Long working hours and preventive oral health behaviors: a nationwide study in Korea (2007-2021).

BACKGROUND: This study explored the association between working hours and preventive oral health behaviors. METHODS: In total, 48,599 workers (22,992 females) were included from the Korea National Health and Nutrition Examination Survey (2007-2021). Weekly working hours were self-reported. The following three preventive oral health behaviors were set as outcomes: participation in annual dental check-ups; adherence to the recommended toothbrushing frequency (≥twice a day); and use of interdental cleaning devices. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) using logistic regression. RESULTS: In male workers, the adjusted OR (95% CI) of the association between working ≥55 h/week and each outcome was 0.84 (0.77-0.92) for dental check-ups, 0.82 (0.72-0.94) for toothbrushing ≥twice a day, and 0.83 (0.76-0.92) for utilization of interdental cleaning device when compared to 35-40 h/week. In female workers, the adjusted OR (95% CI) of the association between working ≥55 h/week and each outcome was 0.79 (0.70-0.89) for dental check-ups, 0.88 (0.70-1.11) for toothbrushing ≥twice a day, and 0.80 (0.71-0.90) for utilization of interdental cleaning device when compared to 35-40 h/week. Additionally, low socio-economic status, such as low educational attainment, low income level, and blue-collar occupations, were major risk factors associated with non-adherence to preventive oral health behaviors in both male and female workers. CONCLUSIONS: Our study suggests that individuals who work long hours are more likely to exhibit undesirable oral health behaviors.

Exploring the Impact of Workplace Violence on the Mental Health of Chinese Correctional Officers: A JD-R Model Approach.

Background: Correctional officers face widespread workplace violence and the resulting overwork that can profoundly damage their physical and mental health. Purpose: This study aims to investigate the mediating role of overwork in the relationship between workplace violence and the manifestation of physical and mental health issues among correctional officers. Methods: This study enlisted 472 eligible participants. Cross-sectional data were obtained using the Chinese version of the Workplace Violence Scale (WVS), while the physical and mental health of correctional officers was evaluated through relevant scales. Analysis involved descriptive statistics, correlation analyses, and tests for mediation models. Results: The study found significant correlations between workplace violence, overwork, and various mental health variables (depression, anxiety, stress, suicidal ideation, and insomnia), with correlations ranging from 0.135 to 0.822 (p < 0.01). Mediation analysis revealed that workplace violence directly impacts correctional officers' physical and mental health (p < 0.001) and also has an indirect effect through overwork (p < 0.023). These findings underscore the substantial impact of workplace violence on the health of correctional officers, both directly and indirectly. Conclusion: Workplace violence and overwork significantly contribute to the physical and mental health challenges faced by correctional officers. Overwork acts as a mediator in the relationship between workplace violence and these health issues. The study suggests addressing workplace violence and mental health issues among correctional officers by increasing their numbers, improving the work environment, and implementing enhanced welfare policies.

[Exploring the reality of seafarers' deaths and injuries and preventive measures from the cases of overwork-related disorders].

OBJECTIVES: Till date, only few studies have detailed the reality of overwork-related disorders among seafarers. Therefore, in this study, we aimed to evaluate the prevalence of overwork-related disorders among seafarers and assess factors such as patient attributes, diseases diagnosed at the time of determination, workload factors, and other aspects, thereby suggesting relevant preventative measures. METHODS: Among all the patients identified with overwork-related disorders from April 2010 to March 2017, 2,280 cases of cerebrovascular and cardiovascular diseases and 3,517 cases of mental disorders were selected. To identify seafarer-related cases, keywords related to seafarers were extracted. Subsequently, 33 cases of cardiovascular disease and 19 cases of mental disorders were obtained. RESULTS: The average age of the patients with cerebrovascular and cardiovascular diseases was 56.7 years; for those with mental disorders, it was 45.2 years. The patients were most commonly engaged in fishing, transportation, and postal services. Most patients were employed in the deck department or were captains. The most common types of vessels were fishing and cargo ships. Among the diseases diagnosed at the time of determination, cerebrovascular diseases accounted for 20 cases (60.6%) and cardiovascular diseases accounted for 13 cases (39.4%), with cerebral and myocardial infarctions being the most frequent conditions. Among mental disorders, "mood disorders" accounted for 7 cases (36.8%), and "neurotic disorders, stress-related disorders, and somatoform disorders" accounted for 12 cases (63.2%), with major depressive episodes, post-traumatic stress disorder, and adjustment disorders being the most common. The most common workload factor for patients with cerebrovascular and cardiovascular diseases was "long-term excessive work," and among non-workload factors, "long working hours" and "irregular working hours" were prevalent. For mental disorders, 8 cases were attributed to "extreme psychological stress." Specific events leading to these diseases included "interpersonal relationships," "experiencing accidents or disasters," and "work quantity and quality." CONCLUSIONS: Both cerebrovascular and cardiovascular diseases, as well as mental disorders, showed a notable aging trend among seafarers. Thus, measures that consider the characteristics of elderly workers, such as their physical function, are important. Additionally, as seafarers are distributed across various industries and occupations, measures should be specifically tailored to their industry and job type. Our study confirmed that long working hours and irregular working hours were prevalent in both cases. Therefore, there is an urgent need for further efforts to prevent and mitigate overwork-related deaths among seafarers, including organizational support from onshore workplaces and enhancement of medical and operational support using information and communication technology.

