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Abstract: Background and objective Hybrid work, defined as a combination of in-person and digital collaboration, is also becoming increasingly more common in public administration; however, existing research largely stems from the private sector and its applicability to the public sector remains insufficiently explored. This study aims to examine the perceived job demands, resources, health impacts, and support needs of employees engaged in hybrid work within a public administration. Methods As part of a quantitative cross-sectional study, 127 employees and managers from a public administration in Germany were surveyed about their experiences with hybrid collaboration between August and September 2023. In a partial analysis, open-ended responses from 102 participants were evaluated using inductive-deductive qualitative content analysis based on Mayring’s approach, focusing on hybrid work-related demands, resources, perceived health effects and support needs. Results Employee experiences with the implementation of hybrid work in the public administration varied across all examined dimensions. Most frequently reported were demands and resources related to work organization and social relationships. Limited functionality and insufficient technical equipment were commonly perceived as challenges. Nevertheless, most participants reported positive effects of hybrid work on their mental health. They also identified needs for structural (e.g., improved technical infrastructure or work organization) and behavioral (e.g., team-based training) preventive measures. Discussion The findings highlight the need for differentiated prevention strategies. These should target both structural factors (e.g., work processes, equipment) and individual level interventions (e.g., team competence development) to support health-promoting hybrid work in public sector environments. PubDate: 2025-06-19
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Abstract: The work of airfield fuel attendants involves lifting, lowering, holding and pulling hoses in different postures. It is therefore not easy for the company’s practitioner to estimate the musculoskeletal loadings as part of the risk assessment, using simple methods. In the context of this contribution, the external forces involved in handling the hoses were recorded on site. The postures were documented using video recordings and photographs. Furthermore, the frequencies of the respective activities were compiled by the participating company which, in addition, immediately introduced initial preventive measures. In order to describe the situative musculoskeletal load quantitatively and thus like a bottleneck analysis, compressive and shear forces at the lumbosacral joint were calculated for the individual materials handling activities. Derived therefrom, cumulative dose values for the current load spectrum show that occupational causation of disc-related spinal diseases cannot be ruled out a priori. This applies, in particular, when considering a “worst-case scenario” with the assumption of maximum load level as well as maximum duration of the respective activity. Then, the work-related prerequisites in occupational disease evaluation procedures can be regarded as fulfilled after around 20 years of work. Preventive approaches should focus on handling activities that involve the highest individual loadings: the lifting and lowering of the tank hoses at the aircraft. Such an advantage could be achieved using technical lifting aids in combination with organisational measures for ergonomic handling the hoses so that load peaks and the biomechanical overload risk could significantly be reduced. PubDate: 2025-06-19
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Abstract: Background The risk of exposure to solar ultraviolet (UV) radiation affects above all employees who work outdoors. The risk awareness of those affected and their willingness to apply protective measures is still low, which continues to pose major challenges for occupational health and safety. Materials and methods As part of wearing tests of UV protective clothing in different sectors of the German transport industry, the sun protection behavior of the participants was examined before and after the tests. Furthermore, wearing comfort in practice was evaluated by using questionnaires. In total, 137 persons participated in the wearing tests and 119 questionnaires returned. In addition, the protective effect of selected UV protective clothing (n = 13) was tested on 39 samples via laboratory measurements. Results The evaluation of the questionnaires showed that 18% of the participants from different sectors of the transport industry (n = 104) did not use any kind of sun protection at work. The participants of the reference group (n = 15) always protected themselves against solar UV radiation. Before the wearing tests, 11% of all participants (n = 119, including the reference group) already wore long-sleeved clothing when working outdoors. After the wearing tests, the proportion increased to 47%. UV protective clothing was generally rated favorably compared to normal work clothing. With regard to the UV protection declared by the manufacturer, the majority of the clothing was able to achieve the stated protection factor even when new. For some models, the stated protection factor was only achieved after repeated washing. Conclusions The wearing tests showed that the acceptance of UV protective clothing can be significantly increased by involving employees in the decision-making and selection process. To this end, several models should be available for selection before procurement. The UV protective clothing available on the market generally offers reliable protection. In this context, informing employees about the potential risk is fundamental for further action. Education and knowledge transfer are essential components with regard to the primary prevention of UV-induced damage. PubDate: 2025-05-06
