Does it matter for health if steps are taken during work or leisure? A prospective accelerometer study using register-based long-term sickness absence.

BACKGROUND: Walking is known to be good for health. However, it is unknown whether it matters if steps are taken during work or leisure. Therefore, we aimed to examine the prospective association between accelerometer-measured steps taken during work or leisure and register-based long-term sickness absence (LTSA). METHODS: We included 937 blue- and white-collar workers from the PODESA cohort who wore a thigh-based accelerometer over four days to measure number of steps during work and leisure. Steps were divided into domain based on diary data. First event of LTSA was retrieved from a national register with four years' follow-up. We used Cox proportional hazard models to analyze the association between domain-specific and total daily steps and LTSA, adjusted for age, sex, job type, smoking, and steps in the other domain (e.g., work/leisure). RESULTS: We found more steps at work to be associated with a higher LTSA risk [Hazard Ratio (HR):1.04; 95% CI: 1.00-1.08 per 1000 steps]. No significant association was found between steps during leisure and LTSA (HR: 0.97; 95% CI: 0.91-1.02), nor between total daily steps and LTSA (HR: 1.01; CI 95% 0.99-1.04). CONCLUSIONS: More steps at work were associated with higher risk of LTSA, while steps during leisure was not clearly associated with LTSA risk. These findings partly support 'the physical activity paradox' stating that the association between physical activity and health depends on the domain.

Impact of work schedule characteristics on teacher mental health and burnout symptoms while remote working.

BACKGROUND: During the COVID-19 pandemic, teachers quickly shifted to remote teaching with many teachers experiencing increased work demands with limited resources, affecting both mental health and work. METHODS: Within a cross-sectional study, we evaluated the relationship between one type of work demand, non-standard work schedule characteristics, and depressive and burnout symptoms in kindergarten through 8th grade U.S. teachers working remotely in May 2020. We further assessed the impact of COVID-19 and work resources. Work schedule characteristics were self-assessed across six domains on a 5-point frequency scale from always (1) to never (5). We used multilevel Poisson models to calculate prevalence ratios (PRs) and 95% confidence intervals (CIs). RESULTS: In fully adjusted models, frequently working unexpectedly was associated with a higher prevalence of depressive symptoms (PR = 1.18, 95% CI = 1.07-1.31, p < 0.01), high emotional exhaustion (PR = 1.17, 95% CI = 1.05-1.30, p < 0.01), and high depersonalization (PR = 1.40, 95% CI = 1.02-1.92, p = 0.03). Remote work resources were significantly associated with a lower prevalence of depressive symptoms (PR = 0.88, 95% CI = 0.79-0.98, p = 0.02). There was a linear association between low coworker support and a low sense of personal accomplishment (PR = 0.68, 95% CI = 0.53-0.87, p < 0.01). CONCLUSIONS: Frequently having to work unexpectedly while remote teaching was associated with symptoms of depression and burnout during the COVID-19 pandemic. Workplaces should support predictable working times to lessen the disruption caused by unexpected work to promote worker well-being.

Work-related physical and psychosocial risk factors cluster with obesity, smoking and physical inactivity.

OBJECTIVE: This study investigated associations between the co-existence of multiple types of work-related psychosocial and physical risk factors, and (1) obesity; (2) smoking; and (3) leisure-time physical inactivity. It also aimed to identify sociodemographic characteristics related to clustering of work-related risk factors and lifestyle factors. METHODS: Cross-sectional data on work-related risk factors (e.g., decision authority and repetitive movements) and lifestyle was measured using a standardized questionnaire among 52,563 Dutch workers in health care, services, manufacturing and public sector. Multiple-adjusted logistic regression models assessed associations between the co-existence of multiple types of psychosocial and physical risk factors and lifestyle factors. Additionally, logistic regression models related age, gender and educational level to clustering of risk factors and lifestyle factors. RESULTS: The co-existence of multiple types of work-related psychosocial risk factors was associated with higher odds of smoking and being physically inactive. For example, workers exposed to three psychosocial risk factors had a 1.55 times higher odds of being physically inactive (95%CI: 1.42-1.70) compared to unexposed workers. A higher number of physical risk factors was also significantly associated with higher odds of smoking and obesity. The co-existence of multiple types of physical risk factors was not associated with higher odds of physical inactivity. Clustering of work-related risk factors and at least one unhealthy lifestyle factor occurred in particular among workers with low educational level. CONCLUSIONS: Results imply that interventions are needed that focus on workers with a low educational level and address work-related physical and psychosocial risk factors as well as lifestyle.

