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1.
Rev Bras Epidemiol ; 23: e200015, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32159626

RESUMO

OBJECTIVE: To study associated factors with loss productivity in people involved road traffic accidents (RTA). METHODS: The population based cohort study was conducted in Jequié, Brazil between 2013 to 2015. The instrument for interview was used in people involved in RTA and interview in four months. Individuals, occupational, health conditions, injury and support variables were used for bivariate and multivariate analysis. RESULTS: The cumulative incidence was loss productivity was 61.1% and density incidence of 7.45 cases/100 person-month. Multivariate analysis showed association for injury (IDR = 4.23; 95%CI = 2.90 - 6.17) and vehicle used with work instrument (IDR = 2.80; 95%CI = 1.62 - 4.85). CONCLUSION: Public policies are needed to ensure traffic safety in order to minimize the effects of RTA about productivity and to carry news studies to expand knowledge about loss productivity.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Condução de Veículo/estatística & dados numéricos , Efeitos Psicossociais da Doença , Eficiência , Licença Médica/estatística & dados numéricos , Ferimentos e Lesões/economia , Adulto , Brasil , Estudos de Coortes , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Licença Médica/economia , Índices de Gravidade do Trauma , Ferimentos e Lesões/etiologia
2.
Am J Public Health ; 110(4): 499-504, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32078341

RESUMO

Objectives. To estimate if Washington State's paid sick leave law increased access to paid sick leave, reduced employees' working while sick, and relieved care burdens.Methods. I drew on new data from 12 772 service workers collected before and after the law took effect in January 2018 in Washington State and over the same time period in comparison states that did not have paid sick leave requirements. I used difference-in-difference models to estimate the effects of the law.Results. The law expanded workers' access to paid sick leave by 28 percentage points (P < .001). The law reduced the share of workers who reported working while sick by 8 percentage points (P < .05). Finally, there was little evidence that the law served to reduce work-life conflict for Washington workers.Conclusions. Mandated paid sick leave increased access to paid sick leave benefits and led to reductions in employees' working while sick. However, covered workers did not experience reductions in work-life conflict in the period immediately following passage.


Assuntos
Presenteísmo/estatística & dados numéricos , Licença Médica/legislação & jurisprudência , Feminino , Humanos , Masculino , Licença Médica/estatística & dados numéricos , Inquéritos e Questionários , Washington , Equilíbrio Trabalho-Vida/estatística & dados numéricos
3.
BMC Public Health ; 20(1): 8, 2020 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-31907012

RESUMO

BACKGROUND: Poor health could influence how individuals are sorted into occupational classes. Health selection has therefore been considered a potential modifier to the mortality class gradient through differences in social mobility. Direct health selection in particular may operate in the short-term as poor health may lead to reduced work hours or achievement, downward social mobility, unemployment or restricted upward mobility, and death. In this study, the relationship between social mobility and mortality (all-cause, cancer-related, cardiovascular disease-related (CVD), and suicide) is explored when the relationship is adjusted for poor health. METHODS: Using Swedish register data (1996-2012) and discrete time event-history analysis, odds ratios and average marginal effects (AME) of social mobility and unemployment on mortality are observed before and after accounting for sickness absence in the previous year. RESULTS: After adjusting for sickness absence, all-cause mortality remained lower for men after upward mobility in comparison to not being mobile (OR 0.82, AME -0.0003, CI - 0.0003 to - 0.0002). Similarly, upward mobility continued to be associated with lower cancer-related mortality for men (OR 0.85, AME -0.00008, CI - 0.00002 to - 0.0002), CVD-related mortality for men (OR 0.76, AME -0.0001, CI - 0.00006 to - 0.0002) and suicide for women (OR 0.67, AME -0.00002, CI - 0.000002 to - 0.00003). The relationship between unemployment and mortality also persisted across most causes of death for both men and women after controlling for previous sickness absence. In contrast, adjusting for sickness absence renders the relationship between downward mobility and cancer-related mortality not statistically different from the non-mobile. CONCLUSIONS: Health selection plays a role in how downward mobility is linked to cancer related deaths. It additionally accounts for a portion of why upward mobility is associated with lower mortality. That health selection plays a role in how social mobility and mortality are related may be unexpected in a context with strong job protection. Job protection does not, however, equalize opportunities for upward mobility, which may be limited for those who have been ill. Because intra-generational upward mobility and mortality remained related after adjusting for sickness absence, other important mechanisms such as indirect selection or social causation should be explored.