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Abstract: Background Older employees in the healthcare sector faced special challenges during the coronavirus disease 2019 (COVID-19) pandemic. The aim of this article is to describe the working conditions of these employees during the COVID-19 pandemic and to compare their well-being, work stress, health and work ability before and directly after the pandemic. Methods Using data from the lidA study, cross-sectional and longitudinal analyses are conducted. A comparison was made between six occupational groups from the healthcare, education and social sectors: healthcare and nursing, geriatric care, medical assistance as well as child education, social work and school teaching. The analyses include comparisons of frequencies, group means and generalized linear models (GLM) repeated measures ANOVA. Results The results confirm that the COVID-19 pandemic had a particularly stressful impact on older employees in the examined occupational groups. Employees reported frequent worries about becoming infected as well as frequent infections at work. Some employees in the healthcare sector even had to continue working despite having a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. For all six occupational groups, a lower level of well-being, increased stress and a significant deterioration in mental health and work ability were observed immediately after the pandemic compared to the years before. Discussion There was already a shortage of staff in social occupations before the COVID-19 pandemic. This shortage has probably been exacerbated by the effects of the pandemic on work stress, health and work ability. PubDate: 2025-04-24
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Abstract: Background Occupational safety and occupational health are multidisciplinary fields in which occupational health physicians (OP) are the only profession according to theories of profession. So far little is known about the professional self-conception of OPs. This study therefore addresses the following research question: what can we learn about the professional self-conception of OPs from the secondary analysis of qualitative data' Methods We reanalyzed qualitative data from three previous research projects undertaken by the institute in a secondary analysis. The original studies addressed the following topics: the cooperation between general practitioners and OPs, the offers for psychosomatic consultation in the workplace and the availability and utilization of occupational healthcare. The original data were generated in 2009–2012. The secondary analysis was based on five focus group discussions and an interview with OPs in Germany. In total, 23 OPs were part of the secondary analysis. The professional identity of OPs was addressed in all the original data but was not the focus of the studies. We used the integrative basic method to reanalyze the data in detail and with a focus on semantics, syntax and metaphors as well as agency and positioning. Results The OPs criticised the lack of knowledge about their work among other stakeholders. They described several modes of operation of OPs within the company: the fighter, the negotiator and the disengaged OP. They positioned themselves first and foremost as physicians, using medical confidentiality and ethics to protect themselves from attempts of instrumentalization by others. They discussed the employees fear of OPs partiality and how their work was partly dependent on the employers’ willingness to invest in occupational health. They made it clear that their work was nevertheless independent. Discussion The OPs in our study addressed a status triangle dilemma. We could identify five strategies by which they navigated the dilemma: pragmatic orientation, shaping the contractual framework conditions, marketing the benefits of the work of OPs, self-positioning as physicians and turning the status triangle dilemma into a unique competence. The latter can be seen not only as an invitation to discuss the future of occupational medicine but also to ask what physicians from other specialities can learn from OPs in navigating conflicting roles and in constructing strategies for action. PubDate: 2025-04-22
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Abstract: Background As aviation becomes increasingly more complex, the demands on human-machine interaction (HMI) are growing. Adaptive automation systems, based on physiological measurements of pilots, could improve flight safety; however, it remains unclear to what extent pilots will accept these technologies in operational use. Aims of the study The aim of the study was to investigate the acceptance of pilots for the measurement of physiological data in operational settings and its use for adaptive automation systems. Both civilian and military pilots were included in order to analyze how they respond to these technologies, and what requirements they have for such systems. Material and methods In a qualitative study, (semi)structured interviews were conducted with 18 civilian A320 pilots and 5 military Eurofighter pilots. The interviews were analyzed to gain insights into user acceptance. Results The findings showed that civilian pilots see the greatest benefit in measuring physiological data for fatigue and crew management, while military pilots focus on G‑force-induced loss of consciousness (G-LOC) and hypoxia. Both groups expressed concerns regarding comfort and data protection. Adaptive automation systems were viewed sceptically, particularly due to concerns that they might interfere with the control at critical moments. Discussion The study shows that adaptive automation and the collection of physiological data are generally accepted by pilots, provided that the systems do not add extra workload and data protection is ensured. A hybrid approach that integrates the advantages of adaptable automation could be a promising solution for future HMI in aviation. PubDate: 2025-04-22