Cardiorespiratory fitness, occupational aerobic workload and age: workplace measurements among blue-collar workers.

BACKGROUND: The knowledge, from laboratory studies dating back to the 1950s on the importance of the association between cardiorespiratory fitness and aerobic workload for workers health, is fundamental for promoting sustainable healthy employability among ageing blue-collar workers today. However, the association between cardiorespiratory fitness and aerobic workload has not yet been documented during daily work, and we do not know if it applies to the normal work of blue-collar workers in different age groups. We aim to investigate the association between cardiorespiratory fitness and aerobic workload among blue-collar workers using measurements of 24-h heart rate collected over consecutive working days. METHODS: We analyzed baseline cardiorespiratory fitness, assessed using a sub-maximal cycle ergometer test, and 1-4 days of 24-h heart rate measurement from 497 blue-collar workers participating in the DPHACTO study. We investigated the association between cardiorespiratory fitness and aerobic workload defined as the average percentage of heart rate reserve (%HRR), maximum %HRR and the duration time spent at a high HRR (> 30%) during working hours. The association was assessed using multivariate linear regression models adjusted for age, sex, self-rated health, shift-work, prescription medication and occupation, as well as for different age strata. RESULTS: Higher cardiorespiratory fitness was significantly associated with decreased mean %HRR -0.32 [95% CI -0.39 to -0.25], maximum %HRR -0.35 [95% CI -0.45 to -0.25] and time spent at ≥ 30% HRR; -1.8% [95% CI -2.2 to -1.5%]. These associations were evident across age groups, with slightly stronger associations for workers aged 46-51 (total range 18-68). CONCLUSIONS: Higher cardiorespiratory fitness was associated with the decreased aerobic workload during normal work across all age groups and levels of work intensity. Our findings highlight the importance of cardiorespiratory fitness when considering the workload and its relevance in the promotion of healthy sustainable employment.

Work limitations due to neck-shoulder pain and physical work demands in older workers: cross-sectional study.

PURPOSE: Many older workers are working despite having neck-shoulder pain (NSP), which may give rise to work limitations due to pain, especially among those with high physical work demands. This study investigated the joint association of neck-shoulder pain intensity and physical work demands with work limitations among older workers. METHODS: In SeniorWorkingLife, workers ≥ 50 years (n = 11,800) replied to questions about NSP intensity, work limitations due to pain, and physical activity demands at work. The odds ratio for having a higher level of work limitations due to pain in relation to neck-shoulder pain intensity and physical work demands were modeled using logistic regression controlled for various confounders. RESULTS: The results showed that the neck-shoulder pain intensity was associated with work limitations in a dose-response fashion (p < 0.0001). Importantly, a significant interaction existed between neck-shoulder pain intensity and physical activity at work (p < 0.0001), e.g., 77% of workers with high pain and high work demands experienced work limitations due to the pain. CONCLUSION: Higher neck-shoulder pain intensity and higher physical work demands-and particularly in combination-were associated with higher odds of work limitation due to pain among older workers. Thus, it seems especially important to accommodate work demands through a better work environment for these groups of workers.

[Risks and opportunities of digitisation in the professional fields of nursing, care and healing]. / Chancen und Risiken der Digitalisierung in den beruflichen Tätigkeitsfeldern Pflegen, Betreuen und Heilen.