Assuntos
Absenteísmo , Mortalidade/tendências , Licença Médica/estatística & dados numéricos , Mobilidade Social/estatística & dados numéricos , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Suécia/epidemiologia , Adulto Jovem
4.
Support Care Cancer ; 28(1): 185-192, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31001691

RESUMO

PURPOSE: The objective of our study was to assess the rate of work adjustments 1 year after the diagnosis in a population of female breast cancer (BC) survivors, in the context of the French system of social protection. We also characterised these adjustments and their influence on the reduction of professional exclusion of patients 1 year after the diagnosis. METHODS: This observational, prospective study was conducted from February 2015 to April 2016 among female patients with BC. Inclusion criteria were women aged between 18 and 65 years, treated for BC and integrated into the labour market at the time of diagnosis (working or on sick leave). Exclusion criteria were metastatic BC, retired patients and refusal to participate. A 1-year follow-up was scheduled, and data collection was performed with questionnaires. RESULTS: In total, 213 patients were included between February 2015 and April 2016. One year after the diagnosis (T1), among 185 BC survivors, 78 (42.2%) patients were working. Among them, 13 patients did not interrupt their occupational activity and 65 returned to work after a period of sick leave. Sixty-four patients returned to work after the end of chemotherapy (after 6 months), and one returned to work before this therapeutic threshold. Sixty-six patients (35.7%) benefited from at least one adjustment of their work conditions to facilitate their return to work (RTW) or maintenance at work: working hours were decreased for 43 patients, and workstation changes were performed for 22 patients. An occupational health physician was involved for some patients; work adjustments were prescribed to 42 patients, 7 patients had medical restrictions for physical reasons and 4 patients had restrictions for psychological reasons. Forty-three patients benefited from part-time work prescribed for therapeutic reasons. CONCLUSIONS: Referral to occupational health physicians and work adjustments remain limited in the process of RTW or maintenance at work after BC in France, despite their positive impact.


Assuntos
Neoplasias da Mama/epidemiologia , Sobreviventes de Câncer/estatística & dados numéricos , Retorno ao Trabalho , Ajustamento Social , Adaptação Psicológica/fisiologia , Adolescente , Adulto , Idoso , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/psicologia , Neoplasias da Mama/reabilitação , Sobreviventes de Câncer/psicologia , Emprego/psicologia , Emprego/estatística & dados numéricos , Feminino , França/epidemiologia , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Retorno ao Trabalho/psicologia , Retorno ao Trabalho/estatística & dados numéricos , Licença Médica/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem
5.
Int J Radiat Oncol Biol Phys ; 106(1): 146-156, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31521718

RESUMO

PURPOSE: Human papillomavirus (HPV)-associated oropharyngeal cancer (OPC) commonly affects people of working age, yet there is limited data regarding the return-to-work experience in this cohort. This study aimed to investigate the proportion of survivors currently working after completion of radiation therapy and to explore potential facilitators and barriers to working after treatment. METHODS: A cross-sectional, single-institutional study was undertaken at the Peter MacCallum Cancer Centre, a comprehensive cancer center in Melbourne, Victoria, Australia. Eligible participants were 18 to 65 years old at diagnosis, were employed at or within the 3 months before diagnosis, and had completed curative treatment for HPV-associated OPC ≥4 months before enrollment. Participants completed a paper-based survey to assess baseline demographics, employment status, and quality of life (QOL; Functional Assessment of Cancer Therapy Head and Neck). Open-ended questions explored factors affecting return to work. Associations between current employment status and various disease, treatment, and demographic variables and with QOL were examined. Free-text items were analyzed by summarizing content analysis. RESULTS: Of 93 participants approached, 68 responded (73.1%). Mean age was 54.1 years (range, 39-64 years), and 89.7% were male. Most participants (67.6%) had stage II disease and were treated with chemoradiation (85.3%). Mean time after treatment was 2.6 years (range, 0.3-9.1 years). Fifty-eight of 68 participants (85.3%) were working at enrollment; median time to return to work was 6.0 months (interquartile range, 4-10 months); 45 (77.6%) were in the same role and 35 (60.3%) worked the same number of hours. Ten participants were not working, 3 had retired, 5 reported persistent and significant treatment toxicity preventing employment. Survivors currently working reported higher physical, functional, and global QOL scores. Access to leave and support from treating doctors were facilitators for return to work, whereas fatigue was frequently reported as a barrier to returning to work. CONCLUSION: With time, the majority of participants with HPV-associated OPC will return to work after radiation therapy. Attention to symptom management and support from the workplace may enable more successful return to work.


