Journal of Occupational and Environmental Medicine - Current Issue

Workplace Exposures and Cognitive Function During Adulthood: Evidence From National Survey of Midlife Development and the O*NET Objective: Expand understanding of the role of selected workplace exposures (ie, occupational complexity, conflict in the workplace, pace of work, and physical hazards) in adults’ cognitive function. Methods: Cross-sectional data (n = 1991) from the second wave of the Midlife in the United States (MIDUS) study; restricted to participants who completed telephone-based cognitive assessments of episodic memory, executive functioning, and self-perceived memory. Occupational exposure data were harvested from the O*NET Release 6.0. Results: Greater complexity was associated with better self-perceived memory among women and men, and better episodic memory and executive functioning among women. Greater physical hazards were independently associated with poorer episodic memory and executive functioning. Conclusions: Objective assessments of physical and psychosocial exposures in the workplace are independently associated with cognitive outcomes in adulthood, with psychosocial exposures being particularly pronounced among women.

Shiftwork and Diurnal Salivary Cortisol Patterns Among Police Officers Objective: To investigate associations between shiftwork and diurnal salivary cortisol among 319 police officers (77.7% men). Methods: Information on shiftwork was obtained from the City of Buffalo, NY electronic payroll records. Saliva was collected using Salivettes at seven time points and analyzed for free cortisol concentrations (nmol/L) using a chemiluminescence immunoassay. Mean slopes and areas under the curve were compared across shift schedule using analysis of variance (ANOVA)/analysis of covariance (ANCOVA). Results: Officers working primarily on the night shift had a significantly shallower slope. Mean slope (nmol/L/minutes) of the cortisol curve varied significantly across shifts (day: −0.00332 ± 0.00017, afternoon: −0.00313 ± 0.00018, night: −0.00257 ± 0.0002); adjusted P = 0.023. Conclusions: Our results suggest that night shiftwork is a workplace factor that may alter the response of the hypothalamic–pituitary–adrenal (HPA) axis to the circadian cues responsible for the pattern of the diurnal cortisol curve.

Long-Term Cost-Effectiveness and Return-on-Investment of a Mindfulness-Based Worksite Intervention: Results of a Randomized Controlled Trial Objectives: The aim of this study was to conduct a cost-effectiveness and return-on-investment analysis comparing a mindfulness-based worksite intervention to usual practice. Methods: Two hundred fifty-seven governmental research institute employees were randomized to the intervention or control group. Intervention group participants received an eight-week mindfulness training, e-coaching, and supporting elements. Outcomes included work engagement, general vitality, job satisfaction, work ability, and costs. Cost-effectiveness analyses were conducted from the societal and employer's perspective, and a return-on-investment analysis from the employer's perspective. Results: After 12 months, a significant but not clinically relevant adverse effect on work engagement was found (−0.19; 95% confidence interval: −0.38 to −0.01). There were no significant differences in job satisfaction, general vitality, work ability, and total costs. Probabilities of cost-effectiveness were low (≤0.25) and the intervention did not have a positive financial return to the employer. Conclusion: The intervention was neither cost-saving nor cost-effective. Poor e-coaching compliance might partly explain this result.

Workplace Accommodations for Pregnant Employees: Associations With Women's Access to Health Insurance Coverage After Childbirth Objective: This study evaluates the associations between workplace accommodations for pregnancy, including paid and unpaid maternity leave, and changes in women's health insurance coverage postpartum. Methods: Secondary analysis using Listening to Mothers III, a national survey of women ages 18 to 45 years who gave birth in U.S. hospitals during 2011 to 2012 (N = 700). Results: Compared with women without access to paid maternity leave, women with access to paid leave were 0.4 times as likely to lose private health insurance coverage, 0.3 times as likely to lose public health coverage, and 0.3 times as likely to become uninsured after giving birth. Conclusion: Workplace accommodations for pregnant employees are associated with health insurance coverage via work continuity postpartum. Expanding protections for employees during pregnancy and after childbirth may help reduce employee turnover, loss of health insurance coverage, and discontinuity of care.

What Factors Are Associated With Occupational Health Office Staffing, Job Stress, and Job Satisfaction? Objective: This study sought to identify factors associated with occupational health staffing in health care settings, provide benchmarking data, and investigate relationships between staffing and worker stress and satisfaction. Methods: Members of the Association of Occupational Health Professionals in Healthcare were sent an online survey. Data on facility served, staffing, job attitudes, and work stress were collected and analyzed. Results: Number and types of personnel served were the largest predictors of staffing, accounting for 38 and 41% of the variability seen, respectively. Number of personnel served was related to worker stress and lack of work/life balance. Conclusion: Offices that required a provider presence had roughly one provider, seven nurses, and three clerical staff per 8000 personnel served. Occupational health workers are generally highly satisfied, and staffing has little relation to sources of job stress and satisfaction.