Digitisation is increasingly finding its way into the world of work. Although it is unlikely that human work will be replaced by computers and machines in the near future, it can be assumed that human work will change. These changes are less expected at the sectoral and occupational level and more at the activity level. This article first discusses which requirements are, in general, gaining importance as digitalisation progresses. It is thereby assumed that technological change entails similar requirements as organisational restructuring processes. Subsequently, the requirements employees are increasingly confronted with are presented for the field of nursing, caring and curing. The analyses are based on an employment survey jointly carried out by the German Federal Institute for Vocational Education and Training (BIBB) and the German Federal Institute for Occupational Safety and Health (BAuA), which allows a comparison of the years 2006, 2012 and 2018.The activities are characterised both by a high work intensity and by physically stressful activities. Although it is generally assumed that there will be a decline in physical stress, this has not yet been observed in the activity investigated. Job autonomy, as a psychological resource to cope with different work demands, is also considered in the analyses, with ambiguous results. Altogether, it can be stated that the field of activity of nursing, caring and healing is characterized by comparatively stable work demands. The design of good working conditions in the nursing, care and medical professions should take into account existing challenges as well as new factors that are gaining importance as a result of increasing digitalisation.

Job requirement level, work demands, and health: a prospective study among older workers.

PURPOSE: Persons in lower occupational positions experience higher rates of morbidity compared to workers in higher advantaged positions. Working conditions may explain this occupational health gradient. Most studies consider either psychosocial or physical work demands at one point in time. In our study, we examine both physical and psychosocial work demands and their association with health status differentiated by job requirement level. We further distinguish between constant and changing work demands. METHODS: Using data from the first two waves of the German cohort study on work, age and health, we analyse a sample of 3644 older workers born in 1959 and 1965. We test direct and mediating effects of high physical and psychosocial work demands on functional physical and mental health. For this, we estimate a prospective path model using multiple linear regression models. RESULTS: Our results show that (1) constant high physical and psychosocial work demands affect physical and mental health negatively and (2) high physical workload partly mediates the relationship between job requirement level and physical health. Moreover, at least for men, a reduction of physical and psychosocial workload improves mental health status. CONCLUSIONS: Research and prevention measures currently focus particularly on psychosocial work demands. Our study shows that high physical workload is still present among older workers. Its negative health effect refers to occupational safety and health measures that take into account both the physical and psychosocial work environment as well as workers' occupational positions.

The joint association of musculoskeletal pain and domains of physical activity with sleep problems: cross-sectional data from the DPhacto study, Denmark.

PURPOSE: To investigate if occupational physical activity (OPA) and leisure-time physical activity (LTPA) influence the association between musculoskeletal pain and sleep problems. METHODS: Cross-sectional study includes 678 workers in the Danish PHysical ACTivity cohort with Objective measurements (DPhacto). Musculoskeletal pain was assessed by questionnaires, while OPA and LTPA were measured with accelerometers for up to 6 consecutive days. We used logistic regression to calculate odds ratios (ORs) with 95% confidence intervals (CIs) for self-reported insomnia symptoms and non-restorative sleep. RESULTS: Analyses of the joint association of musculoskeletal pain and OPA showed that workers with high pain and high OPA had ORs of 5.80 (95% CI 2.64-12.67) for insomnia symptoms and 2.50 (95% CI 1.37-4.57) for non-restorative sleep, compared to those with low pain and low OPA, whereas workers with high pain and low OPA had ORs of 4.67 (95% CI 2.17-10.07) for insomnia symptoms, and 2.67 (95% CI 1.46-4.89) for non-restorative sleep, respectively. Furthermore, workers with high pain and high LTPA had ORs of 4.23 (95% CI 2.16-8.32) for insomnia symptoms and 1.95 (95% CI 1.09-3.48) for non-restorative sleep, compared to those with low pain and low LTPA, whereas workers with high pain and low LTPA had ORs of 3.34 (95% CI 1.66-6.70) for insomnia symptoms and 2.14 (95% CI 1.21-3.80) for non-restorative sleep, respectively. CONCLUSIONS: Workers with high musculoskeletal pain who also conducted high levels of OPA or LTPA reported higher prevalence of insomnia symptoms.

