Social integration, socioeconomic conditions and type of ill health preceding disability pension in young women: a Swedish population-based study.

BACKGROUND: Disability pension has increased in recent decades and is seen as a public health and socioeconomic problem in Western Europe. In the Nordic countries, the increase has been particularly steep among young women. PURPOSE: The aim was to analyze the influence of low social integration, socioeconomic risk conditions and different measures of self-reported ill health on the risk of receiving disability pension in young women. METHOD: The study comprised all Swedish women born in 1960 to 1979, who had been interviewed in any of the annual Swedish Surveys of Living Conditions (1990-2002). The assumed predictors were related to disability pension by Cox proportional hazard regression. The mean number of years of follow-up for the 10,936 women was 7 years (SD 3.8), and the study base was restricted to the ages 16 to 43 years of age. RESULTS: An increased risk of receiving a disability pension was found among lone women, those who had sparse contacts with others, job-seeking women, homemakers, as well as women with low education, and poor private financial situations. A tenfold increase in the risk of receiving a disability pension was found among women reporting a long-standing illness and poor self-rated health, compared to women without a long-standing illness and good self-rated health. Psychiatric diagnoses and symptoms/unspecified illness were the strongest predictors of disability pension, particularly before 30 years of age. CONCLUSION: The study suggests that weak social relations and weak connections to working life contribute to increase the risk of disability pension in young women, also after control for socioeconomic conditions and self-reported ill health. Self-rated health was the strongest predictor, followed by long-standing illness and not having a job (job seekers and homemakers).

Disability pension among young women in Sweden, with special emphasis on family structure: a dynamic cohort study.

OBJECTIVES: The influence of family structure on the risk of going on disability pension (DP) was investigated among young women by analysing a short-term and long-term effect, controlling for potential confounding and the 'healthy mother effect'. DESIGN AND PARTICIPANTS: This dynamic cohort study comprised all women born in Sweden between 1960 and 1979 (1.2 million), who were 20-43 years of age during follow-up. Their annual data were retrieved from national registers for the years 1993-2003. For this period, data on family structure and potential confounders were related to the incidence of DP the year after the exposure assessment. Using a modified version of the COX proportional hazard regression, we took into account changes in the study variables of individuals over the years. In addition, a 5-year follow-up was used. RESULTS: Cohabiting working women with children showed a decreased risk of DP in a 1-year perspective compared with cohabiting working women with no children, while the opposite was indicated in the 5-year follow-up. Lone working women with children had an increased risk of DP in both the short-term and long-term perspective. The risk of DP tended to increase with the number of children for both cohabiting and lone working women in the 5-year follow-up. CONCLUSIONS: The study suggests that parenthood contributes to increasing the risk of going on DP among young women, which should be valuable knowledge to employers and other policy makers. It remains to be analysed to what extent the high numbers of young women exiting from working life may be counteracted by (1) extended gender equality, (2) fewer work hours among fathers and mothers of young children and (3) by financial support to lone women with children.

Medically certified sickness absence with insurance benefits in women with and without children.

BACKGROUND: Sickness absence in Sweden is high, particularly in young women and the reasons are unclear. Many Swedish women combine parenthood and work and are facing demands that may contribute to impaired health and well-being. We compared mothers and women without children under different conditions, assuming increased sickness absence in mothers, due to time-based stress and psychological strain. METHODS: All women born in 1960-79 (1.2 million) were followed from 1993 to 2003. Information on children in the home for each year was related to medically certified sickness absence with insurance benefits the year after. We used age and time-stratified proportional hazard regression models accounting for the individual's changes on study variables over time. Data were retrieved from national administrative registers. RESULTS: Sickness absence was higher in mothers than in women without children, the relative risks decreased by age, with no effect after the age of 35 years. An effect appeared in lonely women irrespective of age, while in cohabiting women only for the ages 20-25 years. Mothers showed increased sickness absence in all subgroups of country of birth, education, income, sector of employment and place of residence. The relation between number of children and sickness absence was nonlinear, with the highest relative risks for mothers of one child. The upward trend of sickness absence at the end of 1990s was steeper for mothers compared to women without children. CONCLUSION: Despite the well-developed social security system and child care services in Sweden, parenthood predicts increased sickness absence, particularly in young and in lone women.

Stress, energy and psychosocial conditions in different types of call centres.

OBJECTIVE: To identify risk indicators for high stress and low mental energy as well as to describe psychosocial working conditions at different types of call centres. PARTICIPANTS: 1183 operators from 28 call centres in Sweden, both external and internal, with different levels of task complexity, ownership and geographical location. METHOD: A cross sectional questionnaire study. RESULTS: The stress level was moderately high and the energy level fairly high. Stress levels tended to be lower and psychosocial conditions better with increasing level of task complexity. Fourteen per cent of the operators were in a state of high stress/low energy ("worn out") and 47% in high stress/high energy ("committed under pressure"). Operators in a state of low stress/high energy ("committed without pressure") were most likely to report a better health status. High stress and lack of energy was mainly associated with time pressure, low decision latitude, and lack of social and supervisor support. CONCLUSIONS: Time pressure in combination with lack of support and influence should be seen as a potential high risk situation for the development of a "worn-out" state among call centre operators. Management should make use of this knowledge in order to promote a long lasting efficient and healthy call centre work.

