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Abstract: Objectives Mental well-being is critical to quality of life. Workplace mental well-being is crucial to ensure employee health, satisfaction, and performance. Mental ill-health is a global challenge, costing workplaces $17 billion per year. Workplaces have realized the need for investment in interventions to promote mental health and well-being in their workforce. However, given their limited resources, workplace personnel responsible for program implementation need evidence-based guidance on which interventions influence which outcomes.Methods This study employed a scoping review methodology in order to produce an evidence map and includes reviews of workplace mental well-being interventions. The search strategy focused on peer-reviewed articles with the primary aim of investigating workplace mental health interventions. Reviews were assessed for quality using AMSTAR 2. The evidence map includes interventions (rows) and outcomes (columns), with the relative size of the reviews underpinning each intersection represented by circles and the direction of evidence represented by color.Results Eighty reviews were deemed eligible from 4795 citations. The resulting evidence map includes 17 intervention types designed to influence 12 outcomes. Interventions with the highest quality evidence were mindfulness, education and information provision, and individual psychological therapies. The most common outcomes were burnout / stress reduction and mental well-being. Interventions tended to focus on individual level factors rather than organizational or system-level factors.Conclusion The evidence-base for workplace mental health interventions is broad and extensive. There is an apparent knowledge-to-practice gap, presenting challenges to implementing workplace mental health programs (ie, what interventions have the highest quality evidence). This study aims to fill the gap by providing an interactive evidence-map. Future research should look to fill the gaps within the map including the lack of organization and system level factors and especially economic evaluations. by Waddell A, Kunstler B, Lennox A, Pattuwage L, Grundy EAC, Tsering D, Olivier P, Bragge P. doi:10.5271/sjweh.4088 PubDate: Wed, 22 Mar 2023 00:12:00 +020 DOI: 10.5271/sjweh.4088
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Abstract: Since the beginning of the COVID-19 pandemic, there has been a growing literature on COVID and work (1). Major editorials (2–4) and reports from international associations and agencies (5–8) have highlighted the importance of occupational health research in COVID-19 prevention and management. Occupational health research has focused on specific worker populations with high prevalence of COVID-19, particularly healthcare workers, and has studied the associations between different work exposures to SARS-CoV-2 and incidence of COVID-19. Some countries have also begun to provide workers’ compensation for occupationally-acquired COVID-19 (9–13). Return to work (RTW) following COVID-19 is another crucial topic that has been studied among patients with severe cases of SARS-CoV-2 infection in different countries (14–18). Clinicians have also observed patients who suffer from persistent symptoms following COVID-19, often called “long-COVID” (19). Through analyses of large health databases, a variety of post-acute sequelae among patients with COVID-19 have been identified, including malaise, fatigue, musculoskeletal pain, anemia, and other respiratory, neurocognitive, mental health, metabolic, cardiovascular, and gastrointestinal disorders (20). The World Health Organization defined a “post COVID-19 condition” among individuals with a history of probable or confirmed SARS-CoV-2 infection with symptoms continuing three months from the onset of COVID-19 infection, which last for at least two months, and which cannot be explained by an alternative diagnosis (21). Common symptoms include fatigue, shortness of breath, cognitive dysfunction, and generally have a significant impact on everyday functioning. Symptoms may be of new onset following initial recovery from an acute COVID-19 episode or persist from the initial illness. Symptoms may also fluctuate or relapse over time. The “Global Burden of Disease Long COVID Collaborators”, a worldwide collaboration, defined three main post-COVID condition symptoms: (i) persistent fatigue with bodily pain (myalgia) or mood swings; (ii) cognitive problems, often forgetfulness or concentration difficulties, commonly referred to as “brain fog;” and (iii) ongoing respiratory problems (shortness of breath and persistent cough as the main symptoms) (22). This task force showed that, in a pooled study of over one million subjects, the prevalence of post-COVID condition was 0.9% [95% confidence interval (CI) 0.3–2.0%] after one year, but was at as high as 15% for symptoms that were presents at three months. Different factors were associated with a post-COVID condition, including age 20–49 years, female sex, and initial severity of illness (including hospitalization, intensive