Assuntos
Sobreviventes de Câncer/estatística & dados numéricos , Emprego/estatística & dados numéricos , Neoplasias Orofaríngeas/terapia , Infecções por Papillomavirus/complicações , Qualidade de Vida , Retorno ao Trabalho/estatística & dados numéricos , Adulto , Sobreviventes de Câncer/psicologia , Quimiorradioterapia/efeitos adversos , Quimiorradioterapia/estatística & dados numéricos , Estudos Transversais , Fadiga/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Orofaríngeas/patologia , Neoplasias Orofaríngeas/virologia , Papillomaviridae , Pesquisa Qualitativa , Aposentadoria/estatística & dados numéricos , Retorno ao Trabalho/psicologia , Licença Médica/estatística & dados numéricos , Apoio Social , Inquéritos e Questionários , Fatores de Tempo , Vitória , Tolerância ao Trabalho Programado , Local de Trabalho
6.
BMC Public Health ; 19(1): 1668, 2019 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-31829186

RESUMO

BACKGROUND: Given today's high prevalence of common mental disorders and related sick leave among teachers, an urgent need exists for a more systematic approach to the management of social and organizational risk factors within schools. In 2015, we launched the first Swedish occupational health guideline to support a structured prevention of these risks at the workplace. The existence of guidelines does however not guarantee their usage, as studies show that guidelines are often underused. Knowledge is therefore needed on effective implementation strategies that can facilitate the translation of guidelines into practice. The primary aim of the randomized waiting list-controlled trial described in this study protocol is to compare the effectiveness of a multifaceted implementation strategy versus a single implementation strategy for implementing the Guideline for the prevention of mental ill-health at the workplace within schools. The effectiveness will be compared regarding the extent to which the recommendations are implemented (implementation effectiveness) and with regard to social and organisational risk factors for mental ill-health, absenteeism and presenteeism (intervention effectiveness). METHODS: The trial is conducted among primary schools of two municipalities in Sweden. The single implementation strategy is an educational strategy (an educational meeting). The multifaceted strategy consists of the educational meeting, an implementation team and a series of workshops. The outcome measure of implementation effectiveness is guideline adherence. The primary outcome of intervention effectiveness is exhaustion. Secondary outcomes include demands at work, work organization and job contents, interpersonal relations and leadership, presenteeism, work performance, recovery, work-life balance, work-engagement, self-reported stress, self-perceived health, sickness absence and psychosocial safety climate. Process outcomes as well as barriers and facilitators influencing the implementation process are assessed. Data will be collected at baseline, 6, 12, 18 and 24 months by mixed methods (i.e. survey, focus-group interviews, observation). DISCUSSION: The study described in this protocol will provide valuable knowledge on the effectiveness of implementation strategies for implementing a guideline for the prevention of common mental disorders within schools. We hypothesize that successful implementation will result in reductions in school personnel's perceived social and organizational risk factors, mental ill-health and sick-leave. TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT03322839 (trial registration: 09/19/2017).


Assuntos
Guias como Assunto , Transtornos Mentais/prevenção & controle , Serviços de Saúde do Trabalhador/organização & administração , Professores Escolares/psicologia , Instituições Acadêmicas/organização & administração , Absenteísmo , Cidades , Grupos Focais , Fidelidade a Diretrizes/estatística & dados numéricos , Humanos , Projetos de Pesquisa , Professores Escolares/estatística & dados numéricos , Instituições Acadêmicas/estatística & dados numéricos , Licença Médica/estatística & dados numéricos , Inquéritos e Questionários , Suécia , Local de Trabalho/psicologia
7.
BMC Health Serv Res ; 19(1): 895, 2019 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-31771576

RESUMO

BACKGROUND: Organizational change is often associated with reduced employee health and increased sickness absence. However, most studies in the field accentuate major organizational change and often do not distinguish between and compare types of change. The aim of this study was to examine the different relationships between six unit-level changes (upsizing, downsizing, merger, spin-off, outsourcing and insourcing) and sickness absence among hospital employees. METHODS: The study population included employees working in a large Norwegian hospital (n = 26,252). Data on unit-level changes and employee sickness absence were retrieved from objective hospital registers for the period January 2011 to December 2016. The odds of entering short- (< = 8 days) and long-term (> = 9 days) sickness absence for each individual employee were estimated in a longitudinal multilevel random effects logistic regression model. RESULTS: Unit-level organizational change was associated with both increasing and decreasing odds of short-term sickness absence compared to stability, but the direction depended on the type and stages of change. The odds of long-term sickness absence significantly decreased in relation to unit-level upsizing and unit-level outsourcing. CONCLUSIONS: The results from this study suggested that certain types of change, such as unit-level downsizing, may produce greater strain and concerns among employees, possibly contributing to an increased risk of sickness absence at certain stages of the change. By contrast, changes such as unit-level insourcing and unit-level upsizing were related to decreased odds of sickness absence, possibly due to positive change characteristics.


