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PubMed2003

With health comes work? People living with HIV/AIDS consider returning to work.

Many people living with HIV/AIDS (PHAs) ham experienced significant improvements in their health over the last few years, to the point that many are considering returning to work. The objectives of this study were to develop a model of return to work which could apply to chronic illnesses with a fluctuating or uncertain course. Issues related to health, work and return to work were explored using in-depth interviews with 20 PHAs in Toronto, Canada, who had been on long-term disability for at least five years. Data were analyzed using a grounded theory approach. Contextual factors like the approach of disability and health (drug) insurance plans and intervening conditions like PHAs' current activities influenced their consideration of returning to work and the strategies they employed as a result of considering such a return. More than two-thirds of the sample had undertaken more activities as their health improved. The three study participants who had returned to work either had an opportunity for a low-risk trial of work or could return to their old job. Employers and disability compensation plan administrators, assisted by AIDS service organizations and governments, can facilitate return to work for PHAs by reducing the risks of and removing the barriers to returning to work.

Acquired Immunodeficiency Syndrome↗

PubMed2005

Influence of modified work on return to work for employees on sick leave due to musculoskeletal complaints.

OBJECTIVE: To determine which individual and work-related factors are associated with performing modified work and to evaluate the influence of modified work on the duration of sick leave and health-related outcomes among employees with musculoskeletal complaints. STUDY DESIGN: A prospective study with 12 months follow-up. METHODS: In this prospective study a total of 164 employees on sick leave for 2-6 weeks due to musculoskeletal complaints completed 2 questionnaires. At baseline we gathered information about individual characteristics, physical and psychosocial workload, and disease specific and general health. The follow-up questionnaire, sent to respondents who returned to their original job on full duty, collected information about having performed modified work, and disease-specific and general health. RESULTS: Employees were less likely to perform modified work when their regular work was characterized by frequent lifting and their relationship with colleagues was less than good. Employees were more likely to return to modified work when they had a better mental health, had prolonged periods of standing in their regular job and had less skill discretion. Duration of sick leave was influenced by chronicity of complaints and disability, but not by modified work. CONCLUSION: Modified work, as the only advice given by a occupational health physician, did not influence the total duration of sick leave nor the improvement in health during sick leave for employees on sick leave due to musculoskeletal complaints.

Adult↗

PubMed1992

Graded work exposure to promote work return after severe hand trauma: a replicated study.

Fifty-one patients with posttraumatic stress disorder after work-related hand injuries were placed on a graded work exposure program to facilitate return to work. These patients consisted of an initial group of 25 patients and a replication group of 26 patients. The program returned 92% of the initial group and 88% of the replicated group to work with their previous employers. At 6-month follow-up, 88% of the initial group and 80.1% of the replication group were still working full-time at the jobs to which they had returned. All of the patients not working with their previous employer at follow-up had appraisal/projected flash-backs, which have previously been associated with a 90% failure to return to work. This intervention was successful with 73% of the patients experiencing such flashbacks. In conclusion, graded work exposure was an effective treatment to promote return to work for patients experiencing significant psychological symptomatology after severe hand injury.

Accidents, Occupational↗

PubMedDate not supplied

Time off work and return to work rates after burns: systematic review of the literature and a large two-center series.

The literature on time off work and return to work after burns is incomplete. This study addresses this and includes a systematic literature review and two-center series. The literature was searched from 1966 through October 2000. Two-center data were collected on 363 adults employed outside of the home at injury. Data on employment, general demographics, and burn demographics were collected. The literature search found only 10 manuscripts with objective data, with a mean time off work of 10 weeks and %TBSA as the most important predictor of time off work. The mean time off work for those who returned to work by 24 months was 17 weeks and correlated with %TBSA. The probability of returning to work was reduced by a psychiatric history and extremity burns and was inversely related to %TBSA. In the two-center study, 66% and 90% of survivors had returned to work at 6 and 24 months post-burn. However, in the University of Washington subset of the data, only 37% had returned to the same job with the same employer without accommodations at 24 months, indicating that job disruption is considerable. The impact of burns on work is significant.