care unit admission, and mechanical ventilation) (22–24). For example, 26.6% (95% CI 11.5-47.8) of women who needed intensive care support had a post-COVID condition after a year. In 2023 in the United Kingdom, it was estimated that 2.0 million people living in private households (3.0% of the population) were experiencing self-reported post-COVID conditions (defined as symptoms continuing for more than four weeks after the first confirmed or suspected COVID-19 infection that were not explained by something else) (25). In the sample, more than 85% were in the working age. The consequences of such unexpected persistence of disease on the health of the workforce are large. Most of the post-COVID symptoms found in the general population were similar for workers: in a recent review including 60 cohort studies of working age adults and 10 cases studies, the most frequently reported post-COVID-19 symptoms were fatigue (92%), shortness of breath (82%), muscle pain (44%) and joint pain (35%) (26). In a recent study with a 15-month follow-up of workers, similar symptoms were reported as well as cognitive symptoms and autonomic dysregulation (27). This study also assessed the Work Ability Index, and found that women had a larger self-reported reduction in work ability following COVID infection than men. RTW and work factors related to post-COVID condition have been examined in small samples of workers, and found that poorer work ability was related to previous comorbidities, symptoms of fatigue, and some occupational and work organizational factors (28–31). Previous comorbidities related to chronic disease (obesity, hypertension and respiratory disorders), were associated with slower RTW among healthcare workers hospitalized for COVID-19. Asthenia / reported loss of memory and sleep disorders were associated with the longest duration of work absence (>3 months) (29). Some type of work and activity sectors have also been related to RTW outcomes. For example, in a small Canadian descriptive study, among healthcare workers physicians had better improvement than nurses and healthcare assistants (28), and business, finance and management sectors had overall the RTW outcome though not significant (31). Modification of work duties improved RTW in this same study, whereas skeptical reactions from employers and colleagues and lack of support from the social welfare system complicated RTW in a qualitative study (30).Aben et al (32) conducted a study among employees who reported sick due to COVID-19 (N=30 396) or flu-like symptoms not due to COVID-19 (N=15,862), using routinely collected data from a national Dutch occupational health service. Even though there was a 100% RTW rate three months after a flu-like syndrome, the RTW rate after COVID-19 was only 92.8%. The authors were also able to determine important predictors contributing to later return to work in specific statistical models: older age [hazard ratio (HR) 0.99, 95% CI 0.99–0.99], female sex (HR 0.88, 95% CI 0.86–0.90), belonging to a risk group – including chronic illness, compromised immune system, diabetes, and obesity (HR 0.85, ... PubDate: Tue, 21 Mar 2023 23:25:54 +020 DOI: 10.5271/sjweh.4086
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Abstract: Objective This study aimed to investigate the effects of occupational exposures on the risk of a positive COVID-19 test, and whether this differed across pandemic waves.Methods Data from 207 034 workers from The Netherlands with test data on COVID-19 from June 2020 until August 2021 were available. Occupational exposure was estimated by using the eight dimensions of a COVID-19 job exposure matrix (JEM). Personal characteristics, household composition and residence area were derived from Statistics Netherlands. A test-negative design was applied in which the risk of a positive test was analyzed in a conditional logit model.Results All eight dimensions of occupational exposure included in the JEM increased the odds of a positive test for the entire study period and three pandemic waves [OR ranging from 1.09, (95% confidence interval (CI) 1.02–1.17) to 1.77 (95% CI 1.61–1.96)]. Adjusting for a previous positive test and other covariates strongly reduced the odds to be infected, but most dimensions remained at elevated risk. Fully adjusted models showed that contaminated work spaces and face covering were mostly relevant in the first two pandemic waves, whereas income insecurity showed higher odds in the third wave. Several occupations have a higher predicted value for a positive COVID-19 test, with variation over time.Discussion Occupational exposures are associated with a higher risk of a positive test, but variations over time exist in occupations with the highest risks. These findings provide insights for interventions among workers for future pandemic waves of COVID-19 or other respiratory epidemics. by Eekhout I, van Tongeren M, Pearce N, Oude Hengel KM. doi:10.5271/sjweh.4085 PubDate: Mon, 13 Mar 2023 23:18:41 +020 DOI: 10.5271/sjweh.4085
