An urgent call to address work-related psychosocial hazards and improve worker well-being.

Work-related psychosocial hazards are on the verge of surpassing many other occupational hazards in their contribution to ill-health, injury, disability, direct and indirect costs, and impact on business and national productivity. The risks associated with exposure to psychosocial hazards at work are compounded by the increasing background prevalence of mental health disorders in the working-age population. The extensive and cumulative impacts of these exposures represent an alarming public health problem that merits immediate, increased attention. In this paper, we review the linkage between work-related psychosocial hazards and adverse effects, their economic burden, and interventions to prevent and control these hazards. We identify six crucial societal actions: (1) increase awareness of this critical issue through a comprehensive public campaign; (2) increase etiologic, intervention, and implementation research; (3) initiate or augment surveillance efforts; (4) increase translation of research findings into guidance for employers and workers; (5) increase the number and diversity of professionals skilled in preventing and addressing psychosocial hazards; and (6) develop a national regulatory or consensus standard to prevent and control work-related psychosocial hazards.

Measuring the benefits of occupational safety and health research with economic metrics: Insights from the National Institute for Occupational Safety and Health.

Measuring the ultimate impact of research on health and economic well-being has presented challenges that have rarely been surmounted, and research on preventing occupational injuries and illnesses is no exception. Nevertheless, there is an increasing need to demonstrate the value of publicly funded research. The National Institute for Occupational Safety and Health (NIOSH) recently contracted with the RAND Corporation to conduct six in-depth case studies that aimed to quantify the benefits of key NIOSH research efforts using economic metrics. These case studies focused on silica exposure in asphalt pavement milling, firefighter cancer risks, a multi-industry matching-grant program for purchase of safety equipment, personal coal dust monitors for coal miners, re-design of ambulance patient compartments for safety, and workplace amputation surveillance. In this article, we summarize what we learned about how measurement of research benefits may be pursued. We summarize the benefit measurement methods that were used and the results of these research efforts in terms of costs saved, injuries and illnesses prevented, and the statistical value of reductions in risk of death or illness. We then distill some observations about the characteristics of research efforts that make measurement of research benefits feasible and suggest steps that could make it feasible to apply the same methods more widely. We also outline key NIOSH activities that appear not to be amenable to benefit measurement but suggest potentials for progress toward at least partial or qualitative benefit assessment. Finally, we discuss implications of the benefit measurement case studies for strategic research planning.

Precarious work, job stress, and health-related quality of life.

OBJECTIVES: Recent technological and work organization changes have resulted in an increased prevalence of nonstandard work arrangement types. One of the consequences has been an increased prevalence of precarious work. Our objective was to generate a scale to measure work precariousness in the United States and examine the associations between this study precariousness scale with job stress, unhealthy days, and days with activity limitations among US workers from 2002 to 2014, to determine if precarious work adversely affects worker health. METHODS: Our scale was inspired by the Employment Precariousness Scale that measures work precariousness reported by salaried workers and developed for the US workforce. We used pooled cross-sectional data from 22 representative items from the General Social Survey, Quality of Work Life survey for the years 2002, 2006, 2010, and 2014. These data included 4534 observations for analysis. We used regression models to examine associations between work precariousness and job stress, unhealthy days, and days with activity limitations. RESULTS: Statistically significant positive association existed between job stress and work precariousness. Workers reporting work precariousness were more likely to experience more days in poor physical and mental health and more days with activity limitations due to health problems. CONCLUSIONS: The results of our study provide support for our precariousness scale and its suitability for assessing the health-related quality of life of workers in different work arrangements.

Envisioning the future of work to safeguard the safety, health, and well-being of the workforce: A perspective from the CDC's National Institute for Occupational Safety and Health.