Assuntos
Absenteísmo , Inovação Organizacional , Recursos Humanos em Hospital/estatística & dados numéricos , Licença Médica/estatística & dados numéricos , Adulto , Feminino , Hospitais/estatística & dados numéricos , Humanos , Modelos Logísticos , Masculino , Análise Multinível , Noruega , Saúde do Trabalhador , Organizações
8.
BMC Public Health ; 19(1): 1418, 2019 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-31666045

RESUMO

BACKGROUND: Early exit from paid employment is a notable public health and societal challenge. Previous research has largely focused on the relationships among variables instead of the relationships among individuals with different work participation history. Person-oriented methods enable to identify latent groups of individuals who are likely to follow similar development in their work participation over time. We thus aimed to identify work participation trajectories during early and midlife careers and their social determinants using large nationally representative data comprising over 1 million initially employed individuals and a 10-year follow-up for their work participation. A further aim was to determine the cumulative incidence of sickness absence due to key diagnostic groups, mental disorders and musculoskeletal diseases within the trajectories. METHODS: Young (25-38 years at baseline, n = 495,663) and midlife (39-52 years at baseline, n = 603,085) Finnish people, all working in 2004, were followed up through 2013, with registers of the Social Insurance Institution, and the Statistics Finland. The registers provided data for work participation and its determinants, as well as for computing the cumulative incidence of sickness absence. Latent class growth analysis was used to identify trajectories. RESULTS: Three distinctive trajectories were identified: temporary exit, permanent exit, and continuously employed people. As compared to the other trajectories, those belonging to the permanent exit trajectory were more likely men, manual workers and had a lower income. The cumulative incidence of sickness absence due to mental disorders was highest in the permanent exit trajectory group. For musculoskeletal diseases, the cumulative incidence of sickness absence increased in the permanent exit trajectory mainly in the older age groups. CONCLUSION: Distinct group-based trajectories of early work exit can be identified in a representative cohort of initially employed people. Focusing on the determinants of premature exit and early intervention to tackle increasing sickness absence may promote work participation particularly in the most vulnerable groups.


Assuntos
Absenteísmo , Emprego , Renda , Transtornos Mentais/epidemiologia , Doenças Musculoesqueléticas/epidemiologia , Ocupações , Licença Médica , Fatores Etários , Idoso , Estudos de Coortes , Emprego/estatística & dados numéricos , Feminino , Finlândia/epidemiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Ocupações/estatística & dados numéricos , Fatores Sexuais , Licença Médica/estatística & dados numéricos , Desemprego
9.
Pan Afr Med J ; 33: 320, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692933

RESUMO

Introduction: Occupational stress is a recognized health problem among nurses. Globally, its prevalence varies between 9.2% and 68.0%. It detracts from nurses' quality of life and efficiency of job performance. In Ghana, we do not know the important contributory factors to this problem. Our study sought to identify the important predictors of occupational stress among nurses. Methods: In January 2016, we conducted an institutional-based survey among nurses of Salaga Government Hospital. They completed a five-point Likert type questionnaire adopted from the British Psychological Working Conditions Survey, and the Nurse Stress Index. Across 30 predictor variables, a mean score of 4.00 to 5.00 represented high to extreme occupational stress. We performed bivariate and multivariate analyses to identify important predictors of occupational stress at 95% confidence level. Results: Of 167 nurses, 58.1% (97) were females. Respondents who experienced high to extreme stress levels had a 2.3 times odds of reporting sickness absence (CI: 1.03-5.14). Sources of occupational stress included: manual lifting of patients and pieces of equipment (OR: 16.23; CI: 6.28 - 41.92), the risks of acquiring infections (OR: 14.67; CI 5.90 - 36.46), receiving feedback only upon unsatisfactory performance (OR: 28.00; CI: 9.72 - 80.64), and inadequate opportunities for continuous professional development (OR: 63.50; CI: 19.99 - 201.75). Conclusion: The working conditions of nurses were stressful. The most significant predictors of occupational stress were poor supportive supervision by superiors, lack of adequate skills to perform routine tasks, uncertainty about their job role, and the lack of adequate opportunities for career advancements.


Assuntos
Competência Clínica , Recursos Humanos de Enfermagem no Hospital/psicologia , Estresse Ocupacional/epidemiologia , Licença Médica/estatística & dados numéricos , Adulto , Mobilidade Ocupacional , Feminino , Gana , Humanos , Masculino , Pessoa de Meia-Idade , Papel do Profissional de Enfermagem , Recursos Humanos de Enfermagem no Hospital/normas , Qualidade de Vida , Inquéritos e Questionários , Adulto Jovem
10.
Respir Res ; 20(1): 215, 2019 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-31601216