Absenteeism↗

PubMed2005

Life after 80 hours: the impact of resident work hours mandates on trauma and emergency experience and work effort for senior residents and faculty.

BACKGROUND: The purpose of this study was to evaluate the impact of work hours mandates on (1) senior resident patient exposure and operating experience in trauma and emergency surgery and (2) faculty work effort. METHODS: We measured resident and faculty work on the trauma and emergency surgery services at our Level I trauma center during two comparable 6-month periods. Period 1 (July 1-December 31, 2002) had no call restrictions, separate trauma and emergency service resident call, and some overlap of faculty call responsibilities. Period 2 (July 1-December 31, 2003) had resident work hours compliance and complete integration of resident and faculty trauma and emergency call. Work hours were measured by surveys for faculty and residents. All data were collected prospectively. RESULTS: Resident exposure to trauma patients was similar during both time periods. Emergency surgery admissions declined during period 2; however, intensive care unit admissions increased. The number of operations performed by senior residents did not change; however, there was a shift in the median number of emergency surgery cases to more senior residents. Faculty work hours increased slightly despite a decrease in faculty call. CONCLUSION: Work hours compliance resulted in a 50% reduction in senior resident call and a 19% decrease in their work hours with no significant change in trauma/emergency patient care exposure or operative case load. Service call amalgamation reduced faculty call by 21% but did not result in a corresponding change in work hours or productivity.

Clinical Competence↗

PubMed2006

Discrepancy of performance among working memory-related tasks in autism spectrum disorders was caused by task characteristics, apart from working memory, which could interfere with task execution.

Working memory performance has been inconsistently reported in autism spectrum disorders (ASD). Several studies in ASD have found normal performance in digit span and poor performance in digit symbol task although these are closely related with working memory. It is assumed that poor performance in digit symbol could be explained by confirmatory behavior, which is induced due to the vague memory representation of number-symbol association. Therefore it was hypothesized that the performance of working memory task, in which vagueness did not cause confirmatory behavior, would be normal in ASD. For this purpose, the Advanced Trail Making Test (ATMT) was used. The performance of digit span, digit symbol and ATMT was compared between ASD and normal control. The digit span, digit symbol and ATMT was given to 16 ASD subjects and 28 IQ-, age- and sex-matched control subjects. The scores of these tasks were compared. A significantly lower score for ASD was found only in digit symbol compared with control subjects. There were no significant difference in digit span and working memory estimated by ATMT. Discrepancy of scores among working memory-related tasks was demonstrated in ASD. Poor digit symbol performance, normal digit span and normal working memory in ATMT implied that ASD subjects would be intact in working memory itself, and that superficial working memory dysfunction might be observed due to confirmatory behavior in digit symbol. Therefore, to evaluate working memory in ASD, tasks that could stimulate psychopathology specific to ASD should be avoided.

Adult↗

PubMed1995

Psychosocial work factors, physical work load and associated musculoskeletal symptoms among home care workers.

This study was based on a questionnaire and included a group of home care workers (HCW) (n = 305) and a reference group of municipal employees (n = 694). The relationship between the work environment and musculoskeletal symptoms was analysed. The HCW were less satisfied with their control over their work and stimulus from their work and had a higher physical work load and prevalence of musculoskeletal symptoms, compared with the reference group. The Rate Ratio (RR) of neck and shoulder symptoms among HCW was 83 and 54%, respectively, higher among those reporting a "high" psychological work load compared with those reporting a "low" load. The highest RR for a single risk indicator was 2.5, and this concerned low-back symptoms among HCW who often worked with twisted postures. A combination of "poor" psychosocial work environment and "high" physical work load produced the highest RR for work-related neck (RR = 2.57) and shoulder (RR = 2.13) symptoms.

Adult↗

PubMed2005

Work-related psychosocial factors, worry about work conditions and health complaints among female and male ambulance personnel.