Independence in activities of daily living was achieved using aerobic exercise without overwork weakness during rehabilitation: a case report of Lambert-Eaton myasthenic syndrome.

[Purpose] Lambert-Eaton myasthenic syndrome (LEMS) is an autoimmune disease characterized by decreased transmitter secretion from neuromuscular junctions and nerve terminals. Such cases require physical therapy for independently performing daily activities; however, care must be taken to avoid overwork weakness. This study aimed to investigate the effects of aerobic exercise-based physical therapy in patients with LEMS. [Participants and Methods] We report a case of LEMS with decreased muscle endurance due to inactivity. The participant was subjected to physical therapy with an exercise modality-improved muscle endurance with low-intensity repetitions, while monitoring subjective exercise intensity over time. [Results] The participant achieved independence activities of daily living without developing overwork weakness. [Conclusion] Appropriate physical therapy is an important aspect in treating LEMS.

Overwork as a concept to understand health inequities for ethnicised patients in health care.

Health inequities for ethnically minoritised patients are well-documented. In this ethnographic study, we follow thirteen patients categorised as 'ethnic minorities' in Danish health care during hospitalisation in three orthopaedic wards across two hospitals. The categorisation of 'ethnic minority patient' has been problematised for its Eurocentric origin and practices within Westernised health care. We use ethnicised to emphasise the process of becoming minoritised based on markers of physical appearance, religious symbols, language or names. Access to health care also rely on perceived legitimacy as health-care recipients which requires work by patients. We demonstrate the workings patients categorised as 'ethnic minorities' engage in by (re)producing othering ideas about non-Danishness, including distancing from other patients perceived as problematic. These were then (counter)produced by positioning oneself as the opposite, as deserving health-care receivers by displaying welfare reciprocity, supporting egalitarian ideas by discounting discriminatory experiences, showing gratitude and identifying staff with good vibes. We propose these doings as creating overwork. This theoretical approach enables a sensitivity towards subtle and covert workings for patients placed in the margins of health care. In this study, overwork is closely related to notions of Danishness and takes on specific forms within a modernised and universalised Danish health-care system.

Can digital financial inclusion help reduce migrant workers' overwork? Evidence from China.

Introduction: Migrant workers in China are migrants from the rural to the urban areas who usually work in the cities and return to the countryside after a certain period. Due to China's strict household registration system, they differ significantly from urban residents' access to public services. However, at the same time, China's workers are facing a severe phenomenon of overwork, and the group of migrant workers is even more hard-hit by overwork, which will cause various adverse effects on workers and society and should attract the attention of all sectors of society. Methods: This paper focuses on the impact of digital financial inclusion on the overwork of migrant workers. This study considered cross-sectional data containing 98,047 samples based on the 2017 China Migrants Dynamic Survey 2017 (CMDS) and China Municipal Statistical Yearbook after robustness tests and heterogeneity analysis using probit models. Results: (1) digital financial inclusion can effectively alleviate overwork among migrant workers; (2) the impact of digital finance on overwork is more significant for the new generation, digitized industries, and self-employed migrant workers; it is also more significant for the South, East, and small and medium-sized cities than for the North, the Midwest, and large cities; (3) job quality and income are crucial factors in how digital financial inclusion affects overwork among migrant workers. Digital financial inclusion can improve the quality of employment for migrant workers and alleviate overwork. However, the income substitution effect partially reduces the inhibitory impact of digital financial inclusion on overwork. Conclusion: Continuously promote the development of digital inclusive finance, improve laws and regulations, and protect the labor rights and interests of migrant workers. At the same time, vocational training and skills upgrading for rural migrant workers should be strengthened to improve the quality of their employment so that they can leave the secondary labor market and enter the primary labor market.