RESUMO

BACKGROUND: Evidence on the economic impact of chronic obstructive pulmonary disease (COPD) for third-party payers and society based on large real world datasets are still scarce. Therefore, the aim of this study was to estimate the economic impact of COPD severity and its comorbidities, stratified by GOLD grade, on direct and indirect costs for an unselected population enrolled in the structured German Disease Management Program (DMP) for COPD. METHODS: All individuals enrolled in the DMP COPD were included in the analysis. Patients were only excluded if they were not insured or not enrolled in the DMP COPD the complete year before the last DMP documentation (at physician visit), had a missing forced expiratory volume in 1 s (FEV1) measurement or other missing values in covariates. The final dataset included 39,307 patients in GOLD grade 1 to 4. We used multiple generalized linear models to analyze the association of COPD severity with direct and indirect costs, while adjusting for sex, age, income, smoking status, body mass index, and comorbidities. RESULTS: More severe COPD was significantly associated with higher healthcare utilization, work absence, and premature retirement. Adjusted annual costs for GOLD grade 1 to 4 amounted to €3809 [€3691-€3935], €4284 [€4176-€4394], €5548 [€5328-€5774], and €8309 [€7583-9065] for direct costs, and €11,784 [€11,257-€12,318], €12,985 [€12,531-13,443], €15,805 [€15,034-€16,584], and €19,402 [€17,853-€21,017] for indirect costs. Comorbidities had significant additional effects on direct and indirect costs with factors ranging from 1.19 (arthritis) to 1.51 (myocardial infarction) in direct and from 1.16 (myocardial infarction) to 1.27 (cancer) in indirect costs. CONCLUSION: The findings indicate that more severe GOLD grades in an unselected COPD population enrolled in a structured DMP are associated with tremendous additional direct and indirect costs, with comorbidities significantly increase costs. In direct cost category hospitalization and in indirect cost category premature retirement were the main cost driver. From a societal perspective prevention and interventions focusing on disease control, and slowing down disease progression and strengthening the ability to work would be beneficial in order to realize cost savings in COPD.


Assuntos
Gerenciamento Clínico , Custos de Cuidados de Saúde/estatística & dados numéricos , Doença Pulmonar Obstrutiva Crônica/economia , Doença Pulmonar Obstrutiva Crônica/terapia , Fatores Etários , Idoso , Comorbidade , Progressão da Doença , Feminino , Volume Expiratório Forçado , Alemanha , Hospitalização/economia , Humanos , Renda , Masculino , Aceitação pelo Paciente de Cuidados de Saúde , Doença Pulmonar Obstrutiva Crônica/complicações , Aposentadoria/economia , Aposentadoria/estatística & dados numéricos , Fatores Sexuais , Licença Médica/economia , Licença Médica/estatística & dados numéricos , Fumar/efeitos adversos , Fumar/economia
11.
Muscle Nerve ; 60(6): 700-706, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31478207

RESUMO

INTRODUCTION: Labor-market participation is potentially very difficult for patients with refractory myasthenia gravis (MG). In this study, employment status and work absences are compared between refractory and nonrefractory MG. METHODS: Adults (aged 18-64 years, all diagnosed ≥2 years previously) were included if enrolled in the Myasthenia Gravis Foundation of America Patient Registry during July 2013 to February 2018. RESULTS: Seventy-six patients (9.2%) had refractory and 749 (90.8%) had nonrefractory disease; demographic data did not differ between groups. Relative to the nonrefractory group, the refractory group patients were more than twice as likely to work fewer hours per week (odds ratio [95% confidence interval]: currently employed, 2.777 [1.640-4.704]; employed over previous 6 months, 2.643 [1.595-4.380]), but those employed were not more likely to be absent from work. DISCUSSION: Because absence from the labor market adversely affects quality of life and personal finances, these findings reaffirm the considerable disease burden associated with refractory MG.


Assuntos
Emprego/estatística & dados numéricos , Miastenia Gravis/fisiopatologia , Licença Médica/estatística & dados numéricos , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Miastenia Gravis/terapia , Falha de Tratamento , Desemprego/estatística & dados numéricos , Adulto Jovem
12.
BMC Public Health ; 19(1): 1248, 2019 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-31510964

RESUMO

BACKGROUND: To date, there have not been any workforce-based Japanese cohort studies investigating work sustainability after return to work (RTW). The objective of this study was to investigate the post-RTW cumulative recurrent sick leave rate and cumulative resignation rate among female cancer survivors. METHODS: Among Japanese employees who were registered in the Japan sickness absence and return to work (J-SAR) study, the subjects were those female employees who returned to work after sick leave due to newly clinically diagnosed cancer (C01-C99; ICD-10), based on a physician's certificate, between 2000 and 2011. The last day of the follow-up period was December 31, 2012. The recurrent sickness leave rate and resignation rate were calculated using competing risk survival analysis. RESULTS: Of 223 cancer survivors, 61 took further physician-certified sick leave after their RTW. The median duration of the post-RTW work period among all cancer survivors was 10.6 years. The work continuance rates of the female cancer survivors were 83.2 and 60.4% at 1 and 5 years after they returned to work, respectively. There was a steep reduction in the work continuance rate during the first post-RTW year. There were considerable differences in the work continuance rate according to the primary cancer site. Cumulative recurrent sick leave rates of 11.8 and 28.9% were seen at 1 and 5 years after the subjects returned to work. The cumulative resignation rate was 5.0 and 10.7% at 1 and 5 years after the subjects returned to work. Most recurrent sick leave occurred in the first year after the subjects returned to work, followed by the second year. CONCLUSIONS: Sixty percent of female cancer survivors were still working at 5 years after returning to work, although the work continuance rates for different types of cancer varied significantly.