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Abstract: Objective This study aimed to investigate the prospective association of lifting duration and lifting load with the risk of long-term sickness absence (LTSA).Methods We followed manual workers with occupational lifting (N=45 346) from the Work Environment and Health in Denmark Study (2012–2018) for two years in a high-quality national register on social transfer payments (DREAM). Cox regressions with model-assisted weights were employed to estimate the risk of LTSA from lifting duration and loads.Results During follow-up, 9.6% of the workers had an episode of LTSA. Compared to workers with seldom lifting (reference), workers lifting ½ and ¾ of the workday had increased risk of LTSA [hazard ratios (HR) of 1.36 [95% confidence interval (CI) 1.20–1.56] and 1.22 (95% CI 1.07–1.39)], respectively. Lifting load showed a positive exposure–response association with LTSA (trend test, P PubDate: Tue, 07 Mar 2023 23:01:43 +020 DOI: 10.5271/sjweh.4084
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Abstract: Objectives Integrating vocational rehabilitation and mental healthcare has shown effects on vocational outcomes during sick leave with common mental disorders. In a previous paper, we showed that a Danish integrated healthcare and vocational rehabilitation intervention (INT) had a surprisingly negative impact on vocational outcomes compared to service as usual (SAU) at 6- and 12-month follow-up. That was also the case with a mental healthcare intervention (MHC) tested in the same study. This article reports the 24-month follow-up results of that same study.Method A randomized, parallel-group, three-arm, multi-centre superiority trial was conducted to test the effectiveness of INT and MHC compared to SAU.Results In total, 631 persons were randomized. Contrary to our hypothesis, SAU showed faster return to work than both INT [hazard rate (HR) 1.39, P=0.0027] and MHC (HR 1.30, P=0.013) at 24-month follow-up. Overall, no differences were observed regarding mental health and functional level.Discussion Compared to SAU, we observed some health benefits of MHC, but not INT, at 6-month follow-up but not thereafter, and lower rates of employment at all follow-ups. Since implementation problems might explain the results of INT, we cannot conclude that INT is no better that SAU. The MHC intervention was implemented with good fidelity and did not improve return to work.Conclusion This trial does not support the hypothesis that INT lead to faster return to work. However, implementation failure may explain the negative results. by Hoff A, Poulsen RM, Fisker JP, Hjorthøj C, Nordentoft M, Bojesen AB, Eplov LF. doi:10.5271/sjweh.4083 PubDate: Sun, 05 Mar 2023 23:37:38 +020 DOI: 10.5271/sjweh.4083
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Abstract: Objective Previous literature has established associations between psychosocial working conditions and sickness absence (SA), but only few studies have examined associations among younger employees. This study aimed to investigate associations between psychosocial working conditions and SA among employees, aged 15–30 years, who entered the labor market in Denmark between 2010 and 2018.Method We followed 301 185 younger employees in registers for on average 2.6 years. Using job exposure matrices, we assessed job insecurity, quantitative demands, decision authority, job strain, emotional demands, and work-related physical violence. Adjusted rate ratios of SA spells of any length were estimated for women and men separately with Poisson models.Results Among women, employment in occupations with high quantitative demands, low decision authority, high job strain, high emotional demands, or high work-related physical violence was associated with higher rates of SA. Being employed in occupations with high versus low emotional demands showed the strongest association with SA, with a rate ratio of 1.44 [95% confidence interval (CI) 1.41–1.47]. Among men, being employed in occupations with low decision authority showed the strongest association with SA (1.34, 95% CI 1.31–1.37), whereas occupations with high quantitative demands, high job strain, and high emotional demands were associated with lower rates of SA.Conclusion We found that several psychosocial working conditions were associated with SA spells of any length. Associations with SA spells of any length resemble associations with long-term SA, suggesting that results from previous studies on long-term SA may be generalizable to all lengths of SA among younger employees. by Sørensen JK, Pedersen J, Burr H, Holm A, Lallukka T, Lund T, Melchior M, Rod NH, Rugulies R, Sivertsen B, Stansfeld S, Christensen KB, Madsen IEH. doi:10.5271/sjweh.4082 PubDate: Sun, 19 Feb 2023 18:55:27 +020 DOI: 10.5271/sjweh.4082