Reliability and validity of the Japanese version of the Overwork Climate Scale.

This study aimed to investigate the validity and reliability of the Japanese version of the Overwork Climate Scale. Japanese workers were invited to participate in online surveys at baseline and 1-month follow-up. The Overwork Climate Scale was translated into Japanese, according to international guidelines. Reliability was assessed using Cronbach's alpha and the intra-class correlation coefficient (ICC), while structural validity was evaluated through confirmatory factor analysis (CFA). Psychological job demands, work engagement, psychological safety, and workaholism were assessed for convergent validity. The number of respondents was 302 at baseline and 169 at follow-up. Results indicated robust Cronbach's alpha values of 0.86 (for overwork endorsement) and 0.80 (for lacking overwork reward) at baseline, complemented by ICC of 0.89 and 0.82, respectively. CFA confirmed the suitability of the two-factor model. Moreover, the Japanese Overwork Climate Scale exhibited significant correlations with anticipated constructs. Structural equation modeling revealed a consistent association between overwork climate and both workaholism and work engagement, similar to the original version. In conclusion, the Japanese version of the Overwork Climate Scale demonstrates acceptable levels of reliability and validity, warranting its potential adoption among Japanese workers.

Entrepreneurial failure influences the health of Chinese farmers: Evidence from the data of China labor-force dynamic survey.

High failure rate is a primary characteristic of current farmer entrepreneurial activities in China. We examined the impact of entrepreneurial failure on the health of Chinese farmers based on the data from the China Labor-force Dynamics Survey (CLDS). We found that entrepreneurial failure significantly depresses the health of Chinese farmers. Specifically, the farmers with entrepreneurial failure experience are more likely to have low self-reported levels of psychological and physical health, and the probability of experiencing severe injury and illness is elevated by 4.6 %. Mechanism analysis shows that entrepreneurial failure depresses the health of Chinese farmers through weakening informal social support and increasing the probability of overwork. Furthermore, these effects are more significant in the older generation of farmers who were born before 1980 and the farmers striving to make a living.

Long working hours, work-life imbalance, and poor mental health: a cross-sectional mediation analysis based on the sixth Korean Working Conditions Survey, 2020-2021.

Background There has been growing concern about the negative mental health impact of long working hours and overwork. Our study examined how work-life imbalance (WLI) could be a mediator between working hours and poor mental well-being.Methods We included 34,968 individuals from a nationwide cross-sectional survey in Korea. Self-reported working hours per week was collected, and mental health was assessed by the WHO-5 Well-Being Index. Counterfactual-based mediation models were employed to disentangle the total effects into a direct effect (work hour - poor mental health) and an indirect effect (work hour - WLI - poor mental health).Results Out of 34,968 participants, 52.6% worked 35-40 h/week, 20.0% worked 41-48 h/week, 11.7% worked 49-54 h/week, and 15.6% worked ≥55 h/week. The odds ratios (ORs) of the total impact of working hours on poor mental health were 1.08 (95% CI: 1.01-1.16) for 41-48 h/week, 1.28 (1.17-1.39) for 49-54 h/week, and 1.60 (1.48-1.74) for ≥55 h/week in comparison to 35-40 h/week. The ORs of the indirect effects were 1.04 (1.03-1.05) for 41-48 h/week, 1.08 (1.07-1.09) for 49-54 h/week, and 1.14 (1.12-1.16) for ≥55 h/week, accounting for 51%, 31%, and 28% of the total effects.Conclusion: Our findings suggest that WLI can partially mediate the association of long working hours with mental health deterioration. Policy efforts are required to mitigate the adverse mental health effects of overwork.

