 3 days during the previous year. The frequency of subjective reports on the presence, severity, and location of pain and related behaviors was assessed in relation to sex, age, education, and job position. Descriptive statistics and cross tabulation with the chi-squared test as well as multinomial logistic regression were applied to the data. Overall, 27.7% of respondents (n = 678) reported experiencing pain, predominantly in the lower back (14.3%) and mostly moderate (47.1%) or severe (45.1%). Only one-fifth of respondents (20.5%) took sick leave from work and one-third (29.0%) did not take action to alleviate their pain. Participants aged 55-74 years had a significantly higher odds ratio (OR) for pain in at least one body region-including hands and legs-than those aged 18-24 years. Women had significantly higher odds of headache (OR = 2.55) and neck pain (OR = 1.85) than men. Respondents with a primary or elementary education level had higher odds of pain in at least one body region (OR = 1.60) and in the lower back (OR = 1.86), while those with secondary education had higher odds of pain in hands (OR = 1.51) than employees with higher education. Unskilled workers had significantly higher odds of pain in hands (OR = 2.42) and legs (OR = 2.12) than directors. Official data revealed a dramatic increase in the proportion of MSDs and related disabilities in the last decade, reaching 75.5% of all first registered ODs in 2019. These results demonstrate a high prevalence of painful conditions among Latvian employees; urgent attention to diagnostics, treatment, and prevention is needed to ensure the musculoskeletal health and productivity of this population.

Reasons for Low Protection of Vulnerable Workers from COVID-19-Results from the Quantitative and Qualitative Study on Working Life in Latvia.

Several individual factors like older age and chronic diseases have been linked with more severe symptoms often leading to hospitalization and higher mortality from COVID-19. Part of adults with such factors is still active in the workforce. The objective of the study was to identify measures taken by the employer to protect them and to investigate reasons for low protection of vulnerable workers during the 1st wave of the COVID-19 pandemic. Answers from 1000 workers collected via web-survey and results from 10 focus group discussions were analyzed. Only 31.5% of respondents mentioned that their employer had identified existing vulnerable groups and offered specific measures to protect them. Moving vulnerable workers away from the workplace was the most frequent measure (e.g., transfer to the back-office without contact with clients, telework, paid vacations, paid downtime). Most employers do not see elderly workers and workers with chronic diseases as risk groups, thus are not specifically protecting them. Instead, several employers have included workers critical for business continuity in their risk group. Others had not taken measures because of the lack of information due to general data protection regulation. Poor communication and lack of interest of employers to ask their workers if they need special protection is the topic to be addressed at the national level.

Impact of Workplace Conflicts on Self-Reported Medically Certified Sickness Absence in Latvia.

Sickness absence is one of the most important working population health indicators. It is a complex phenomenon that is investigated by health care and occupational health specialists, economists, and work psychologists. Sickness absence is used as a predictor for morbidity and mortality, but besides the health status of an individual, sickness absence is influenced by demographic, socio-economic factors, and work environment factors. Conflicts at work are a common psychosocial risk factor that can affect sickness absence. The aim of the study was to investigate the association between different types of workplace conflict and self-reported medically certified sickness absence using cross-sectional survey data pooled from four periodic national surveys-Work conditions and risks in Latvia (2006-2018). The sample is representative of the working population of Latvia, as respondents were randomly drawn from different regions and industries. In total, the study sample (n = 8557) consisted of employees between 16 and 80 years old (average 42.8 +/- 12.6) of which 46.2% were males and 53.8% were females. Researchers used the computer-assisted personal interviewing (CAPI) method for collecting data. The association between workplace conflicts and sickness absence was analysed by using binomial logistic regression and calculated as odds ratios (OR) with 95% confidence intervals (CI), with adjustment for gender, age, education and survey year. The risk of sickness absence was higher among women (OR = 1.24, CI 1.13-1.35), employees aged 25-44 years old and employees with higher income. Controlling for socio-demographic factors and survey year, the odds of sickness absence increased significantly for all types of workplace conflict analysed. The strongest association with sickness absence was related to conflicts between managers and employees (OR = 1.51, CI 1.37-1.66) and conflicts between groups of employees (OR = 1.45, CI 1.31-1.61). Conflicts between employees and with customers also increased the odds of sickness absence (OR = 1.39, CI 1.27-1.52 and OR = 1.11, CI 1.01-1.23, respectively). Our findings suggest that tailored interventions at a company level for reducing workplace conflicts as risk factors of sickness absence are required. Those should focus on the improvement of managers' leadership and human resource management skills.

