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PubMed1997

The changing workforce, job stress, and psychological distress.

The change in the United States from a manufacturing economy to a service economy has important implications for theoretical models of the relationships between job characteristics and workers' psychological distress. A sample of 600 men and women employed full-time were recruited to test 2 theoretical models. The job demand-control model posits that jobs that are both high in job demands and low in decision latitude are associated with greater psychological distress. The job demand-service model posits that jobs that are high in job demands and low in service to others are associated with greater psychological distress. Results show that the job demand-control model is a significant predictor of psychological distress among employees in the manufacturing industry, whereas the job demand-service model is a significant predictor of psychological distress among employees in the services industries.

Adult↗
PubMed1998

Cancer mortality in relation to monitoring for radionuclide exposure in three UK nuclear industry workforces.

Cancer mortality in 40,761 employees of three UK nuclear industry facilities who had been monitored for external radiation exposure was examined according to whether they had also been monitored for possible internal exposure to tritium, plutonium or other radionuclides (uranium, polonium, actinium or other unspecified). Death rates from cancer were compared both with national rates and with rates in radiation workers not monitored for exposure to any radionuclides. Among workers monitored for tritium exposure, overall cancer mortality was significantly below national rates [standardized mortality ratio (SMR) = 83, 165 deaths; 2P = 0.02] and none of the cancer-specific death rates was significantly above either the national average or rates in non-monitored workers. Although the overall death rate from cancer in workers monitored for plutonium exposure was also significantly low relative to national rates (SMR = 89, 581 deaths; 2P = 0.005), mortality from pleural cancer was significantly raised (SMR = 357, nine deaths; 2P = 0.002); none of the rates differed significantly from those of non-monitored workers. Workers monitored for radionuclides other than tritium or plutonium also had a death rate from all cancers combined that was below the national average (SMR = 86, 418 deaths; 2P = 0.002) but prostatic cancer mortality was raised both in relation to death rates in the general population (SMR = 153, 37 deaths; 2P = 0.02) and to death rates in radiation workers who had not been monitored for exposure to any radionuclide [rate ratio (RR) = 1.65; 2P = 0.03]. Mortality from cancer of the lung was also significantly increased in workers monitored for other radionuclides compared with those of radiation workers not monitored for exposure to radionuclides (RR = 1.31, 164 deaths; 2P = 0.01). For cancers of the lung, prostate and all cancers combined, death rates in monitored workers were examined according to the timing and duration of monitoring for radionuclide exposure, with rates of radiation workers not monitored for any radionuclide forming the comparison group. In tritium-monitored workers, RRs for prostatic cancer varied significantly according to the number of years in which they were monitored (2P = 0.03). In workers monitored for plutonium exposure, RRs for all cancers combined increased with the number of years in which they were monitored (2P = 0.04) and with the number of years since first monitoring (2P = 0.0003). There was little suggestion of systematic variation in RRs for workers monitored for other radionuclides in relation to the timing or duration of monitoring, nor did it appear that their raised rates of cancer of the lung and prostate were explained by external radiation dose. These analyses of cancer mortality in relation to monitoring for radionuclide exposure reported in a large cohort of nuclear industry workers suggest that certain patterns of monitoring for some radionuclides may be associated with higher death rates from cancers of the lung, pleura, prostate and all cancers combined. Some of these findings may be due to chance. Moreover, because of the paucity of related data and lack of information about other possible exposures, such as whether plutonium workers are more likely to be exposed to asbestos, firm conclusions cannot be drawn at this stage. Further investigations of the relationship between radionuclide exposure and cancer in nuclear industry workers are needed.

Adolescent↗
PubMed2004

Obesity, body fat distribution and incidence of sick leave in the Belgian workforce: the Belstress study.

OBJECTIVES: In many studies, obesity has been associated with morbidity or mortality, but only a few have studied the relation between obesity and sick leave. Our aim is to analyse the independent effects of both adiposity and body fat distribution in relation to the 1-y incidence of sick leave in a large cohort of male and female workers covering a variety of occupations, taking into account a wide range of socio-demographic, behavioural and bioclinical variables. DESIGN AND SETTING: The baseline survey of the Belstress study was conducted in 25 companies across Belgium between 1994 and 1998. A cohort of 20 463 workers (15 557 males and 4906 females) aged 35-59 y was followed for absenteeism during 1 y. The 75th percentile of the distribution of the total annual sickness days was used as a cutoff to classify the workers with a high 1-y incidence rate of sick leave. The relation between sick leave and both obesity and body fat distribution assessed by the body mass index (BMI) and the waist circumference, respectively, was analysed by multivariate logistic regression models. RESULTS: Using a backward procedure based on the likelihood ratio, we found central abdominal fatness to be an independent predictor of sick leave in both genders (high sick-leave incidence and long spells), but not BMI. In men, the odds ratios was 1.31 (99% CI 1.12-1.52, P<0.0001) and in women it ranged from 1.32 (99% CI 1.03-1.70, P=0.005) to 1.47 (99% CI 1.14-1.90, P<0.0001). Two baseline covariables, respiratory problems and perceived health, are confounders or mediators. CONCLUSIONS: In this study, body fat distribution was associated with a high annual sick-leave incidence and long spells of sickness absence. If this link is reversible, employers may benefit from programs aiming at the prevention and treatment of central obesity.