Emotional demands and exhaustion: cross-sectional and longitudinal associations in a cohort of Danish public sector employees.

PURPOSE: To examine cross-sectional and longitudinal associations between content-related emotional demands at work and exhaustion, and to investigate if these associations were modified by other psychosocial work characteristics. METHODS: In 2007, 4489 Danish public service employees participated in the PRISME study by completing postal questionnaires, and 3224 participated in the follow-up in 2009. Content-related emotional demands were measured by a scale (scored 1 to 5) based on five work-content-related items, and exhaustion was measured with the general exhaustion scale from the Copenhagen Burnout Inventory (CBI) (scored 1 to 5). The cross-sectional and longitudinal associations with exhaustion were analysed in the same model and adjusted for effects of potential confounders. Effect modifications were examined separately for self-reported emotional enrichment, meaningful work, job control, social support at work and quantitative demands. RESULTS: Exhaustion increased with increasing emotional demands, both cross-sectionally and longitudinally. However, although statistically significant, the effect was small. In the longitudinal analysis, a one unit increase in emotional demands was associated with a 0.03 unit (95% CI: 0.01-0.06) increase in exhaustion. We found statistically significant effect modification for three of six potentially modifying work characteristics. The effect of emotional demands on exhaustion was lower for participants with high levels of emotional enrichment (cross-sectionally and longitudinally), high levels of meaningful work (longitudinally), and higher for high levels of quantitative demands (cross-sectionally). CONCLUSIONS: Increasing content-related emotional demands were associated with increasing levels of exhaustion, cross-sectionally and longitudinally. This effect was reduced if the work was experienced as emotionally enriching and meaningful.

Decrease in musculoskeletal pain after 4 and 12 months of an aerobic exercise intervention: a worksite RCT among cleaners.

BACKGROUND: Prevalence of musculoskeletal pain is high in jobs with high physical work demands. An aerobic exercise intervention targeting cardiovascular health was evaluated for its long term side effects on musculoskeletal pain. OBJECTIVE: The objective was to investigate if aerobic exercise affects level of musculoskeletal pain from baseline to 4- and 12-months follow-up. METHODS: One-hundred-and-sixteen cleaners aged 18-65 years were cluster-randomized. The aerobic exercise group ( n = 57) received worksite aerobic exercise (30 min twice a week) and the reference group ( n = 59) lectures in health promotion. Strata were formed according to closest manager (total 11 strata); clusters were set within strata (total 40 clusters, 20 in each group). Musculoskeletal pain data from eight body regions was collected at baseline and after 4- and 12-months follow-up. The participants stated highest pain in the last month on a scale from 0, stating no pain, up to 10, stating worst possible pain. A repeated-measure 2 × 2 multi-adjusted mixed-models design was applied to compare the between-groups differences in an intention to treat analysis. Participants were entered as a random effect nested in clusters to account for the cluster-based randomization. RESULTS: Clinically significant reductions (>30%, f 2 > 0.25) in the aerobic exercise group, compared to the reference group, in pain intensity in neck, shoulders, arms/wrists were found at 12-months follow-up, and a tendency ( p = 0.07, f 2 = 0.18) to an increase for the knees. At 4-months follow-up the only significant between-group change was an increase in hip pain. CONCLUSIONS: This study indicates that aerobic exercise reduces musculoskeletal pain in the upper extremities, but as an unintended side effect may increase pain in the lower extremities. Aerobic exercise interventions among workers standing or walking in the majority of the working hours should tailor exercise to only maintain the positive effect on musculoskeletal pain.