The future of work embodies changes to the workplace, work, and workforce, which require additional occupational safety and health (OSH) stakeholder attention. Examples include workplace developments in organizational design, technological job displacement, and work arrangements; work advances in artificial intelligence, robotics, and technologies; and workforce changes in demographics, economic security, and skills. This paper presents the Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health's Future of Work Initiative; suggests an integrated approach to address worker safety, health, and well-being; introduces priority topics and subtopics that confer a framework for upcoming future of work research directions and resultant practical applications; and discusses preliminary next steps. All future of work issues impact one another. Future of work transformations are contingent upon each of the standalone factors discussed in this paper and their combined effects. Occupational safety and health stakeholders are becoming more aware of the significance and necessity of these factors for the workplace, work, and workforce to flourish, merely survive, or disappear altogether as the future evolves. The future of work offers numerous opportunities, while also presenting critical but not clearly understood difficulties, exposures, and hazards. It is the responsibility of OSH researchers and other partners to understand the implications of future of work scenarios to translate effective interventions into practice for employers safeguarding the safety, health, and well-being of their workers.

Prevalence and risk factors of soil-transmitted helminth infections in school age children (6-14 years) - A cross-sectional study in an urban resettlement colony of Delhi.

BACKGROUND: Soil-transmitted helminth (STH) infections have adverse physical and mental effect, especially in preschool (3-6 years) and school-age children (6-14 years). They are associated with socio-behavioral factors of poverty and poor personal and community hygiene. OBJECTIVES: To determine the prevalence, intensity, and the type of helminths infection harbored by the school age children (6-14 years) and to examine the relationship between STH infection and their potential risk factors and associated variables. METHODS: This cross-sectional study was conducted from January to December 2016 among 250 school age children residing in an urban resettlement colony of East Delhi. Data were collected using a semistructured interview schedule. Stool sample was tested using the Kato Katz technique. Data were analyzed in SPSS software version 16, and multivariable regression analysis was done to calculate the odds of various risk factors. RESULTS: The prevalence of STH was found to be 54.8%, and majority (85.3%) of Ascaris and all Trichuris infections were of light intensity. Multivariable logistic regression analysis confirmed that children having poor handwashing behavior in school, irregular handwashing before eating, having pica, and lack of de-worming had higher odds of having STH infection. CONCLUSION: The prevalence of STH in the study area is substantially high, and the findings suggest that besides mass de-worming strategy, behavior change, and improvement in hygiene are required to control STH.

Determinants of Expenditure on Diabetes Care: A Community Based Longitudinal Study in aResettlement Colony of Delhi.

INTRODUCTION: Diabetes is one of the expensive diseases due to its chronic nature and gradual involvement of multiple organs, Moreover loss of economic productivity further enhances the cost of care. Several factors were reported to have impact on overall economic burden in diabetic patients. So, the present study aims to determine influence of various socio-demographic and clinical factors on expenditure of diabetes care among patients residing in resettlement colony of East Delhi. METHODOLOGY: A community based one year longitudinal study was conducted in Kalyanpuri area of East Delhi. All the diabetes patients aged 25 years and who were the permanent residents of Kalyanpuri, attending the Diabetic Clinic of a government hospital in November-December 2014 were selected for the study. A pre-tested semi-structured interview schedule was used as study tool. Each subject was followed up 3 monthly from January to December 2015. RESULTS: Data of 150 study subjects was analyzed. Out of 150 subjects 45(30 %) were male and 105 (70%) female. Overall mean age of study subjects was 53 ± 10 years Among socio-demographic factors, Expenditure on diabetes care showed significant association with male gender and among clinical factors, longer duration since diagnosis, use of Insulin with Oral Hypoglycemic drugs, hospitalization and utilization of private care has shown positive association with expenditure on diabetes care. CONCLUSION: The present study concludes that there is need of better provisioning of services for diabetes care in government health facilities to cater needs of growing diabetic population..

Workplace mistreatment and sickness absenteeism from work: results from the 2010 National Health Interview survey.