This study aimed at investigating the relationships between work-related psychosocial factors, worry about work conditions and health complaints (sleeping problems, headache and stomach symptoms) among female and male ambulance personnel. Out of 4000 ambulance personnel in Sweden, 1500 (300 female and 1200 male personnel) were randomly selected. They answered a questionnaire including items on self-reported health complaints, individual characteristics, work-related psychological demands, decision latitude, social support and worry about work conditions. Twenty-five per cent of the female and 20% of the male ambulance personnel reported two or more health complaints sometimes or often. According to the demand-control-support questionnaire, ambulance personnel reported a generally positive psychosocial work environment, although psychological demands were associated with sleeping problems, headache and stomach symptoms among both female and male ambulance personnel. Another factor that was significantly associated with health complaints among both genders was worry about work conditions. When worry about work conditions was added to the regression models, this variable took over the role from psychological demands as a predictor for health complaints among the female ambulance personnel. The prevalence of sleeping problems, headache and stomach symptoms were significantly associated with psychological demands among both female and male ambulance personnel. Notably, worry about work conditions seems to be an important risk factor for health complaints. This suggests that worry about work conditions should not be neglected when considering risk factors among ambulance personnel.

Adult↗

PubMed1995

[A study of preventive medicine in relation to mental health among middle-management employees (Part 2)--effects of long working hours on lifestyles, perceived stress and working-life satisfaction among white-collar middle-management employees].

Recently, we have introduced the holistic method into health care of workers and aimed at improvement of Quality of Life (QOL). It has been made clear that primary prevention of diseases needs lifestyle appraisal. Therefore, we studied the daily working hours and the effects of long working hours on lifestyles, perceived stress and working-life satisfaction, which we used as a subjective index of Quality of Life (QOL), based on data obtained from a survey of 1,026 department chiefs and 2,902 section chiefs in 110 large companies in Japan in 1990. The results are summarized as follows. (1) The percentage of those working 10 hours per day was 41.6% for department chiefs and 40.4% for section chiefs, and for 11 or more working hours it was 24.1% in department chiefs and 30.9% in section chiefs. The younger both department and section chiefs, the longer their working hours. (2) Both department and section chiefs had a significant relationship between long working hours and poor sleeping habits, poor physical exercise, feeling busy, irregularity of daily life and irregularity of daily meals. The department chiefs had a significant relationship between long working hours and unbalanced nutrition or no hobbies. The section chiefs had a significant relationship between long working hours and drinking many cups of tea or coffee, taking a lot of salt or ill physical condition during the past six months.

Female↗

PubMed2003

Determinants of stability and changes in self-reported work disability among older working-age populations.

Data from the Health and Retirement Study, 1992-1994, were used to analyze (1) the prevalence and incidence of self-reported work disability among older working-age populations over a two-year period, and (2) the effect of the stability/changes in physical and functional health conditions, controlling for socioeconomic and occupational characteristics, on the stability/changes in self-reported work ability/disability. Findings show a high rate of transitions into and out of work-disabled status over the two-year period. Findings also show that, although objective physical and functional health problems and low self-ratings of health at wave 1 were significant determinants of self-reported work disability at wave 1, most subsequent changes in objective physical and functional health conditions over the two-year period were not significantly associated with the changes in self-report of work disability between wave 1 and wave 2. Especially, improved health conditions were not significantly associated with regained work ability between the two waves. Of the demographic variables, female gender significantly increased the likelihood of reporting work disability at wave 2, and being Black or Hispanic significantly decreased the likelihood of reporting regained work ability at wave 2. Research and policy implications of the findings are discussed.

Persons with Disabilities↗

PubMedDate not supplied

Towards a longer and better working life: a challenge of work force ageing.

The aim of this overview is to describe the background of work force ageing and its consequences in the society, to introduce concepts for the solutions, to emphasize the actions needed, to point out the new challenges for occupational health, to review the targets of work life improvements, and to highlight the new innovations needed. Work life must be lengthened for the sake of society. Early retirement and low employment rates of 55-64-years old employees make the dependency ratios an increasingly heavy burden. New innovations and concepts like promotion of work ability and age management training have been effective tools for the increase of employment rates and decrease of age discrimination in Finland. The increase of the prevalence and incidence rates of work-related symptoms and diseases during ageing is a serious challenge for occupational health experts. The better adjustments of the working life with the individual health is a crucial element for a longer career. The European working life has not improved markedly for workers over 45 years between 1996 and 2000. Therefore, evidence based concepts should be widely and effectively implemented and new innovations created. A better co-operation between macro-, meso and micro levels is necessary, social partners should create mutual programmes in work places and a new deal is needed between the generations. Life course approach combines the needs and possibilities of different generations. Age management takes into consideration the different strengths of the diverse work force.