Effects of 12 months aerobic exercise intervention on work ability, need for recovery, productivity and rating of exertion among cleaners: a worksite RCT.

PURPOSE: This study assessed the effects of a worksite aerobic exercise intervention among cleaners on: work ability, need for recovery, productivity, and rating of exertion. METHODS: In a monocentric randomised controlled trial in Denmark, 116, of 250 invited, cleaners were cluster-randomised (work location; sex; age; length of service) to aerobic exercise [N = 57, 44.9 years, 75.4% female, body mass index (BMI) 26.2], receiving 2 weekly aerobic exercise sessions during 12 months, or a reference group (N = 59, 45.7 years, 76.3% female, BMI 27.1), receiving health-promoting lectures. Self-reported data on outcomes and sociodemographic information were collected at baseline, and at 4 and 12 month follow-up. All outcomes were analysed in a linear repeated-measures 2 × 2 mixed-model by an intention-to-treat analysis approach. RESULTS: Drop-out was 26 and 33% at 4 and 12 months, respectively. Aerobic exercise adherence was 51% during the first 4 months. At 4 month follow-up no effects were found. At 12 month follow-up, work ability significantly increased by 0.59 on a 0-10 scale (95% CI 0.05-1.13) and need for recovery significantly decreased by - 11.0 on a 0-100 scale (95% CI - 19.8 to - 2.2) in the aerobic exercise group compared to the reference group. Productivity and rating of exertion were unaltered. Analysis stratified on age showed significant effects only among the participants aged ≤ 45 years. CONCLUSIONS: After 12 months work ability improved and need for recovery decreased. A period of 4 months was insufficient to affect these outcomes emphasising that longer interventions may be needed to induce effects on work ability and need for recovery.

Job strain, long work hours, and suicidal ideation in US workers: a longitudinal study.

PURPOSE: To investigate whether chronic psychosocial work stressors (low job control, high job demands, job strain, low supervisor and coworker support, job insecurity, and long work hours) are longitudinally associated with suicidal ideation in a working population. METHODS: Five-hundred seventy-eight workers (aged 34-69) were chosen for this analysis from those who participated in both project 1 (2004-2006 at baseline) and project 4 (2004-2009 at follow-up) of the Midlife Development in the United States II study. The median time interval between the two projects was 26 months (range 2-62 months). RESULTS: About 11% of the workers reported suicidal ideation at follow-up, while 3% of them reported moderate/severe suicidal ideation at follow-up. After controlling for age, marital status, race, family history of suicide, and suicidal ideation at baseline, low skill discretion and job strain (a combination of low job control and high job demands) were associated with total suicidal ideation. After excluding those with suicidal ideation at baseline from analysis and further controlling for other work stressors, job strain was strongly associated with moderate/severe suicidal ideation: ORs, 4.29 (1.30-14.15) for quartile-based job strain and 3.77 (1.21-11.70) for median-based job strain. Long work hours (> 40 h/week vs. ≤ 40 h/week) also increased the likelihood for moderate/severe suicidal ideation: OR 4.06 (1.08-15.19). CONCLUSIONS: Job strain and long work hours were longitudinally associated with moderate/severe suicidal ideation. Increasing job control and ensuring optimal level of work demands, including 40 h or less of work per week may be an important strategy for the prevention of suicide in working populations.

Perseverative Cognition as an Explanatory Mechanism in the Relation Between Job Demands and Sleep Quality.