OBJECTIVE: This study examined the association between workplace mistreatment and occurrence, duration, and costs of sickness absenteeism. METHODS: We used the 2010 National Health Interview Survey and considered 13,807 employed adult respondents. We used a zero-inflated negative binomial (zinb) model to examine the association between exposure to workplace mistreatment and the occurrence and number of workdays missed due to illness/injury in the preceding 12 months. RESULTS: In 2010, 7.6% of US workers employed at the time of the survey reported having been mistreated at their workplace. Both occurrence and duration of sickness absence were higher for mistreated than for non-mistreated workers. The zinb results showed that being mistreated was associated with a 42% increase in the number of missed workdays, controlling for covariates. The marginal effect analysis showed that lost workdays differed by 2.45 days between mistreated and non-mistreated workers. This implies that workplace mistreatment was associated with $4.1 billion, or 5.5%, of sickness absenteeism costs in 2010. CONCLUSIONS: Workplace mistreatment is associated with sickness absence in the United States. While a causal relationship could not be established due to the cross-sectional design of the study, this study reveals the economic importance of developing workplace mistreatment prevention strategies.

Possible health benefits from reducing occupational magnetic fields.

BACKGROUND: Magnetic fields (MF) from AC electricity are a Possible Human Carcinogen, based on limited epidemiologic evidence from exposures far below occupational health limits. METHODS: To help formulate government guidance on occupational MF, the cancer cases prevented and the monetary benefits accruing to society by reducing workplace exposures were determined. Life-table methods produced Disability Adjusted Life Years, which were converted to monetary values. RESULTS: Adjusted for probabilities of causality, the expected increase in a worker's disability-free life are 0.04 year (2 weeks) from a 1 microtesla (µT) MF reduction in average worklife exposure, which is equivalent to $5,100/worker/µT in year 2010 U.S. dollars (95% confidence interval $1,000-$9,000/worker/µT). Where nine electrosteel workers had 13.8 µT exposures, for example, moving them to ambient MFs would provide $600,000 in benefits to society (uncertainty interval $0-$1,000,000). CONCLUSIONS: When combined with the costs of controls, this analysis provides guidance for precautionary recommendations for managing occupational MF exposures.

Work related well-being is associated with individual subjective well-being.

This study utilizes Gallup-ShareCare Well-being Index data to investigate the association between work-related well-being, i.e., job satisfaction, and overall subjective well-being among US workers. Subjective well-being is measured by i) daily positive and negative emotional experiences - happiness, smiles, enjoyment, sadness, anger, worry, and stress (hedonic well-being); and ii) current and future life evaluation (evaluative well-being). The study finds significant positive relationships between job satisfaction and subjective well-being both in terms of higher odds of positive hedonic experiences and increased life evaluation scores after controlling for covariates and other nonwork-related contributors to well-being. Job satisfaction accounted for a 14% increase in current and an 8% increase in future life evaluation scores. The results emphasize that not only the income generated by work but the quality of work is also important for worker well-being. In fact, those without a job had higher well-being than those workers who are dissatisfied at work. This is probably the first study that relates work-related well-being to overall well-being, using a nationally representative sample of US workers. Further, this is one of the few instances where the subjective measure of well-being is used in the occupational safety and health literature.

Hospitalizations for COVID-19 Among US People Experiencing Incarceration or Homelessness.