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Abstract: Objective Heat exposure and heat stress/strain is a concern for many workers. There is increasing interest in potential chronic health effects of occupational heat exposure, including cancer risk. We examined potential associations of occupational heat exposure and colorectal cancer (CRC) risk in a large Spanish multi-case–control study.Methods We analyzed data on 1198 histologically confirmed CRC cases and 2690 frequency-matched controls. The Spanish job-exposure matrix, MatEmEsp, was used to assign heat exposure estimates to the lifetime occupations of participants. Three exposure indices were assessed: ever versus never exposed, cumulative exposure and duration (years). We estimated odds ratios (OR) and 95% confidence intervals (CI) using unconditional logistic regression adjusting for potential confounders.Results Overall, there was no association of ever, compared with never, occupational heat exposure and CRC (OR 1.09, 95% CI 0.92–1.29). There were also no associations observed according to categories of cumulative exposure or duration, and there was no evidence for a trend. There was no clear association of ever occupational heat exposure and CRC in analysis conducted among either men or women when analyzed separately. Positive associations were observed among women in the highest categories of cumulative exposure (OR 1.81, 95% CI 1.09–3.03) and duration (OR 2.89, 95% CI 1.50–5.59) as well as some evidence for a trend (P PubDate: Sun, 19 Feb 2023 17:52:59 +020 DOI: 10.5271/sjweh.4080
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Abstract: Objective This study aimed to quantify the risk of COVID-19-related hospital admission in spouses living with partners in at-risk occupations in Denmark during 2020–21.Methods Within a registry-based cohort of all Danish employees (N=2 451 542), we identified cohabiting couples, in which at least one member (spouse) held a job that according to a job exposure matrix entailed low risk of occupational exposure to SARS-CoV-2 (N=192 807 employees, 316 COVID-19 hospital admissions). Risk of COVID-19-related hospital admission in such spouses was assessed according to whether their partners were in jobs with low-, intermediate- or high-risk for infection. Overall and sex-specific incidence rate ratios (IRR) of COVID-19-related hospital admission were computed by Poisson regression with adjustment for relevant covariates.Results The risk of COVID-19-related hospital admission was increased among spouses with partners in high-risk occupations [adjusted IRR (IRRadj)1.59, 95% confidence interval (CI) 1.1–2.2], but not intermediate-risk occupations (IRRadj 0.97 95% 0.8–1.3). IRR for having a partner in a high-risk job were elevated during the first three pandemic waves but not in the fourth (IRRadj 0.48 95% CI 0.2–1.5). Sex did not modify the risk of hospital admission.Conclusions SARS-CoV-2 transmission at the workplace may pose an increased risk of severe COVID-19 among spouses in low-risk jobs living with partners in high-risk jobs, which emphasizes the need for preventive measures at the workplace in future outbreaks of epidemic contagious disease. When available, effective vaccines seem essential. by Bonde JPE, Begtrup LM, Coggon D, Jensen JH, Flachs EM, Jakobsson K, Nielsen C, Nilsson K, Rylander L, Vilhelmsson A, Petersen KU, Tøttenborg SS. doi:10.5271/sjweh.4081 PubDate: Tue, 07 Feb 2023 23:47:34 +020 DOI: 10.5271/sjweh.4081
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Abstract: Objective The present study aims to investigate the association between exposure to precarious employment three years after graduation and the risk of labor market marginalization (LMM) ten years later.Methods A registered-linked cohort study based on the Swedish Work, Illness, and Labor-market Participation (SWIP) cohort was conducted among all individuals born between 1973 and 1976, who were registered in Sweden the year they turned 27 years old (N=365 702). Information on the exposure of labor market establishment three years after graduating from school and outcome of LMM ten years after graduating was collected from nationwide registers. Relative risk ratios (RRR) with 95% confidence intervals (CI) were obtained by multinominal logistic regression.Results After considering important covariates, young adults in precarious employment three years after graduation were at an increased risk of future long-term unemployment (RRR 2.31), later precarious employment (RRR 2.85), and long-term sickness absence/disability pension (RRR 1.43) compared to individuals who had obtained standard employment arrangements within three years of graduating. Young precariously employed men had a slightly strong association compared to females with regards to all outcomes.Conclusion The result of this study suggests that both young men and women in precarious employment three years after graduation are more likely to have a weaker attachment to the labor force later in life compared to individuals of the same age in standard employment. This is important as the prevalence of precarious employment is increasing globally, and young adults appear to be especially vulnerable. by Thern E, Matilla-Santander N, Bodin T, Hemmingsson T. doi:10.5271/sjweh.4078 PubDate: Mon, 23 Jan 2023 14:56:04 +020 DOI: 10.5271/sjweh.4078