PURPOSE: The aim of this longitudinal three-wave study was to examine (i) reciprocal associations among job demands, work-related perseverative cognition (PC), and sleep quality; (ii) PC as a mediator in-between job demands and sleep quality; and (iii) continuous high job demands in relation to sleep quality and work-related PC over time. METHOD: A representative sample of the Swedish working population was approached in 2010, 2012, and 2014, and 2316 respondents were included in this longitudinal full-panel survey study. Structural equation modelling was performed to analyse the temporal relations between job demands, work-related PC, and sleep quality. Additionally, a subsample (N = 1149) consisting of individuals who reported the same level of exposure to job demands during all three waves (i.e. stable high, stable moderate, or stable low job demands) was examined in relation to PC and sleep quality over time. RESULTS: Analyses showed that job demands, PC, and poor sleep quality were positively and reciprocally related. Work-related PC mediated the normal and reversed, direct across-wave relations between job demands and sleep quality. Individuals with continuous high job demands reported significantly lower sleep quality and higher work-related PC, compared to individuals with continuous moderate/low job demands. CONCLUSION: This study substantiated reciprocal relations between job demands, work-related PC, and sleep quality and supported work-related PC as an underlying mechanism of the reciprocal job demands-sleep relationship. Moreover, this study showed that chronically high job demands are a risk factor for low sleep quality.

Presenteeism exposures and outcomes amongst hospital doctors and nurses: a systematic review.

BACKGROUND: Presenteeism is a behavior in which an employee is physically present at work with reduced performance due to illness or other reasons. Hospital doctors and nurses are more inclined to exhibit presenteeism than other professional groups, resulting in diminished staff health, reduced team productivity and potentially higher indirect presenteeism-related medical costs than absenteeism. Robust presenteeism intervention programs and productivity costing studies are available in the manufacturing and business sectors but not the healthcare sector. This systematic review aims to 1) identify instruments measuring presenteeism and its exposures and outcomes; 2) appraise the related workplace theoretical frameworks; and 3) evaluate the association between presenteeism, its exposures and outcomes, and the financial costs of presenteeism as well as interventions designed to alleviate presenteeism amongst hospital doctors and nurses. METHODS: A systematic search was carried out in ten electronic databases from 1998 to 2017 and screened by two reviewers. Quality assessment was carried out using the Critical Appraisal Skills Program (CASP) tool. Publications meeting predefined assessment criteria were selected for data extraction. RESULTS: A total of 275 unique English publications were identified, 38 were selected for quality assessment, and 24 were retained for data extraction. Seventeen publications reported on presenteeism exposures and outcomes, four on financial costing, one on intervention program and two on economic evaluations. Eight (39%) utilized a theoretical framework, where the Job-Demands Resources (JD-R) framework was the most commonly used model. Most assessed work stressors and resources were positively and negatively associated with presenteeism respectively. Contradictory and limited comparability on findings across studies may be attributed to variability of selected scales for measuring both presenteeism and its exposures/outcomes constructs. CONCLUSION: The heterogeneity of published research and limited quality of measurement tools yielded no conclusive evidence on the association of presenteeism with hypothesized exposures, economic costs, or interventions amongst hospital healthcare workers. This review will aid researchers in developing a standardized multi-dimensional presenteeism exposures and productivity instrument to facilitate future cohort studies in search of potential cost-effective work-place intervention targets to reduce healthcare worker presenteeism and maintain a sustainable workforce.

Musculoskeletal pain among surgeons performing minimally invasive surgery: a systematic review.

BACKGROUND: Musculoskeletal pain is the most common occupational disease in Europe. Surgeons with awkward and static working postures are no exception. Robotic-assisted laparoscopy has been postulated to be superior to conventional laparoscopy regarding the ergonomic strain for surgeons. In this review, we aimed to systematically evaluate the existing literature comparing the two surgical modalities. METHODS: A systematic literature search was employed in PubMed, Embase and Cochrane Library in spring 2015. Inclusion criteria were as follows: English language, full text available, original data, and comparative data on surgeons' physical workload with robotic-assisted laparoscopy and conventional laparoscopy. Studies only describing a single surgical modality were excluded. We applied the checklist, STrengthening the Reporting of OBservational studies in Epidemiology (STROBE), to assess the quality of reporting of the included studies. Semi-quantitative comparisons were made. RESULTS: In total, 2685 records were screened and 15 articles were included in the analysis. All studies were observational with sample sizes ranging from one single surgeon to 250 questionnaire responses. None of the studies fully fulfilled the criteria of STROBE, with an average score of 13 (range 10-16) out of 18. DISCUSSION: Results, mainly self-reported measures, suggest that robotic-assisted laparoscopy is less strenuous compared with conventional laparoscopy. However, results are limited by the large methodological heterogeneity and a high risk of bias. We advocate for further high-quality exposure studies to assess the potential ergonomic deficits related to different minimally invasive surgical techniques. In addition, future intervention studies should evaluate possible means to alleviate and prevent musculoskeletal pain among surgeons.