Importance: People experiencing incarceration (PEI) and people experiencing homelessness (PEH) have an increased risk of COVID-19 exposure from congregate living, but data on their hospitalization course compared with that of the general population are limited. Objective: To compare COVID-19 hospitalizations for PEI and PEH with hospitalizations among the general population. Design, Setting, and Participants: This cross-sectional analysis used data from the Premier Healthcare Database on 3415 PEI and 9434 PEH who were evaluated in the emergency department or were hospitalized in more than 800 US hospitals for COVID-19 from April 1, 2020, to June 30, 2021. Exposures: Incarceration or homelessness. Main Outcomes and Measures: Hospitalization proportions were calculated. and outcomes (intensive care unit admission, invasive mechanical ventilation [IMV], mortality, length of stay, and readmissions) among PEI and PEH were compared with outcomes for all patients with COVID-19 (not PEI or PEH). Multivariable regression was used to adjust for potential confounders. Results: In total, 3415 PEI (2952 men [86.4%]; mean [SD] age, 50.8 [15.7] years) and 9434 PEH (6776 men [71.8%]; mean [SD] age, 50.1 [14.5] years) were evaluated in the emergency department for COVID-19 and were hospitalized more often (2170 of 3415 [63.5%] PEI; 6088 of 9434 [64.5%] PEH) than the general population (624 470 of 1 257 250 [49.7%]) (P < .001). Both PEI and PEH hospitalized for COVID-19 were more likely to be younger, male, and non-Hispanic Black than the general population. Hospitalized PEI had a higher frequency of IMV (410 [18.9%]; adjusted risk ratio [aRR], 1.16; 95% CI, 1.04-1.30) and mortality (308 [14.2%]; aRR, 1.28; 95% CI, 1.11-1.47) than the general population (IMV, 88 897 [14.2%]; mortality, 84 725 [13.6%]). Hospitalized PEH had a lower frequency of IMV (606 [10.0%]; aRR, 0.64; 95% CI, 0.58-0.70) and mortality (330 [5.4%]; aRR, 0.53; 95% CI, 0.47-0.59) than the general population. Both PEI and PEH had longer mean (SD) lengths of stay (PEI, 9 [10] days; PEH, 11 [26] days) and a higher frequency of readmission (PEI, 128 [5.9%]; PEH, 519 [8.5%]) than the general population (mean [SD] length of stay, 8 [10] days; readmission, 28 493 [4.6%]). Conclusions and Relevance: In this cross-sectional study, a higher frequency of COVID-19 hospitalizations for PEI and PEH underscored the importance of adhering to recommended prevention measures. Expanding medical respite may reduce hospitalizations in these disproportionately affected populations.

Work Flexibility and Work-Related Well-Being.

Work organization practices, including work flexibility, are changing and can affect worker well-being. Common work flexibility types include working at home, taking time off when needed, and changing one's work schedule. Given the changes in and the importance of work flexibility, the study assesses its prevalence and association with worker well-being in the United States. We used 2002-2018 General Social Survey-Quality of Worklife (GSS-QWL) data, descriptive statistics, and regression analyses to assess the reported likelihood of job stress, job satisfaction, healthy days, and days with activity limitations among workers reporting work flexibility. The prevalence of work flexibility remained relatively stable during the period examined. Working at home increased the likelihood of job stress by 22% and job satisfaction by 65%. Taking time off decreased the likelihood of job stress by 56% and days with activity limitations by 24%, and more than doubled the likelihood of job satisfaction. Changing one's schedule decreased the likelihood of job stress by 20% and increased the likelihood of job satisfaction by 62%. This study used all the available data from GSS-QWL and demonstrated the ongoing importance of work flexibility for well-being.

Association between Risk Factors of Common Noncommunicable Diseases (Diabetes, Hypertension, and Cardiovascular Diseases) and SocioDemographic Factors in Young Adult Women.

INTRODUCTION: During the past 50 years, there is a substantial rise in noncommunicable diseases (NCDs) mortality in developing countries. India is also undergoing demographic transitions. Lifestyle which increases the risk of NCDs in younger age group will lead to increase in NCDs burden further in future generation. OBJECTIVES: The objective of this study is to determine the association between risk factors of common NCDs and sociodemographic factors in young adult women of Palam Village, New Delhi. SETTINGS AND DESIGN: A community-based cross-sectional study was conducted in Palam Village, New Delhi. MATERIALS AND METHODS: A total of 585 study participants were interviewed using a predesigned, semi-structured questionnaire. Waist circumference, blood pressure (BP), and weight were measured using nonstretchable measuring tape, digital BP apparatus, and digital weighing scale, respectively. Qualitative data are expressed in proportions and Chi-square test is applied. Mean and standard deviation are used for quantitative data. RESULTS: As the socioeconomic status improved, the frequency of consuming adequate amount of fruits and vegetables in a day also increased. This association was statistically significant (P < 0.05). CONCLUSION: The present study reported varied prevalence of different risk factors with various sociodemographic characteristics and there is an urgent need to implement population, individual, and program wide prevention and control interventions.