Adult↗

PubMed1980

[Analysis of the usefulness of different methods of the evaluation of heart rate during work in work load studies].

The load of the circulatory system during work is usually evaluated basing on the heart beats above the heart rate at rest (i.e. the difference between the heart rate during work and at rest). To differentiate this evaluation according to the subjects' age, the percentage of heart rate reserve (the difference between the maximum heart rate and that at rest), constituted by the heart beats above the heart rate during work and at rest). To differentiate this evaluation according to the subjects' age, the percentage of heart rate reserve (the difference between the kers as well as at the model exercise on cycle ergometer in the group of students and female whitecollar workers has demonstrated that the heart rate before work is often higher than at breaks during the working day, whereas the heart rate during work depends on the output level when work results in a slight tachycardia. It was also found that incusion of the maximum heart rate results in much greater changes in evaluating individual groups--when it is calculated what percentage of this value constitutes heart rate at work, then when calculating the heart rate reserve percentage constituted by the difference between the maximum heart rate and that at rest. Therefore the calculation of the percentage of the maximum heart rate is promoted for evaluating the load of the circulatory system during work.

Analysis of Variance↗

PubMed2003

Work-related beliefs about injury and physical capability for work in individuals with chronic pain.

According to a fear-avoidance model of chronic pain, disability is largely determined by the erroneous belief that an increase in activity level is potentially harmful. Further, recent literature suggests that excessive fears regarding physical activities contribute to significant disability. However, the relation of changes in these fears to functional work capabilities has gone largely uninvestigated. The present study examined how changes in physical capability for work were related to changes in pain severity and fear-avoidance beliefs for general physical and work-specific activities, as well as investigating whether an interdisciplinary treatment program for chronic pain was associated with changes in these specific fears in 65 individuals with chronic pain. Results revealed that significant decreases in fear and pain levels occurred from pre- to post-treatment, in addition to increases in physical capability for work. Further, changes in work-specific fears were more important than changes in pain severity and fear of physical activity in predicting improved physical capability for work. These results expand previous research, which has found a relation between self-reported disability and fear-avoidance beliefs, by demonstrating the relation with fear of work to actual work-related behaviors.

Activities of Daily Living↗

PubMedDate not supplied

Man works from sun to sun, but woman's work is never done: insights on research and policy.

Gender equity and equality in health and human development are key national and international goals. To achieve these goals, the androcentric definition of work needs to be addressed. The current definition is driven by the globalized capitalistic model, which equates "work" with generating income or the production of goods. Indeed, employment in the formal labor force has become the de facto definition of work. Women's work, unpaid and reflecting the gendered role of caring for others, does not fit the economic mold and is, therefore, devalued. The health and social welfare sectors rely heavily on the unremunerated work of women to reduce their budgets, ignoring the unequal burden of care shouldered by women worldwide. Research on women's health has also been hampered by the dichotomous nature of work as employment. Changing the definition of work to value explicitly women's work could significantly impact social, health, and research policies.

Female↗

PubMedDate not supplied

Type A and Type B behaviors, work stressors, and social support at work.

BACKGROUND: How Type A personality is related to the stress process has been investigated. However, in the occupational health field, stressful aspects of the work environment for Type A or B workers have not been fully revealed. METHODS: In the present study, using signal detection analysis, we analyzed data concerning work stressors and social support (SS) at work among Japanese white-collar workers (n = 560) and identified the respective aspects of work that are stressful for Type A and B workers. We also evaluated the interactions of SS at work and stressor variables among Type A and B workers, individually. RESULTS: Except for one significant predictor, i.e., being unable to learn new things at work, the significant predictors of mental stress were generally quite different for Type A and B workers. Specifically, SS from management was a cause of mental stress for certain groups of Type A workers. CONCLUSIONS: It was revealed that the stressful aspects of work environment varied markedly in accord with the Type A vs Type B personality status of the subjects. The results also implied that even support from management can be stressful for Type A workers who had heavy workloads. The present study used specific measures sensitive to individual stressors and identified specific subgroups with the same work stressors. The findings provide information that is useful for stress reduction intervention.