Associations between common diseases and work ability and sick leave among health care workers.

PURPOSE: This study investigates whether common diseases, i.e., musculoskeletal diseases (MSD), cardiovascular diseases (CVD), mental disorders (MD), and respiratory diseases (RD), influence work ability and sick leave and whether lifestyle-related factors, and psychosocial and physical work-related factors are associated with low work ability and sick leave. METHODS: In a cross-sectional study among 8364 Dutch health care employees, self-reported information was acquired concerning common diseases, lifestyle-related factors, psychosocial and physical work-related factors, work ability, and sick leave. Logistic regression analyses were performed to describe the associations between common diseases with low work ability and sick leave, and to evaluate differences in associations between lifestyle-related and work-related factors with low work ability and sick leave among healthy employees and employees with common diseases. RESULTS: Employees with MD (OR 6.35), CVD (OR 2.63), MSD (OR 2.62), and RD (OR 2.11) had a higher risk of low work ability compared to healthy employees. Workers with common diseases also reported more often sick leave (ORs > 1.60), in particular long-term sick leave (>25 days). Multimorbidity increased both the occurrence of low work ability and sick leave. Unfavourable psychosocial work-related factors were associated with low work ability and sick leave regardless of health status. Physical work-related factors and lifestyle factors were less consistently associated with low work ability and sick leave. CONCLUSIONS: Common diseases, and foremost mental disorders, were related to both low work ability and sick leave. To maintain or improve work ability and prevent sick leave, interventions that promote a healthy psychosocial work environment are needed.

Relations between work and upper extremity musculoskeletal problems (UEMSP) and the moderating role of psychosocial work factors on the relation between computer work and UEMSP.

PURPOSE: Computer work has been identified as a risk factor for upper extremity musculoskeletal problems (UEMSP). But few studies have investigated how psychosocial and organizational work factors affect this relation. Nor have gender differences in the relation between UEMSP and these work factors  been studied. We sought to estimate: (1) the association between UEMSP and a range of physical, psychosocial and organizational work exposures, including the duration of computer work, and (2) the moderating effect of psychosocial work exposures on the relation between computer work and UEMSP. METHODS: Using 2007-2008 Québec survey data on 2478 workers, we carried out gender-stratified multivariable logistic regression modeling and two-way interaction analyses. RESULTS: In both genders, odds of UEMSP were higher with exposure to high physical work demands and emotionally demanding work. Additionally among women, UEMSP were associated with duration of occupational computer exposure, sexual harassment, tense situations when dealing with clients, high quantitative demands and lack of prospects for promotion, and among men, with low coworker support, episodes of unemployment, low job security and contradictory work demands. Among women, the effect of computer work on UEMSP was considerably increased in the presence of emotionally demanding work, and may also be moderated by low recognition at work, contradictory work demands, and low supervisor support. CONCLUSIONS: These results suggest that the relations between UEMSP and computer work are moderated by psychosocial work exposures and that the relations between working conditions and UEMSP are somewhat different for each gender, highlighting the complexity of these relations and the importance of considering gender.

Are work demands associated with mental distress? Evidence from women in rural India.