Relationship of work injury severity to family member hospitalization.

BACKGROUND: Working while under stress due to a family health event may result in injuries of greater severity. Work leave might mitigate such consequences. DATA AND METHODS: Workers' compensation data for 33,817 injured workers and inpatient medical data for 76,077 members of their families were extracted from the 2002-2005 Thomson Reuters Medstat MarketScan Health and Productivity Management (HPM) and Commercial Claims and Encounter (CCE) datasets. Using a probit model, the impact of family hospitalization on the probability that a subsequent injury would be severe (above average indemnity costs) was estimated, adjusting for age, sex, hourly versus salaried status, industry sector, state, and family size. RESULTS: Family hospitalization within 15 days before injury increased the likelihood that the injury would be severe (from 12.5% to 21.5%) and was associated with 40% higher indemnity costs and 50% higher medical costs. Hospitalizations over 30 days before injury had no impact. CONCLUSION: The observed higher severity of work injuries following family hospitalizations suggests additional analyses may find higher injury rates as well, and that timely family leaves might help prevent severe workplace injuries.

Employment arrangement, job stress, and health-related quality of life.

OBJECTIVE: We aimed to understand the characteristics of U.S. workers in non-standard employment arrangements, and to assess associations between job stress and Health-related Quality of Life (HRQL) by employment arrangement. BACKGROUND: As employers struggle to stay in business under increasing economic pressures, they may rely more on non-standard employment arrangements, thereby increasing the pool of contingent workers. Worker exposure to job stress may vary by employment arrangement. Excessive exposure to stressors at work is considered to be a potential health hazard, and may adversely affect health and HRQL. METHODS: We used the Quality of Worklife (QWL) module which supplemented the General Social Survey (GSS) in 2002, 2006, 2010, and 2014. GSS is a biannual, nationally representative cross-sectional survey of U.S. households that yields a representative sample of the civilian, non-institutionalized, English-speaking, U.S. adult population. The QWL module assesses an array of psychosocial working conditions and quality of work life topics among GSS respondents. We used pooled QWL responses from 2002 to 2014 by only those who reported being employed at the time of the survey. After adjusting for sampling probabilities, including subsampling for non-respondents and correcting for the number of adults in the household, 6005 respondents were included in our analyses. We grouped respondents according to their employment arrangement, including: (i) independent contractors (contractor), (ii) on call workers (on call), (iii) workers paid by a temporary agency (temporary), (iv) workers who work for a contractor (under contract), or (v) workers in standard employment arrangements (standard). Respondents were further grouped into those who were stressed and those who were not stressed at work. Descriptive population prevalence rates were calculated by employment arrangement for select demographic and organizational characteristics, psychosocial working conditions, work-family balance, and health and well-being outcomes. We also assessed the effect of employment arrangement on job stress, and whether job stress was associated with the number of reported unhealthy days and days with activity limitations. These two health and well-being outcomes capture aspects of worker HRQL. RESULTS: Our results underscored the importance of employment arrangement in understanding job stress and associated worker health and well-being outcomes. Between 2002 and 2014, the prevalence of workers in non-standard employment arrangements increased from 19% to 21%; however, the observed trend did not monotonically increase during that period. Compared with workers in standard arrangements, independent contractors and on call workers were significantly less likely to report experiencing job stress. For workers in standard arrangements and for contractors, we observed significant association between perceived job stress and reported unhealthy days. We observed a similar association for reported days with activity limitations, for workers in standard and temporary arrangements. CONCLUSION: The major contribution of our study was to highlight the differences in job stress and HRQL by employment arrangement. Our results demonstrated the importance of studying each of these employment arrangements separately and in depth. Furthermore, employment arrangement was an important predictor of job stress, and compared with non-stressed workers, stressed workers across all employment arrangements reported more unhealthy days and more days with activity limitations.

Evaluation of a Workplace Exercise Program for Control of Shoulder Disorders in Overhead Assembly Work.