Assuntos
Sobreviventes de Câncer/estatística & dados numéricos , Retorno ao Trabalho/estatística & dados numéricos , Licença Médica/estatística & dados numéricos , Adulto , Estudos de Coortes , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Análise de Sobrevida
13.
Artigo em Inglês | MEDLINE | ID: mdl-31540506

RESUMO

Breast cancer is the most common cancer among women in Western countries with clear socioeconomic differences. Higher occupational class is associated with higher breast cancer incidence but with better survival from the disease, whereas lower occupational class is associated with higher risk of sickness absence. We are not aware of previous studies examining changes over time in occupational class differences in sickness absence due to breast cancer. This paper focuses on occupational class differences in the incidence and duration of sickness absence due to breast cancer over the period of 2005-2013. Age-adjusted occupational class differences in the cumulative incidence and duration of sickness absence due to breast cancer were calculated utilising a nationally representative 70% random sample of employed Finnish women aged 35-64 years (yearly N varying between 499,778 and 519,318). The results show that higher occupational class was associated with higher annual cumulative incidence of sickness absence due to breast cancer. Lower occupational class was associated with longer duration of absence. Occupational class differences in both cumulative incidence and duration of absence remained broadly stable. As a conclusion, these results suggest that measures should be targeted particularly to promotion of work capacity among employees with breast cancer in lower occupational classes.


Assuntos
Neoplasias da Mama/epidemiologia , Ocupações/estatística & dados numéricos , Licença Médica/estatística & dados numéricos , Adulto , Emprego , Feminino , Finlândia/epidemiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Projetos de Pesquisa
14.
BMC Public Health ; 19(1): 1110, 2019 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-31412832

RESUMO

BACKGROUND: Experiencing work-related stress constitutes an obvious risk for becoming sick-listed. In primary health care, no established method to early identify, advise and treat people with work-related stress exists. The aim was to evaluate if the use of the Work Stress Questionnaire (WSQ) brief intervention, including feedback from the general practitioner (GP), had an impact on the level of sickness absence. METHOD/DESIGN: In total 271 (intervention group, n = 132, control group, n = 139) non-sick-listed employed women and men, aged 18 to 64 years, who had mental and physical health complaints and sought care at primary health care centers participated in this two-armed randomized controlled trial. The main outcomes were the number of registered sick leave days and episodes, and time to first sick leave during the 12-months follow-up. The intervention included early identification of work-related stress by the WSQ, GP awareness supported by a brief training session, patients' self-reflection by WSQ completion, GP feedback at consultation, and initiation of preventive measures. RESULTS: The mean days registered for the WSQ intervention group and the control group were 39 and 45 gross days respectively, and 31 and 39 net days respectively (ns). No statistical significant difference for the number of sick leave episodes or time to first day of sick leave episode were found between the groups. CONCLUSIONS: The WSQ brief intervention combined with feedback and suggestions of measures at patient-GP-consultation was not proven effective in preventing sick leave in the following 12 months compared to treatment as usual. More research is needed on methods to early identify, advise and treat people with work-related stress in primary health care, and on how and when GPs and other professionals in primary health care can be trained to understand this risk of sick leave due to work-related stress, on how to prevent it, and on how to advise and treat employees at risk. TRIAL REGISTRATION: ClinicalTrials.gov. Identifier: NCT02480855 . Registered 20 May 2015.


Assuntos
Clínicos Gerais/psicologia , Estresse Ocupacional/diagnóstico , Relações Médico-Paciente , Licença Médica/estatística & dados numéricos , Adolescente , Adulto , Diagnóstico Precoce , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estresse Ocupacional/psicologia , Atenção Primária à Saúde , Medição de Risco , Inquéritos e Questionários , Adulto Jovem
15.
BMC Public Health ; 19(1): 943, 2019 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-31307453