Association between long working hours and diet quality and patterns: A latent profile analysis of a nationally representative sample of Korean workers.

BACKGROUND: Long working hours are associated with cardiovascular and metabolic diseases. This study investigated the relationship between the working hours and dietary qualities and patterns in Korean workers. METHODS: Data from 24,523 workers were extracted from the Korea National Health and Nutrition Examination Survey, 2013-2021. The Korean Healthy Eating Index (KHEI), which ranges from 0 to 100, with a higher score indicating greater adherence to Korean dietary guidelines and superior dietary quality, was used for dietary assessment. We identified dietary patterns and classified workers using latent profile analysis. Logistic regressions were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: Five distinct dietary patterns emerged: healthy diet (24.8%), low-vegetable diet (14.0%), average diet (7.8%), low-fruit diet (31.4%), and poor diet (22.0%). The mean KHEI score was 60.8, with the highest score observed in the healthy diet pattern (71.3) and the lowest, in the poor diet pattern (50.0). Compared with working 35-40 h/week, working ≥55 h/week was negatively associated with KHEI scores (ß: -1.08; 95% CI: -1.67, -0.49). Those working ≥55 h/week were less likely to have a healthy diet pattern (OR: 0.81; 95% CI: 0.72, 0.91) and more likely to have a low-fruit diet (OR: 1.36; 95% CI: 1.20, 1.55) or poor diet pattern (OR: 1.23; 95% CI: 1.05, 1.43) compared with those working 35-40 h/week. CONCLUSION: Long working hours are associated with undesirable dietary quality and patterns. Policy interventions aimed at enhancing dietary quality are needed to alleviate the health burdens associated with long working hours.

Association between long working hours and the development of suicidal ideation among female workers: An 8-year population-based study using the Korean Longitudinal Survey of Women & Family (2012-2020).

Long working hours and overwork have recently emerged as pressing public health concerns. We explored the association between long working hours and suicidal ideation in female workers. A total of 8017 women (24,331 observations) from the fourth to eighth waves of the Korean Longitudinal Survey of Women and Families (2012-2020) were analyzed. To address the repeated measurements within each participant, we employed a generalized estimating equation to estimate the odds ratio (OR) and 95% confidence intervals (CIs). The prevalence of suicidal ideation was 1.9% for those working 35-40 h/week and 4.4% for those working ≥55 h/week. Compared to individuals working 35-40 h/week, those working ≥55 h/week were more likely to experience concurrent suicidal ideation (OR [95% CI]:1.85 [1.43-2.39]). The OR (95% CI) of the association between long working hours and onset of suicidal ideation in the subsequent wave was 1.69 (1.20-2.38) for ≥55 h/week. In subgroup analysis, this association was pronounced among workers with low-income levels (OR [95% CI]: 1.97 [1.29-3.02]) and blue-collar occupations (OR [95% CI]: 2.27 [1.41-3.66]). Policy efforts are required to protect the mental health of female workers exposed to long working hours.

Association between long working hours and engagement in preventive healthcare services in Korean workers: Findings from the Korean National Health and Nutrition Examination Survey.

BACKGROUND: Engagement in preventive healthcare services is crucial for preventing diseases. We explored how working hours are associated with engagement in preventive healthcare services, with a focus on gender differences. METHODS: This cross-sectional study used data from the 2007-2012 Korean National Health and Nutrition Examination Survey. The dependent variable was engagement in each of the five preventive healthcare services (health check-ups, influenza vaccination, and stomach, breast, and cervical cancer screenings). We estimated the prevalence ratios (PRs) and 95% confidence intervals (CIs) using robust Poisson regression. RESULTS: The study analyzed 19,819 workers (9119 women). The adjusted PRs (95% CI) of the association between working ≥55 h per week and engagement in preventive healthcare services among men were 0.95 (0.90-1.00) for health check-ups, 0.86 (0.77-0.96) for influenza vaccination, and 0.95 (0.87-1.03) for stomach cancer screening compared to working 35-40 h per week. Among women, the adjusted PRs (95% CI) of the association between working ≥55 h per week and engagement in preventive healthcare services were 0.84 (0.78-0.91) for health check-ups, 0.82 (0.73-0.92) for influenza vaccination, and 0.88 (0.80-0.97) for stomach, 0.85 (0.78-0.94) for breast, and 0.82 (0.74-0.91) for cervical cancer screenings. CONCLUSION: Long working hours were negatively associated with engagement in preventive healthcare services, and the association was pronounced among female workers. Efforts to promote preventive healthcare participation among individuals with long working hours are necessary, and it is essential to consider the unique vulnerabilities of women when developing such policies.