Harmonized definition of occupational burnout: A systematic review, semantic analysis, and Delphi consensus in 29 countries.

Objective A consensual definition of occupational burnout is currently lacking. We aimed to harmonize the definition of occupational burnout as a health outcome in medical research and reach a consensus on this definition within the Network on the Coordination and Harmonisation of European Occupational Cohorts (OMEGA-NET). Methods First, we performed a systematic review in MEDLINE, PsycINFO and Embase (January 1990 to August 2018) and a semantic analysis of the available definitions. We used the definitions of burnout and burnout-related concepts from the Systematized Nomenclature of Medicine Clinical Terms (SNOMED-CT) to formulate a consistent harmonized definition of the concept. Second, we sought to obtain the Delphi consensus on the proposed definition. Results We identified 88 unique definitions of burnout and assigned each of them to 1 of the 11 original definitions. The semantic analysis yielded a first proposal, further reformulated according to SNOMED-CT and the panelists` comments as follows: "In a worker, occupational burnout or occupational physical AND emotional exhaustion state is an exhaustion due to prolonged exposure to work-related problems". A panel of 50 experts (researchers and healthcare professionals with an interest for occupational burnout) reached consensus on this proposal at the second round of the Delphi, with 82% of experts agreeing on it. Conclusion This study resulted in a harmonized definition of occupational burnout approved by experts from 29 countries within OMEGA-NET. Future research should address the reproducibility of the Delphi consensus in a larger panel of experts, representing more countries, and examine the practicability of the definition.

Improving Education and Training to Reduce the Burden of Occupational Cancer. The Riga-European Association of Schools of Occupational Medicine (EASOM) Statement on Work-Related Cancer.

Reducing the burden of occupational cancers (OCs) is currently one of the most challenging Occupational Health (OH) issues. The European Union (EU) has made efforts to improve the existing legal framework and developed specific legislation aimed at reducing the burden of OC. However, available data suggest that OC are underreported. In August 2019, the European Association of Schools of Occupational Medicine (EASOM) adopted a statement that highlighted the importance of improving the education and training of Medical Doctors (MDs) to facilitate improvements in recognizing and reporting OC. To achieve this, EASOM proposes to promote OH education and training of MDs at undergraduate and postgraduate levels, foster harmonization of OH education and teaching standards and programs across EU countries, and enhance cooperation between universities and international scientific associations. Finally, we suggest that occupational data should be recorded in cancer and medical registers. By engaging MDs more fully in the debate about OCs, they will become more aware of the Occupational Physician's role in reducing the burden of OCs and, furthermore, embed consideration of occupation as a potential cause of cancer into their own practice. These interventions will help promote the implementation of policies and interventions aimed to reduce OC in the workplace.

Workplace health promotion in health care settings in Finland, Latvia, and Lithuania.

BACKGROUND AND OBJECTIVE: Health care workers (HCWs) have a great background to promote their health - not only their professional knowledge on health but often also special equipment in their work environment. However, it is unclear if HCWs can use such infrastructure to promote their own health as well as what is their motivation to change their own lifestyles. Thus, the aim of the article was to describe workplace health promotion (WHP) situation in health care settings in Finland, Latvia, and Lithuania. MATERIALS AND METHODS: A questionnaire survey of 357 workers from health care sector in three European countries was conducted. Participants were asked to indicate various WHP activities/facilities/programs organized at their workplaces, WHP needs, opportunities to initiate changes related to the healthiness of their workplaces, and readiness to change their lifestyles. RESULTS: Participants from three European countries differed in their WHP needs and in their responses on various activities/facilities/programs implemented at the institutions. Workers from Finnish institutions had the greatest opportunities to make initiatives relevant to their workplaces' healthiness, while Lithuanian workers were least provided with such opportunities. Furthermore, the results showed that there were differences of readiness to change among the workers from the three countries. CONCLUSIONS: HCWs recognized various WHP activities, facilities and programs organized at their workplaces; however, their needs were notably higher than the situation reported. WHP situation differed among the three European countries.

The legislative backgrounds of workplace health promotion in three European countries: a comparative analysis.