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Abstract: Objectives This study aimed to investigate (i) the main effects of office design and access to telework from home (TWFH) on self-certified sickness absence and (ii) the moderating effects of access to TWFH on the relationship between office design and self-certified sickness absence.Methods The study used cross-sectional survey data from a nationally representative sample from Norway (N=4329). Research objectives were investigated with negative binomial hurdle models, adjusting for age, gender, education level, leadership responsibility, and time spent on office work. Moderating effects of TWFH were evaluated with pairwise comparisons and plots of estimated marginal means.Results In adjusted models, employees in conventional open-plan offices [odds ratio (OR) 1.32, 95% confidence interval (CI) 1.13–1.54] had significantly higher odds of sickness absence than employees in private offices. Employees with access to TWFH (OR 0.86, 95% CI 0.74–0.99) had significantly lower odds of sickness absence than employees with no access. Among employees with access to TWFH, those in conventional open-plan offices had significantly higher predicted probability of self-certified sickness absence than those in private offices (z=4.41, P PubDate: Mon, 16 Jan 2023 23:19:08 +020 DOI: 10.5271/sjweh.4077
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Abstract: Objectives The aim of this study was to evaluate employee return-to-work (RTW) rates and examine predictors of absence duration after COVID-19. RTW rates were referenced against RTW rates after absence due to flu-like symptoms and assessed over the course of the pandemic.Methods Routinely collected data from a nationally operating Dutch occupational health service was used. The data were retrieved from employees who reported sick due to COVID-19 (N=30 396) or flu-like symptoms (N=15 862). Data consisted of responses to a triage survey combined with longitudinal register-based information on sickness absence. RTW rates after COVID-19 were evaluated through Kaplan-Meier estimates and compared to RTW rates for flu-like symptoms, and between three periods with different dominant virus variants. Predictors for absence duration were examined through Cox proportional hazards models.Results RTW after COVID-19 was found to be notably later than after flu-like symptoms (median RTW=10 versus 6 days, respectively). On average, 5.5% of employees who contracted COVID-19 were absent for over 12 weeks. Time-to-RTW shortened as different virus variants became dominant over time. The main predictors contributing to later RTW were older age, female sex, belonging to a risk group, and the symptoms shortness of breath and fatigue.Conclusions Estimates of the RTW rate after COVID-19 and identification of predictors may aid healthcare professionals in gaining insight into variations in the disease course and rehabilitation process. The present findings can help employers and policy-makers grasp the impact of COVID-19 on the workplace. by Aben B, Kok RN, de Wind A. doi:10.5271/sjweh.4076 PubDate: Sun, 01 Jan 2023 18:35:45 +020 DOI: 10.5271/sjweh.4076
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Abstract: Objective This study aimed to assess whether workplace exposures as estimated via a COVID-19 job exposure matrix (JEM) are associated with SARS-CoV-2 in the UK.Methods Data on 244 470 participants were available from the Office for National Statistics Coronavirus Infection Survey (CIS) and 16 801 participants from the Virus Watch Cohort, restricted to workers aged 20–64 years. Analysis used logistic regression models with SARS-CoV-2 as the dependent variable for eight individual JEM domains (number of workers, nature of contacts, contact via surfaces, indoor or outdoor location, ability to social distance, use of face covering, job insecurity, and migrant workers) with adjustment for age, sex, ethnicity, index of multiple deprivation (IMD), region, household size, urban versus rural area, and health conditions. Analyses were repeated for three time periods (i) February 2020 (Virus Watch)/April 2020 (CIS) to May 2021), (ii) June 2021 to November 2021, and (iii) December 2021 to January 2022.Results Overall, higher risk classifications for the first six domains tended to be associated with an increased risk of infection, with little evidence of a relationship for domains relating to proportion of workers with job insecurity or migrant workers. By time there was a clear exposure-response relationship for these domains in the first period only. Results were largely consistent across the two UK cohorts.Conclusions An exposure-response relationship exists in the early phase of the COVID-19 pandemic for number of contacts, nature of contacts, contacts via surfaces, indoor or outdoor location, ability to social distance and use of face coverings. These associations appear to have diminished over time. by Rhodes S, Beale S, Wilkinson J, van Veldhoven K, Basinas I, Mueller W, Oude Hengel KM, Burdorf A, Peters S, Stokholm ZA, Schlünssen V, Kolstad H, Pronk A, Pearce N, Hayward A, van Tongeren M. doi:10.5271/sjweh.4075 PubDate: Tue, 20 Dec 2022 12:09:57 +020 DOI: 10.5271/sjweh.4075