PURPOSE: High work demands might be a determinant of poor mental health among women in low- and middle-income countries, especially in rural settings where women experience greater amounts of labor-intensive unpaid work. Research originating from such settings is lacking. METHODS: We estimated the cross-sectional association between work demands and mental distress among 3177 women living in 160 predominantly tribal communities in southern Rajasthan, India. A structured questionnaire captured the number of minutes women spent on various activities in the last 24 h, and we used this information to measure women's work demands, including the total work amount, nature of work (e.g., housework), and type of work (e.g., cooking). Mental distress was measured with the Hindi version of the 12-item General Health Questionnaire. We used negative binomial regression models to estimate the association between work demands (amount, nature, and type) and mental distress. RESULTS: On average, women spent more than 9.5 h a day on work activities. The most time, intensive work activity was caring for children, the elderly, or disabled (149 min). In adjusted models, we found a U-shaped association between work amount and mental distress. High amounts of housework were associated with higher distress, whereas paid work and farmwork amount were not. Certain types of housework, including collecting water and cleaning, were associated with increased distress scores. CONCLUSIONS: We found an association between aspects of work demands and mental distress. Research in other contexts where women perform high amounts of unpaid work, particularly within the home or farm, is warranted.

Stand up: comparison of two electrical screed levelling machines to reduce the work demands for the knees and low back among floor layers.

Electrical screed levelling machines are developed to reduce kneeling and trunk flexion of sand-cement-bound screed floor layers. An observational intervention study among 10 floor layers was performed to assess the differences between a self-propelled and a manually moved machine. The outcome measures were work demands, production time, perceived load, discomfort and applicability. Compared to the self-propelled machine, the duration of kneeling (∆13 min; p = 0.003) and trunk flexion (∆12 min; p < 0.001) was shorter using the manually moved machine, and the duration of pushing and pulling increased (∆39 min; p < 0.001). No significant or relevant differences were found for production time, perceived load and discomfort. Nine out of ten floor layers found the manually moved machine applicable and three out of ten found the self-propelled machine applicable. When compared with the traditional manner of floor laying, both electrical machines reduced the exposure towards kneeling and trunk flexion. Practitioner Summary: Electrical machines may help to reduce high physical work demands on floor layers. A manually moved machine is better applicable for the installation of screed floors in residences with smaller floor areas. A self-propelled machine is better applicable on large floor areas with a minimum width of 4 m.

Prevalence and perpetrators of workplace violence by nursing unit and the relationship between violence and the perceived work environment.

AIMS: To identify the prevalence and perpetrators of workplace violence against nurses and to examine the relationship of work demands and trust and justice in the workplace with the occurrence of violence. DESIGN: This study employed cross-sectional data from a 2013 nurse survey conducted at a university hospital in Seoul, South Korea. The study sample included 970 female nurses from 47 nursing units, including general, oncology, intensive care units (ICUs), operating rooms, and outpatient departments. METHODS: The second version of the medium-sized Copenhagen Psychosocial Questionnaire (COPSOQ II) was used to measure work demands (i.e., quantitative demands, work pace, and emotional demands), trust and justice, and violence. Relationships among those variables were examined by conducting multiple logistic regression analyses with multilevel modeling. FINDINGS: The 12-month prevalence of verbal abuse (63.8%) was highest, followed by threats of violence (41.6%), physical violence (22.3%), and sexual harassment (19.7%), but bullying had the lowest prevalence (9.7%). Physical violence, threats of violence, and verbal abuse occurred most frequently in ICUs, whereas sexual harassment and bullying were highest in operating rooms. The main perpetrators were patients, followed by physicians and patients' families. Nurses perceiving greater work demands and less trust and justice were more likely to have been exposed to violence. CONCLUSIONS: The prevalence and perpetrators of violence varied considerably among nursing units. Greater work demands and less trust and justice were associated with nurses' experiences of violence. CLINICAL RELEVANCE: Adequate work demands and a trusted and just work environment may reduce violence against nurses. In return, reduction of violence will contribute to creating a better nursing work environment.