Work-related sickness absences and mandatory occupational health surveillance
October 8, 2008 on 9:00 am | In Uncategorized | Comments OffBackground To prevent work-related ill-health, selection of workers for mandatory occupational health surveillance should be based on the actual risk of work-related disease.
Aims (i) To determine the proportion of sick-listed workers with self-reported work-related health problems not under mandatory occupational health surveillance. (ii) To determine whether self-reported work-related sickness absences occur more frequently among workers under mandatory occupational health surveillance or among workers not under mandatory surveillance.
Methods Questionnaire-based descriptive study. The setting was the work inability assessment consultation of social insurance physicians in Belgium. Patients’ inclusion criteria were employee, age 18–50 and 1–12 months of sickness absence. Workers with pregnancy-related sicknesses were excluded. We cross-tabulated the questionnaire results, noting (i) the workers’ perception of the work relatedness of their sickness absence and (ii) workers’ knowledge of the occupational physician, which was assumed to reflect workers who had undergone mandatory occupational health surveillance.
Results There were 1564 participants. Thirty-seven per cent of workers with self-reported work-related sickness absences were not under mandatory occupational health surveillance. Work-related sickness absences occurred as frequently among workers under mandatory occupational surveillance as among those not under mandatory occupational health surveillance (34 and 35%, respectively; P = 0.80).
Conclusion To prevent work-related illnesses and sickness absences, a revision of the mandatory occupational health surveillance system is indicated.
Flexible work arrangements and work-family conflict after childbirth
October 8, 2008 on 9:00 am | In Uncategorized | Comments OffBackground Previous research has revealed that work–family conflict negatively influences women’s health following childbirth.
Aim To examine if flexible work arrangements were associated with work–family conflict among women, 1 year after childbirth.
Methods Employed women, aged ≥18, were recruited while hospitalized for childbirth. Flexible work arrangements were measured at 6 months and work–family conflict was measured at 12 months. General linear models estimated the association between flexible work arrangements and work–family conflict.
Results Of 1157 eligible participants, 522 were included in this analysis giving a 45% response rate. Compared to women who reported that taking time off was very hard, those who reported it was not too hard (β = –0.80, SE = 0.36, P < 0.05) and not at all hard (β = –1.08, SE = 0.35, P < 0.01) had lower average job spillover scores. There was no association between taking time off and home spillover. The ability to change hours was associated with greater home spillover (β = 0.46, SE = 0.18, P < 0.05) but not with job spillover. The ability to take work home was associated with increased home spillover (β = 0.35, SE = 0.14, P < 0.05) but not with job spillover.
Conclusions The ability to change work hours and the ability to take work home were associated with increased home spillover to work. The ability to take time off was associated with decreased job spillover to home. Additional research is needed to examine the intentional and unintentional consequences of flexible work arrangements.
Work ability in sick-listed patients with major depressive disorder
October 8, 2008 on 9:00 am | In Uncategorized | Comments OffBackground Major depressive disorder (MDD) is often a chronic relapsing disease resulting in work disability. For evaluation purposes a practical set of aspects of work ability would be helpful.
Aim To identify the most important disease-specific aspects of work ability for sick-listed employees with MDD.
Methods An expert brainstorming session identified the specific abilities that were thought to be associated with work ability in sick-listed employees with MDD and that could also be associated with the items of the Hamilton Rating scale for Depression. Sixty-four insurance physicians (IPs) were then selected to participate in a two-round Delphi study. The aim of the first Delphi round was to identify the abilities that were thought to be important by at least 80% of the IPs. In the second Delphi round, the abilities ranked in the top 10 by at least 55% of the IPs were identified as being the most important items.
Results Sixty-one IPs participated in the two Delphi rounds. The most important abilities to be evaluated in work ability evaluation for sick-listed employees with MDD were to take notice, to sustain attention, to focus attention, to complete operations, to think in a goal-directed manner, to remember, to perform routine operations, to undertake structured work activities, to recall and to perform autonomously.
Conclusion According to 55% of the IPs, there were 10 important aspects of work ability that have to be considered in a work ability evaluation of sick-listed employees with MDD.
Does exercise cause asthma?
October 8, 2008 on 9:00 am | In Uncategorized | Comments OffBackground The Israel Defence Forces needed to define the correlation between physical activity and asthma.
Aim To determine whether combat unit (CU) soldiers are more susceptible to exercise-induced asthma (EIA) than other military units.
Methods A follow-up study of recruits with normal clinical and pulmonary function tests over a period of 30 months after having been assigned to CU, maintenance units (MU) or clerical tasks (CT). The participants chosen had already been subjected to additional tests 6 weeks after induction to eliminate any cases of active asthma.
Results Out of 799 subjects, 125 developed asthma during the follow-up. Twenty-one per cent of those in the CU developed asthma against 15% in the MU and 5% in the CT. The relative risks for newly diagnosed asthma were 3.7 for CU/CT (P < 0.001), 2.7 for MU/CT (P < 0.001) and 1.4 for CU/MU (P < 0.05). EIA was observed as the only manifestation of asthma in 32% of the soldiers posted in CU compared to 13 and 11% in MU and CT, respectively.
Conclusion The increased risk of EIA in CU compared to MU and CT may indicate that any one or all the factors associated with CU service conditions could contribute to this increased risk of uncovering the mild cases of asthma, especially EIA, that had been overlooked up to the time of induction into the army.
Do occupational health assessments match guidelines for low back pain?
October 8, 2008 on 9:00 am | In Uncategorized | Comments OffBackground Audit is an important facet of clinical governance and good occupational health practice. There are well-established clinical guidelines for the management of low back pain. Occupational Health Guidelines for the Management of Low Back Pain at Work were launched by the Faculty of Occupational Medicine in March 2000, based on an extensive, systematic review of the scientific literature predominantly from occupational settings or concerning occupational outcomes.
Aim To determine whether documented National Health Service occupational health assessment of low back pain in the North West region of England conforms to the published guidelines.
Methods A retrospective audit of case notes was conducted. Six performance indicators were derived from the Occupational Health Guidelines for the Management of Low Back Pain at Work in order to evaluate the performance by occupational physicians. Two hundred and seventy-seven case notes were identified from eight different occupational health departments.
Results Low rates of compliance with national standards were observed for recording of some performance indicators, notably for the assessment and documentation of ‘red’ and ‘yellow flags’. Our findings suggest that the quality of documentation of key information in the notes leaves significant room for improvement.
Conclusions For future audits, we recommend having two external auditors and seek to demonstrate a high degree of agreement between observers by conducting a reproducibility exercise. Future Faculty guidelines should emphasize documentation of the assessment and perhaps consider assessment tools to improve documentation.
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