BACKGROUND: This article investigates the legal database and theoretical basis of workplace health promotion (WHP) in three European countries: Finland, Latvia and Lithuania, and aims to find insights into effective WHP implementation. METHODS: In November 2013, a stakeholders' survey was carried out. The questionnaire included questions about legal documents and non-legislative measures relevant to WHP, institutions and other bodies/organizations working in the field, WHP conception/definition, and implementation of WHP activities according to the enterprises' size. RESULTS: Only Finland has adopted a specific law on occupational health care (separate from occupational safety). ILO conventions No. 161 (Occupational Health Services Convention) and No. 187 (Promotional Framework for Occupational Safety and Health Convention) are ratified only in Finland. In Finland, the Ministry of Social Affairs and Health acts as one ministry, while two Baltic countries have two separate ministries (one for health and another for social affairs). None of the countries has legally approved a definition of WHP. Latvia and Lithuania tend to separate WHP from other activities, whereas Finland integrates WHP into other occupational health and safety elements. CONCLUSIONS: Finland has a more extensive legislative and organizational background to WHP than Latvia and Lithuania. In defining WHP, all the countries refer to the Luxembourg Declaration on Workplace Health Promotion in the European Union. Finland's practice of integrating WHP into other occupational health and safety elements is important.

Telomere length in Chernobyl accident recovery workers in the late period after the disaster.

The outcome of the Chernobyl nuclear power plant (CNPP) accident was that a huge number of people were exposed to ionizing radiation. Previous studies of CNPP clean-up workers from Latvia revealed a high occurrence of age-associated degenerative diseases and cancer in young adults, as well as a high mortality as a result of cardiovascular disorders at age 45-54 years. DNA tandem repeats that cap chromosome ends, known as telomeres, are sensitive to oxidative damage and exposure to ionizing radiation. Telomeres are important in aging processes and carcinogenesis. The aim of this study was to investigate the long-term effect of protracted ionizing radiation exposure on telomere length in CNPP clean-up workers. Relative telomere length (RTL) was measured in peripheral blood leukocytes of 595 CNPP clean-up workers and 236 gender- and age-matched controls using real-time quantitative polymerase chain reaction (q-PCR). Close attention was paid to participation year and tasks performed during the worker's stay in Chernobyl, health status, and RTL differences between subgroups. Telomere shortening was not found in CNPP clean-up workers; on the contrary, their RTL was slightly greater than in controls (P = 0.001). Longer telomeres were found in people who worked during 1986, in those undertaking 'dirty' tasks (digging and deactivation), and in people with cancer. Shorter telomeres appeared frequently in those with cataract, osteoporosis, atherosclerosis, or coronary heart disease. We conclude that the longer telomeres revealed in people more heavily exposed to ionizing radiation probably indicate activation of telomerase as a chromosome healing mechanism following damage, and reflect defects in telomerase regulation that could potentiate carcinogenesis.

Assessment of skeletal muscle fatigue of road maintenance workers based on heart rate monitoring and myotonometry.

OBJECTIVE: This research work is dedicated to occupational health problems caused by ergonomic risks. The research object was road building industry, where workers have to work very intensively, have long work hours, are working in forced/constrained work postures and overstrain during the work specific parts of their bodies. The aim of this study was to evaluate the work heaviness degree and to estimate the muscle fatigue of workers after one week work cycle. The study group consisted of 10 road construction and maintenance workers and 10 pavers aged between 20 and 60 years. METHODS: Physical load were analyzed by measuring heart rate (HR), work postures (OWAS) and perceived exertion (RPE). Assessments of the muscles strain and functional state (tone) were carried out using myotonometric (MYO) measurements. The reliability of the statistical processing of heart rate monitoring and myotonometry data was determined using correlating analysis. RESULTS: This study showed that that road construction and repairing works should be considered as a hard work according to average metabolic energy consumption 8.1 +/- 1.5 kcal/min; paving, in its turn, was a moderately hard work according to 7.2 +/- 1.1 kcal/min. Several muscle tone levels were identified allowing subdivision of workers into three conditional categories basing on muscle tone and fatigue: I--absolute muscle relaxation and ability to relax; II--a state of equilibrium, when muscles are able to adapt to the work load and are partly able to relax; and III--muscle fatigue and increased tone. It was also found out that the increase of muscle tone and fatigue mainly depend on workers physical preparedness and length of service, and less on their age. CONCLUSION: We have concluded that a complex ergonomic analysis consisting of heart rate monitoring, assessment of compulsive working postures and myotonometry is appropriate to assess the work heaviness degree and can provide prognosis of occupational pathology or work-related musculoskeletal disorders for the workers under different workload conditions. These results can also be used when deciding on necessary rest time and its periodicity.