RESUMO

BACKGROUND: In recent years, bicycle injuries have increased, yet little is known about the impact of such injures on sickness absence (SA) and disability pension (DP). The aim was to explore SA and DP among individuals of working ages injured in a bicycle crash. METHOD: A nationwide register-based study, including all individuals aged 16-64 years and living in Sweden, who in 2010 had in- or specialized out-patient healthcare (including emergency units) after a bicycle crash. Information on age, sex, sociodemographics, SA, DP, crash type, injury type, and injured body region was used. We analyzed individuals with no SA or DP, with ongoing SA or full-time DP already at the time of the crash, and with new SA > 14 days in connection to the crash. Crude and adjusted odds ratios (OR) with 95% confidence intervals for new SA were estimated by logistic regression. RESULTS: In total, 7643 individuals had healthcare due to a new bicycle crash (of which 85% were single-bicycle crashes). Among all, 10% were already on SA or full-time DP at the time of the crash, while 18% had a new SA spell. The most common types of injuries were external injuries (38%) and fractures (37%). The body region most frequently injured was the upper extremities (43%). Women had higher OR (1.40; 1.23-1.58) for new SA than men, as did older individuals compared with younger (OR 2.50; 2.02-3.09, for ages: 55-64 vs. 25-34). The injury types with the highest ORs for new SA, compared with the reference group external injuries was fractures (8.04; 6.62-9.77) and internal injuries (7.34; 3.67-14.66). Individuals with traumatic brain injury and injuries to the vertebral column and spinal cord had higher ORs for SA compared with other head, face, and neck injuries (2.72; 1.19-6.22 and 3.53; 2.24-5.55, respectively). CONCLUSIONS: In this explorative nationwide study of new bicycle crashes among individuals of working ages, 18% had a new SA spell in connection to the crash while 10% were already on SA or DP. The ORs for new SA were higher among women, older individuals, and among individuals with a fracture.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Ciclismo/lesões , Licença Médica/estatística & dados numéricos , Adolescente , Adulto , Pessoas com Deficiência/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pensões/estatística & dados numéricos , Sistema de Registros , Suécia , Adulto Jovem
16.
Occup Environ Med ; 76(8): 554-559, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31300561

RESUMO

OBJECTIVE: To determine the association between several whole-body vibration (WBV) exposure estimates and back pain-related work absence. METHODS: Exposures (based on the weighted daily root mean square acceleration, A(8); the daily vibration dose value, VDV(8); and the daily equivalent static compression dose, Sed(8)) of 2302 workers during 4 years were estimated using each worker's monthly vehicle operation records and WBV measurements from 11 different types of heavy equipment vehicles in a large coal mine. Company payroll data provided work absence during the concurrent 4 years of exposure. Cox regression models estimated the associations between the different WBV metrics and time to first work absence related to back pain. An adjusted R2 statistic provided a measure of model fit. RESULTS: All estimated metrics of WBV exposures were positively and significantly associated with back pain-related absence. HRs varied from 2.03 to 12.39 for every 0.21 m/s2 increase in the A(8)-based exposures; from 1.03 to 1.18 for every 1.72 m/s1.75 increase in VDV(8)-based exposures; and from 1.04 to 1.07 for every 0.06 MPa increase in Sed(8)-based exposures. Models using the estimated VDV(8) metric for the z axis fit the data best as measured by the R2 statistic. CONCLUSION: Higher WBV exposures were associated with back pain-related absences in this population, which appears after a few years of follow-up. Introducing controls to lower exposure levels may help reduce back pain-related work absences.


Assuntos
Dor nas Costas/epidemiologia , Exposição Ocupacional/efeitos adversos , Licença Médica/estatística & dados numéricos , Vibração/efeitos adversos , Adulto , Idoso , Minas de Carvão , Colômbia/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Veículos Automotores , Doenças Profissionais/epidemiologia
17.
Clin Exp Rheumatol ; 37 Suppl 118(3): 83-89, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31287413

RESUMO

OBJECTIVES: To assess trends in treatments and outcomes in patients with primary Sjögren's syndrome (pSS), focusing on employment, hospitalisation and medical treatment in the past two decades. METHODS: From 1996 to 2016, approximately 300 patients with pSS were annually documented in the National Database of the German Collaborative Arthritis Centres. Data on treatment, physicians' assessments of disease activity, patient-reported outcomes, hospitalisation and employment were collected and compared to patients with rheumatoid arthritis (RA), matched 1:1 for age, sex and disease duration for each calendar year. RESULTS: Patients with pSS (>90% female, age 44 years at disease onset, disease duration 10 years) were more frequently assessed to be in low disease activity in 2016 (93%) than in 1996 (62%), p<0.01. Treatment with antimalarials increased from 1996 to 2016 (31 to 50%, p<0.01) and less patients were on glucocorticosteroids (50 to 34%, p<0.01) but <5% were treated with biologics. Employment (<65 years) increased by 21 percentage points (43 to 64%, p<0.001), exceeding the increase observed for RA patients (+15 percentage points). Early retirement (22 to 10%, p=0.01), hospitalisation/year (13 to 7%, p=0.08) and sick leave (39% in 1997 to 27%, p=0.09) decreased comparably to RA patients. CONCLUSIONS: Overall, similar trends were observed for RA and pSS cohorts despite minor changes in pSS therapy. Work participation has improved significantly over two decades in pSS. A greater perception of pSS without systemic manifestations may have caused a shift towards less severely affected patient cohorts today.