Effectiveness of a Multilevel Workplace Health Promotion Program on Vitality, Health, and Work-Related Outcomes Objective: Evaluation of the effectiveness of a workplace health promotion program on employees’ vitality, health, and work-related outcomes, and exploring the influence of organizational support and the supervisors’ role on these outcomes. Methods: The 5-month intervention included activities at management, team, and individual level targeting self-management to perform healthy behaviors: a kick-off session, vitality training sessions, workshops, individual coaching, and intervision. Outcome measures were collected using questionnaires, health checks, and sickness absence data at baseline, after the intervention and at 10 months follow-up. For analysis linear and generalized mixed models were used. Results: Vitality, work performance, sickness absence, and self-management significantly improved. Good organizational support and involved supervisors were significantly associated with lower sickness absence. Conclusions: Including all organizational levels and focusing on increasing self-management provided promising results for improving vitality, health, and work-related outcomes.

Psychosocial Working Conditions and Suicide Ideation: Evidence From a Cross-Sectional Survey of Working Australians Objectives: This study examined the relationship between psychosocial working factors such as job control, job demands, job insecurity, supervisor support, and workplace bullying as risk factors for suicide ideation. Methods: We used a logistic analytic approach to assess risk factors for thoughts of suicide in a cross-sectional sample of working Australians. Potential predictors included psychosocial job stressors (described above); we also controlled for age, gender, occupational skill level, and psychological distress. Results: We found that workplace bullying or harassment was associated with 1.54 greater odds of suicide ideation (95% confidence interval 1.64 to 2.05) in the model including psychological distress. Results also suggest that higher job control and security were associated with lower odds of suicide ideation. Conclusions: These results suggest the need for organizational level intervention to address psychosocial job stressors, including bullying.

Psychosocial Factors Related to Lateral and Medial Epicondylitis: Results From Pooled Study Analyses Objective: The goal is to assess the relationships between psychosocial factors and both medial and lateral epicondylitis after adjustment for personal and job physical exposures. Methods: One thousand eight hundred twenty-four participants were included in pooled analyses. Ten psychosocial factors were assessed. Results: One hundred twenty-one (6.6%) and 34 (1.9%) participants have lateral and medial epicondylitis, respectively. Nine psychosocial factors assessed had significant trends or associations with lateral epicondylitis, the largest of which was between physical exhaustion after work and lateral epicondylitis with and odds ratio of 7.04 (95% confidence interval = 2.02 to 24.51). Eight psychosocial factors had significant trends or relationships with medial epicondylitis, with the largest being between mental exhaustion after work with an odds ratio of 6.51 (95% confidence interval = 1.57 to 27.04). Conclusions: The breadth and strength of these associations after adjustment for confounding factors demonstrate meaningful relationships that need to be further investigated in prospective analyses.

Occupational Injury Surveillance Among Law Enforcement Officers Using Workers’ Compensation Data, Illinois 1980 to 2008 Objective: Injuries among law enforcement officers are common, but poorly understood; workers’ compensation (WC) data are an underutilized tool for occupational surveillance. Methods: A stratified analysis of WC claims among four categories of law enforcement officers used descriptive techniques, linear and robust regression. Results: Eighteen thousand eight hundred ninety-two officers filed claims from 1980 to 2008. Correctional officers had the highest rates, with leading causes of falls and assaults; motor vehicle crashes were the most common cause of injury among state police. Total monetary compensation was lower for correctional officers, but was explained by lower time lost and lower average weekly wage. Conclusion: The rate and types of injuries varied by subgroups, with correctional officers having the majority of injuries, but lower severity. WC data elucidate causes and outcomes of occupational injuries, which can guide prevention.

Implementing a Sleep Health Education and Sleep Disorders Screening Program in Fire Departments: A Comparison of Methodology Objective: The objective of this study is to compare three methods of administering a sleep health program (SHP) in fire departments. Methods: An SHP, comprising sleep health education and screening for common sleep disorders, was implemented in eight fire departments using three approaches: expert-led, train-the-trainer, and online. Participation rates, knowledge assessments, surveys, and focus group interviews were analyzed to assess the reach and effectiveness of the methodologies. Results: The Expert-led SHP had the highest participation rate, greatest improvement in knowledge scores, and prompted more firefighters to seek clinical sleep disorder evaluations (41%) than the other approaches (20 to 25%). Forty-two percent of focus group participants reported changing their sleep behaviors. Conclusion: All approaches yielded reasonable participation rates, but expert-led programs had the greatest reach and effectiveness in educating and screening firefighters for sleep disorders.