Adipose Tissue↗
PubMed2001

The globalisation of the nursing workforce: barriers confronting overseas qualified nurses in Australia.

Recent decades have coincided with the rapid globalisation of the nursing profession. Within Australia there has been rising dependence on overseas qualified nurses (OQNs) to compensate for chronic nurse shortages related to the continued exodus of Australian nurses overseas and to emerging opportunities in other professions. Between 1983/4 and 1994/5, 30 544 OQNs entered Australia on either a permanent or temporary basis, counter-balancing the departure overseas of 23 613 locally trained and 6519 migrant nurses (producing a net gain of just 412 nurses in all). The period 1995/6--1999/2000 saw an additional 11 757 permanent or long-term OQN arrivals, with nursing currently ranked third target profession in Australia's skill migration program, in the context of continuing attrition among local nurses. This pattern of reliance on OQNs is a phenomenon simultaneously occurring in the UK, the US, Canada and the Middle East --- the globalisation of nursing reflecting not merely Western demand but the growing agency and participation of women in skilled migration, their desire for improved quality of life, enhanced professional opportunity and remuneration, family reunion and adventure.

Attitude of Health Personnel↗
PubMed2001

Casualization of the nursing workforce: a New Zealand perspective on an international phenomenon.

A discussion of the increased use of 'casual' nursing staff (those nurses employed on a casual or 'per diem' basis) is presented. Reference is made to related literature, together with consideration of the implications associated with this trend. This issue has international significance, with the increased use of casual staff being widely recognised. A New Zealand perspective is included, with the provision of nursing care at Christchurch Hospital presented to illustrate certain aspects of the discussion. The impact of changing health-care systems and increased emphasis on efficiency and accountability are identified. This change to workplace practice will inevitably affect nursing; possible future developments are considered.

Efficiency, Organizational↗
PubMed2002

Association of British Clinical Diabetologists (ABCD): survey of specialist diabetes care services in the UK, 2000. 2. Workforce issues, roles and responsibilities of diabetes specialist nurses.

AIM: To examine the provision and role of diabetes specialist nurses (DSNs), and the content of patient education programmes in the UK. METHOD: A postal survey of secondary care providers of diabetes services in the UK in 2000. RESULTS: Following two reminders, a 77% response rate demonstrated 2.5 (median) whole time equivalent DSNs per 250 000 population, with only 13% of centres meeting the recommended staffing level of four per 250 000 population. The vast majority carried out work both in hospital and in the community, the proportion a reflection of who employed and managed staff. There was a wide variation in the qualifications required and the nursing gradings of DSNs, and regional variation in the number of grade I nurses, with the greatest proportion based in the South-east of England. The vast majority (96%) provided patient education, and where it existed (in 60% of responses), were the major providers of a patient help line (90%). Although key providers of patient education, there had been no specific education for this task in over 20% of responses. There was broad consistency in the topics covered at educational sessions, although advice on footwear (76%) and home urine glucose monitoring (73%) were least frequently documented. The issuing of literature and cards for patient use was also very variable. Over 25% of bids for diabetes service improvement were for additional DSNs, but only 48% of these were successful. CONCLUSIONS: There has been an improvement in staffing levels of DSNs over the last 10 years but the numbers are many fewer than recommended in national strategy documents, with evidence that despite expansion being given a high profile, such efforts are often unsuccessful. There was also evidence of considerable variation in the qualifications and gradings of DSNs throughout the UK and indeed in their day-to-day roles, and the content of patient education programmes. This suggests the need for a nationally co-ordinated approach to training and recruitment.

Diabetes Mellitus↗
PubMedDate not supplied

Air lead exposures and blood lead levels within a large automobile manufacturing workforce, 1980-1985.

Recent (1980-1985) trends in air lead (PbA) exposures and blood lead (PbB) levels experienced by approximately 10,000 workers employed in various stages of the automobile manufacturing process (i.e., auto assembly, lead-acid battery manufacture, foundry work, and "other" manufacturing-related operations) are described. Between 1980-1985, the mean PbB levels of assembly, battery, foundry, and "other" workers decreased by 28, 24, 3, and 27%, respectively, to 16.6, 23.6, 15.9, and 11.8 micrograms Pb/dl. Workers in the following job categories experienced the highest annual mean PbB levels: paste machine operators (battery plants), solder-grinders (assembly plants), and crane operators (foundries). During the same period, median 8-h Time Weighted Average PbA exposures (micrograms Pb/m3) in assembly plants, battery plants, and foundries decreased by 10, 12, and 20%, respectively, to 8.1, 13.6, and 10.9 micrograms/m3.

Adult↗
PubMed1995

Childhood aggression and unconventionality: impact on later academic achievement, drug use, and workforce involvement.

The interrelation of childhood aggression, unconventionality, academic orientation, work involvement, and drug use was explored. Data were obtained for the research participants when they were 5 to 10 years old. Follow-up interviews were conducted when the participants were 15 to 20 years old and again at 21 to 26 years old. Latent variable causal analysis was used, and the findings reveal long-term relations between early childhood aggression and adolescent problem behavior in the academic and occupational areas. The findings also indicate that adolescent drug use generates an early involvement with adult role behaviors, such as work at the expense of further education. Implications of the findings for prevention are discussed.

Adolescent↗