Assuntos
Emprego/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Síndrome de Sjogren , Emprego/tendências , Feminino , Hospitalização/tendências , Humanos , Masculino , Licença Médica/estatística & dados numéricos , Licença Médica/tendências
18.
Artigo em Inglês | MEDLINE | ID: mdl-31200553

RESUMO

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.


Assuntos
Licença Médica/estatística & dados numéricos , Carga de Trabalho , Adulto , Feminino , Finlândia , Seguimentos , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Sistema de Registros , Fatores de Risco , Local de Trabalho
19.
Neurology ; 93(4): e404-e413, 2019 07 23.
Artigo em Inglês | MEDLINE | ID: mdl-31213498

RESUMO

OBJECTIVE: To estimate the prevalence of cluster headache in working-aged people, compare sickness absence rates and disability pension in cluster headache patients to rates in a matched comparison group, and explore associations of sociodemographic factors with such rates. METHODS: Through population-based registers, we identified 3,240 people aged 16-64, living in Sweden in 2010, who at least once during 2001-2010 received inpatient or specialized outpatient health care with cluster headache (ICD-10 code G44.0) as main diagnosis. A comparison group (n = 16,200), matched for age, sex, type of living area, and educational level, from the total population aged 16-64 (n = 5,945,895) was used. Outcomes were sickness absence (>14 days) and disability pension during 2010. Crude and adjusted prevalence rates and odds ratios with 95% confidence intervals were computed. RESULTS: The prevalence of cluster headache in working-aged people was 0.054%. In 2010, 17.30% of the cluster headache group and 9.16% of the comparison group had been on sickness absence. In the cluster headache group, female patients had higher sickness absence rates (25.31%) and full-time disability pension (13.17%) than male patients (13.38% and 8.79%). Cluster headache patients older than 35 had higher rates than those of the same age in the comparison group. Further, cluster headache patients born outside Sweden were more likely to have full-time disability pension than patients born in Sweden. CONCLUSIONS: Much higher rates of the patients had sickness absence or disability pension than in the comparison group. Further shown differences related to sex, age, and other sociodemographic factors need to be addressed.


Assuntos
Cefaleia Histamínica/epidemiologia , Pensões/estatística & dados numéricos , Licença Médica/estatística & dados numéricos , Previdência Social/estatística & dados numéricos , Adolescente , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Suécia/epidemiologia , Adulto Jovem
20.
Int Marit Health ; 70(2): 100-106, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31237669

RESUMO

BACKGROUND: Fishers exposed to unfavourable environmental conditions may suffer negative health ef- fects. This study aimed to identify musculoskeletal symptoms in professional fishers in Norway using data from several sources; register data, telephone survey and questionnaire. MATERIALS AND METHODS: Professional fishers (n = 25,971) registered in the period 2008-2013 were selected by Statistics Norway (SSB). An age- and gender-matched control population (n = 77,913) was also selected. Outpatient consultation and hospitalisation data were received from the Norwegian Patient Registry (NPR). To obtain information about self-reported symptoms, 832 registered fishers on board Norwegian fishing vessels were interviewed by telephone, and a questionnaire was distributed to the crews of 5 trawlers (n = 153). RESULTS: Data from NPR showed that fishers, compared to the control population, suffered significantly more acute incidents related to musculoskeletal disorders (5.4% vs. 4.8%, respectively), injuries to arms (11.3% vs. 9.8%), feet (8.4% vs. 8%), and back (0.9% vs. 0.7%). In the telephone survey, 61% and 43% reported that they performed monotonous work operations and heavy lifting often or very often, respec- tively. Thirty-three per cent had experienced pain in neck/shoulders/arms often or very often during the previous 12 months, and 93% believed this was fully or partly due to their work situation. The questionnaire among trawler crew members showed that 57% and 60% had experienced stiffness and/or pain in neck/ /shoulders and lower back/small of the back respectively during the previous 12 months. CONCLUSIONS: Data from the register study, telephone survey and questionnaire all confirmed that musculo- skeletal problems are common among fishers and related to their work situation. However, 77% of the fishers in all vessel groups and on board the 5 trawlers reported their own health as being very good or good.


Assuntos
Pesqueiros , Doenças Musculoesqueléticas/epidemiologia , Doenças Profissionais/epidemiologia , Adulto , Feminino , Humanos , Masculino , Medicina Naval , Noruega/epidemiologia , Licença Médica/estatística & dados numéricos , Inquéritos e Questionários , Carga de Trabalho
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