The influence of working conditions and individual factors on the incidence of neck and upper limb symptoms among professional computer users.

OBJECTIVES: To assess the influence of working conditions and individual factors on the incidence of neck and upper limb symptoms among professional computer users. METHODS: The study is a prospective cohort study with an observation period of 10 months. A baseline questionnaire about symptoms in the neck, shoulder and arm/hand during previous month, individual factors, work content, physical and psychosocial work-related exposures was answered by 1,283 computer operators (response rate 84%). Incidence data were collected by ten monthly questionnaires regarding the occurrence of symptoms categorized into three gross body regions: neck, shoulders and arms/hands. A case, in the specific gross body region, was defined as a subject who was classified as non-symptomatic in that region at baseline or during minimum one follow-up period and later reported symptoms (>or=3 days). Univariable and multivariable incidence rate ratios with 95% confidence intervals for first occurrence of neck, shoulder and arm/hand cases, respectively, were calculated with Cox regression analysis. RESULTS: The incidence rate was 67, 41 and 47 cases per 100 person years for neck, shoulder and arm/hand symptoms, respectively. In the multivariable analyses, comfort of the computer work environment and gender were related to the incidence of symptoms in all body regions (RR = 1.5-1.9 for low comfort and 1.8-2.1 for females, respectively). Duration of mouse use predicted arm/hand symptoms (RR = 1.7 for >or=3 h/day) and job strain (high demands and low decision latitude) predicted neck symptoms (RR = 1.6 and 2.2 for medium and high strain, respectively). Additionally, age was related to neck and shoulder symptoms. CONCLUSION: Preventive strategies to reduce neck and upper limb symptoms among computer users should include measures to reduce mouse use, to increase the comfort of the work environment and to reduce job strain. Although the effect estimates were relatively weak to moderate, preventive measures may have a marked impact on the incidence of neck and upper limb symptoms in the general population because of the widespread use of computers in working life as well as at home.

Self-reported health in mothers: the impact of age, and socioeconomic conditions.

The aim of the present analysis was to study health and well-being in mothers compared to women without children, and to analyze potential interactions with age and socioeconomic conditions. The study comprised 5,368 Swedish women born in 1960-1979 who were interviewed in any of the population-based Surveys of Living Conditions during the period 1996-2003. Having children at home was related to self-reported health symptoms and long-standing illness in multiple logistic regression models. The impact of age, cohabitation status, full-time or part-time work, and income level were analyzed. While mothers were less burdened by long-standing illness, partly due to selection mechanisms (a "healthy mother effect"), they experienced worse self-rated health and more fatigue than women without children, and the odds of poor self-rated health and fatigue increased by number of children. Conditions that strengthened the association between motherhood and impaired health were young maternal age, full-time employment, high income, and being alone. The study indicates a need for improved negotiations between parents regarding a fair share of work and family duties and extended support for lone mothers to prevent adverse health effects in women combining children and work. The results may be useful to policy-makers and employers in developing new policies.

Musculoskeletal symptoms in relation to work exposures at call centre companies in Sweden.

OBJECTIVES: Call centres (CCs) are one of the most rapidly growing types of workplaces in Sweden. The purpose of the study was to assess associations between exposures at CC work and symptoms in the Neck/shoulders and Arm/hand. Comparisons were made between internal and external CCs. An internal CC is a department or separate unit within a larger company with another main core business, while an external CC is a free-standing company. METHODS: A cross-sectional study of a selected sample of CCs was conducted. A questionnaire, covering characteristics of work and management, physical and psychosocial exposures and symptoms during the last month, was answered by 1,183 operators from 28 CCs. RESULTS: Three out of four operators reported pain or aches in one or more of the requested body regions, with no major difference between internal and external CC operators. Comfort of the work environment, showed the strongest association with symptoms in the Neck/shoulder and Arm/hand, in both types of CCs. Other exposures associated with symptoms in the Neck/shoulder or Arm/hand in either type of CC were: low complexity of work, long total time of customer calls per day, continuous computer work without a break, high psychological demands, low decision latitude, lack of social support from colleagues and supervisor. CONCLUSIONS: The study is unique in that there are no previous studies focusing on a large variety of exposures specific to CC work, based on a large number of workers from different types of CCs. The study confirms previously suggested associations between unfavourable work characteristics and management, a poor physical and psychosocial environment, and musculoskeletal symptoms in computer-telephone interactive tasks. The nature of calls during work were related to symptoms of persons working in internal CCs, whereas the time spent seated and continuous computer work were related to symptoms of those in external CCs.

Symptoms and clinical findings from the musculoskeletal system among operators at a call centre in Sweden--a 10-month follow-up study.

The musculoskeletal health among 57 operators at 1 call centre in Sweden was studied with 10 monthly follow-ups, parallel to a reference group of 1,226 professional computer users in other occupations. Operators at this call centre were more symptom-loaded than the other professional computer users in spite of their younger age and shorter exposure to computer work. Symptoms were long-lasting or recurrent. Muscle tenderness and nerve affections in the neck-shoulder region were the most common specific findings and diagnoses at medical examination of incident symptom cases. More extensive studies should be done on the working conditions and health status among call centre workers.