OBJECTIVE: The aim of this study was to assess effects of exercise on shoulder musculoskeletal symptoms among employees with overhead assembly work exposures. METHODS: A voluntary workplace shoulder exercise program was offered to employees in two automotive assembly departments, while two similar departments served as controls. N = 76 total workers participated. Shoulder Rating Questionnaire (SRQ) and Discomfort of the Arm Shoulder and Hand (DASH) symptoms were queried monthly for 7 baseline months, followed by 6 months that included exercise. RESULTS: SRQ scores were higher for exercisers than among controls in the 6 exercising months, but not in the baseline months. Although the group x month interaction was significant (P < 0.05), the temporal trend was inconsistent. CONCLUSIONS: Exercise may have temporarily lessened decline in SRQ. It is not clear whether shorter term differences were clinically meaningful or predictive of longer term disability prevention.

Synthesis and recommendations of the economic evaluation of OHS interventions at the company level conference.

PROBLEM: In today's economic environment, enterprises may not be able to fund every new project aimed at promoting health and safety in the workplace. Company level economic evaluation of interventions can provide guidance in sound business decision-making. The Economic Evaluation of Occupational Health and Safety Interventions at the Company Level Meeting brought together members of the global occupational safety and health community interested in encouraging the use of economic knowledge and tools to evaluate economic gains from occupational health and safety interventions. DISCUSSION: Discussions of the six models presented explored similarities, reliability, and potential use by corporate enterprises, small and medium enterprises, developing and transitioning nations, and economic theorists. Each group provided specific projects that could be pursued to advance knowledge in the area of economic evaluation at the company level. CONCLUSION: This conference established pathway to incorporate economic evaluation of health and safety interventions or programs at the workplace.

Job satisfaction, common cold, and sickness absence among white-collar employees: a cross-sectional survey.

The purpose of this study is to examine the independent association of job satisfaction with common cold and sickness absence among Japanese workers. A total of 307 apparently healthy white-collar employees (165 men and 142 women), aged 22-69 (mean 36) yr, completed a questionnaire survey during April to June, 2002. Global job satisfaction was measured by a 4-item scale from the Japanese version of a generic job stress questionnaire with higher scores indicating greater satisfaction. Information about whether the employees had a common cold (within the past 6 months) and sickness absence (within the past 12 months) was self-reported. Hierarchical log-linear Poisson regression analysis controlling for confounders revealed that greater job satisfaction was inversely correlated with days (B = -0.116; p<0.001) and times (B = -0.058; p = 0.067) of common cold and days (B = -0.160; p<0.001) and times (B = -0.141; p<0.001) of sickness absence. Our findings suggested that poor job satisfaction is associated with both common cold and sickness absence.

Persons with major psychiatric illness in prisons--a three years study.

A research project entitled 'operation oasis' was implemented in West Bengal prisons by SEVAC, supported by the National Human Rights Commission of India for identification of the persons suffering from major psychiatric illnesses (ie, schizophrenia, psychosis not otherwise specified, mood disorder not otherwise specified) in prisons, making arrangements for their psychiatric treatment and rehabilitation and assessing the changes in them after intervention. Dum Dum Central Jail, Presidency Jail (female section), and Berhampore Central Jail were selected as the project fields. The prison inmates were screened through clinical examination and mental state examination. Among them who were found suffering from mental illness were brought under psychiatric and psychological treatment, rehabilitation and restoration. Their sociodemographical data were also collected on the basis of a structured information schedule developed by the SEVAC team. The patients were followed-up for three consecutive years (2001 to 2004). The global assessment of functioning scores of the patients recorded at the time of initiation and completion of project were compared. During the project implementation period, 3871 prison inmates (male 3527 + female 344) were screened and 10% (n = 401) were identified as suffering from major psychiatric illnesses, of which 64% (n = 258) were housed in the prisons for minor offences/stray cases and 90% (n = 363) were undertrials. The findings concluded with a global assessment of functioning score improvement with a statistical significance of p < 0.01 level (Z = 5.06) for the patients. This study shows that a qualitative change took place in the life situations of the mentally ill people who were brought under the purview of psychiatric treatment and rehabilitation.