Effect of long working hours on psychological distress among young workers in different types of occupation.

BACKGROUND: We investigated how the association between long working hours and psychological distress varies across different employment and occupation types in young workers. METHODS: Examining a nationally representative sample of 7246 Korean workers (3621 women) aged 15 to 40, we analyzed 23,492 observations spanning from 2016 to 2020. Psychological distress was measured using the Brief Encounter Psychosocial Instrument. We employed a generalized estimating equation to estimate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: Of the total observations, 5.2% worked <35 h/week, 52.9% worked 35-40 h/week, 23.5% worked 41-48 h/week, 10.3% worked 49-54 h/week, and 8.2% worked ≥55 h/week. The OR (95% CI) of the association between long working hours and psychological distress was 1.38 (1.11-1.72) for <35 h/week, 1.47 (1.32-1.65) for 41-48 h/week, 1.74 (1.49-2.04) for 49-54 h/week, and 2.11 (1.75-2.55) for ≥55 h/week compared to 35-40 h/week. The OR (95% CI) of the association between working ≥55 h/week and psychological distress was significantly higher among wage workers (OR [95% CI]: 2.37 [1.94-2.89]) compared to self-employed workers (OR [95% CI]: 0.84 [0.52-1.36]). Additionally, the OR (95% CI) of the association between working ≥55 h/week and psychological distress was significantly higher among white-collar workers (OR [95% CI]: 3.24 [2.54-4.13]) compared to service/sales workers (OR [95% CI]: 1.22 [0.86-1.72]) or blue-collar workers (OR [95% CI]: 1.71 [1.10-2.67]). No clear gender differences were observed. CONCLUSION: Psychological distress caused by long working hours can be pronounced among white-collar and wage workers.

Task shifting of medical office works: A preliminary questionnaire survey for generalists.

To reduce physician burden, task shifting of clerical work from physicians to medical assistants is being promoted; however, it depends on hospitals. A questionnaire survey was conducted among 40 general physicians at Okayama University Hospital in December 2022 to investigate physicians' preferences toward task shifting. Compared to other tasks, most physicians thought that ordering examinations (14, 47%), replying to referral letters (19, 63%), and prescriptions (21, 70%) and medical record entries (22, 73%) should not be task shifted. Physicians' controversial opinions on task shifting maybe the reason behind the slow progress in task shifting.

Development of algorithm for work intensity evaluation using excess overwork index of construction workers with real-time heart rate measurement device.

Background: The construction workers are vulnerable to fatigue due to high physical workload. This study aimed to investigate the relationship between overwork and heart rate in construction workers and propose a scheme to prevent overwork in advance. Methods: We measured the heart rates of construction workers at a construction site of a residential and commercial complex in Seoul from August to October 2021 and develop an index that monitors overwork in real-time. A total of 66 Korean workers participated in the study, wearing real-time heart rate monitoring equipment. The relative heart rate (RHR) was calculated using the minimum and maximum heart rates, and the maximum acceptable working time (MAWT) was estimated using RHR to calculate the workload. The overwork index (OI) was defined as the cumulative workload evaluated with the MAWT. An appropriate scenario line (PSL) was set as an index that can be compared to the OI to evaluate the degree of overwork in real-time. The excess overwork index (EOI) was evaluated in real-time during work performance using the difference between the OI and the PSL. The EOI value was used to perform receiver operating characteristic (ROC) curve analysis to find the optimal cut-off value for classification of overwork state. Results: Of the 60 participants analyzed, 28 (46.7%) were classified as the overwork group based on their RHR. ROC curve analysis showed that the EOI was a good predictor of overwork, with an area under the curve of 0.824. The optimal cut-off values ranged from 21.8% to 24.0% depending on the method used to determine the cut-off point. Conclusion: The EOI showed promising results as a predictive tool to assess overwork in real-time using heart rate monitoring and calculation through MAWT. Further research is needed to assess physical workload accurately and determine cut-off values across industries.