Adult↗

PubMed1994

Every mother is a working mother: breastfeeding and women's work.

Working and breastfeeding can be very complicated because of the kinds of work women are doing; the settings in which they are working; recent changes which have made breastfeeding and work less compatible; trade-offs that working mothers must make; the importance of breastfeeding for the working woman; and the range of feeding options for working mothers. To adequately address these and other issues, several initiatives are needed: (1) additional research on breast pumping and breastmilk storage, and the social and emotional benefits of breastfeeding for working mothers and their infants; (2) protective legislation and strategies for its implementation and monitoring; (3) information and support for breastfeeding mothers and families, policy markers, and the general public; and (4) an alliance between breastfeeding advocates and feminists to promote this intrinsically female issue.

Breast Feeding↗

PubMed1996

Paid work, unpaid work and social support: a study of the health of male and female nurses.

Paid work, unpaid work in the home and social support are important elements of the social production of health and illness, though their combined effects on both women and men have only recently become a focus of research. This paper examines their association with the health problems of nurses, presenting data from a survey of a proportional random sample of 2285 male and female nurses registered in the Province of Ontario. The data are first analysed for the full sample and then multiple regression analyses are run separately for male and female Registered Nurses. The demands of paid work (overload, exposure to hazards), unpaid work (time pressures, caring for a dependent adult) and overall stress in life are associated with greater health problems. There is also evidence of significant links between social support and health. A poor relationship with a supervisor is associated with health problems. On the other hand, enjoying a confiding relationship with a friend and having up to 4 children reduces the likelihood of experiencing health problems. The features of nursing associated with fewer health problems are challenge, statisfaction with work and working under 20 hours a week. Several common themes emerge in the analyses of women and men: overload, hazard exposure, satisfaction with work, having 3-4 children and level of overall stress in life. Yet the models are also very different and point to the need for further analyses of the social production of health problems in relation to gender. They also suggest that female nurses, in particular, may suffer the effects of restructuring in the health care sector. Workload issues are especially important for women. Younger women, those reporting time pressures and caring for a dependent adult are more likely to report health problems. Having a confiding relationship with a friend is associated with fewer health problems for women. Among men, those who dislike housework are more likely to experience health problems. Satisfaction with work and overall stress in life were associated with health problems for both men and women, though there may be gender differences in what generates satisfaction and stress.

Adolescent↗

PubMed1998

Working after the sun goes down: exploring how night blindness impairs women's work activities in rural Nepal.

OBJECTIVE: To explore the influence of night blindness during pregnancy on nighttime work activities of women. DESIGN AND SUBJECTS: A community based case-control study was used to compare nighttime activities of night blind (cases) and non-night blind pregnant women (controls) using a 24h recall method to measure work activities (n=116 pairs). SETTING: Rural South-Eastern district in the plains of Nepal. RESULTS: Approximately one third of the night blind women reported being 'inactive' the previous night, not participating in any of the inquired work activities, as compared with only 15% of the control group (P < 0.031). The type of work that was significantly affected was the outdoor kind such as fetching water and washing dishes. Logistic regression analysis showed that night blind women were half as likely (odds ratio=0.49, 95% confidence interval=0.25-0.98) to work at night than women without night blindness after controlling for the effects of confounding variables including gestational age, season, and protein energy malnutrition which were significantly associated with nighttime work activity. CONCLUSIONS: Night blindness during pregnancy, an indicator of vitamin A deficiency, reduces the number and type of work activities women perform at night, thus impairing women's ability to participate in normal subsistence activities by reducing their 'work day'.

Case-Control Studies↗