Lack of compensation for COVID-19-related overtime work and its association with burnout among EMS providers in Korea.

OBJECTIVES: This study examined the association between lack of compensation for COVID-19-related overtime work (LCCOW) and burnout among emergency medical service (EMS) providers in Seoul, Korea. METHODS: We conducted a cross-sectional survey of 693 EMS providers in Seoul, Korea. Participants were classified into 3 groups according to their experience of coronavirus disease 2019 (COVID-19)-related overtime work and LCCOW: (1) "did not experience," (2) "experienced and was compensated," and (3) "experienced and was not compensated." Burnout was measured using the Korean version of the Copenhagen Burnout Inventory, which has 3 subdomains: personal burnout (PB), work-related burnout (WRB), and citizen-related burnout (CRB). Multiple linear regression was applied to examine whether LCCOW was associated with burnout after adjusting for potential confounders. RESULTS: In total, 74.2% of participants experienced COVID-19-related overtime work, and 14.6% of those who worked overtime experienced LCCOW. COVID-19-related overtime work showed a statistically non-significant association with burnout. However, the association differed by LCCOW. Compared to the "did not experience" group, the "experienced and was not compensated" group was associated with PB (ß=10.519; 95% confidence interval [CI], 3.455 to 17.584), WRB (ß=10.339; 95% CI, 3.398 to 17.280), and CRB (ß=12.290; 95% CI, 6.900 to 17.680), whereas no association was observed for the "experienced and was compensated" group. Furthermore, an analysis restricted to EMS providers who worked overtime due to COVID-19 showed that LCCOW was associated with PB (ß=7.970; 95% CI, 1.064 to 14.876), WRB (ß=7.276; 95% CI, 0.270 to 14.283), and CRB (ß=10.000; 95% CI, 3.435 to 16.565). CONCLUSIONS: This study suggests that LCCOW could be critical in worsening burnout among EMS providers who worked overtime due to COVID-19.

Occupational Burnout in Healthcare Workers, Stress and Other Symptoms of Work Overload during the COVID-19 Pandemic in Poland.

This study explored the level and selected determinants of burnout among five groups of healthcare workers (physicians, nurses, paramedics, other medical and nonmedical staff) working during the COVID-19 pandemic in Poland. This cross-sectional study was conducted from February to April 2022, with the use of a self-administered mostly online survey. The BAT-12 scale was used to measure burnout, and the PSS-4 scale was used to measure stress. The sample was limited to 2196 individuals who worked with patients during the COVID-19 pandemic. A series of multivariate logistic regression models with three to nine predictors was estimated. The prevalence of burnout ranged from 27.7% in other nonmedical staff to 36.5% in nurses. Adjusting for age and gender, both physicians (p = 0.011) and nurses (p < 0.001) were at higher risk of burnout. In the final model, elevated stress most likely increased the risk of burnout (OR = 3.88; 95%CI <3.13-3.81>; p < 0,001). Other significant predictors of burnout included traumatic work-related experience (OR =1.91, p < 0.001), mobbing (OR = 1.83, p < 0.001) and higher workload than before the pandemic (OR = 1.41, p = 0.002). Only 7% of the respondents decided to use various forms of psychological support during the pandemic. The presented research can contribute to the effective planning and implementation of measures in the face of crisis when the workload continues to increase.

Work Stress, Vicarious Trauma and the Public Mental Health Framework: Kozarov v Victoria [2022] HCA 12 and Its Aftermath.

The Public Mental Health Framework argues that law and policy are important in preventing mental ill-health and promoting wellbeing. Therefore, the 2022 decision of the Australian High Court in Kozarov v Victoria (Kozarov), in which a lawyer from the Office of Public Prosecutions (OPP) who worked in the Specialist Sex Offences Unit successfully claimed damages for vicarious trauma, has significant implications for the legal profession and those who are employed in emotionally demanding work. This article provides commentary on the Kozarov decision, within the context of other Australian case law including subsequent cases. It explores the significance of Kozarov and post-Kozarov authority for the development of (1) the law in "work stress" cases; (2) employers in the wake of the decision, including the OPP; and (3) the Public Mental Health Framework in relation to work stress and sexual violence as social determinants of health and mental health.