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Abstract: Occupational environmental noise in child daycare centers can have a negative impact on the voice of educators. An unhealthy voice is characterized by limited vocal resilience, which in turn impairs the performance of the occupation. The majority of early childhood educators are female and are particularly at risk for occupational voice disorders. The aim of the study was to investigate whether nursery schoolteachers with a conspicuous dysphonia severity index (DSI) differ from nursery schoolteachers with a normal DSI in terms of the occurrence of voice complaints and vocal resilience.In this study 103 vocally healthy nursery schoolteachers aged 40.9 ± 11.6 years voluntarily participated. To determine an undetected voice disorder, the DSI was calculated and classified. Possible subjective voice complaints were recorded using the vocal tract discomfort scale (VTDS) and the voice handicap index (VHI-9). The vocal resilience was tested with a 10min vocal stress test (alternating test 75 dB(A) or 80 dB(A) on the vowels [a:/e:]). The voice analysis and calculation of the DSI was performed using the DiVAS V2.8 Module Basis software (XION GmbH, Berlin).A normal DSI of 5.5 ± 0.9 points was present in 46 (44.7%) of the educators (group 1). A reduced DSI (2.9 ± 1.0 points) was found in 57 (55.3%) of the nursery teachers (group 2). The groups did not differ in terms of age, length of employment and other influencing factors, such as drinking habits. In the voice stress test, nursery schoolteachers with an inconspicuous DSI performed better. They fell below the required sound pressure level by only 2.7 ± 4.3%, whereas those with a conspicuous DSI fell below the required level by 5.6 ± 7.8% (p = 0.012). Educators with a conspicuous DSI also found the test significantly more strenuous (p = 0.009). In contrast, the two groups did not differ with respect to self-reported voice complaints and discomfort.More than half of the actually vocally healthy nursery schoolteachers were found to have an abnormal DSI, which hypothetically indicates an inadequate speech/voice technique for this occupational strain. This is why nursery schoolteachers need to be made aware of their voice and the importance of vocal hygiene at an early stage. Speech education and voice training should therefore be integrated into teacher training. PubDate: 2025-04-22
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Abstract: Background Today’s working world is increasingly characterized by mental processes and the associated psychological stress for employees. Objective diagnostic methods are being researched to assess these stresses in terms of occupational physiology and to be able to counter the resulting psychological stress reactions and consequences by means of preventive measures. Heart rate variability (HRV) has proven to be a possible stress parameter for determining mental stress. An excessive tendency to overcommitment (OC) is seen as an intrinsic component in the development of gratification crises, which can have an impact on the employee’s ability to work and health. The aim of the work is to analyze the subjectively assessed mental health and objectively measured stress by means of HRV in employees with different levels of OC. Methods Voluntary, clinically healthy subjects (n = 202) from different occupational groups (educators, bank employees and medical assistants) aged 46.5 years (median) answered the Effort-Reward Imbalance Questionnaire (part OC) and the General Health Questionnaire (GHQ) in full and wore a long-term ECG device for HRV analysis over 24 h. Results The group with a critical OC value was significantly older, had worked longer and had a significantly higher GHQ sum score (p PubDate: 2025-04-22
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Abstract: Introduction Health service employees are exposed to an increased risk of infection in the care of patients with infectious diseases. The frequency of occupational infections can be assessed from routine data of the Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW). Methods The evaluation is based on cases reported to the BGW between 2018 and 2023 and on cases recognized as an occupational disease (BK) according to BK no. 3101. Cases with pregnancy-related pathogens are analyzed as a separate sample. For cases with COVID-19, the characteristics hospitalization, rehabilitation management and deaths are analyzed by year of disease, gender and age. Absolute and relative frequencies are reported. Results For the year 2023, the infectious disease was recognized as an occupational disease in 43,540 cases. In the case of infections with pathogens relevant to pregnancy (excluding SARS-CoV-2), this related to 80 cases. Since 2020, COVID-19 infections have made the greatest contribution to occupational diseases. Latent tuberculosis infections are decreasing but are still relevant in the healthcare sector. Blood-borne hepatitis infections are only sporadic events. Scabies is relevant in geriatric care. The highest rates of hospitalization, rehabilitation and mortality are found in 2020 and 2021. Severe clinical courses after COVID-19 were most frequent among those over the age of 50 years. Mortality after COVID-19 was greater for men than for women in 2020 and 2021. Discussion The downward trend for occupational infectious diseases is continuing. Hospitalization and rehabilitation after COVID-19 can be portrayed on the basis of routine data. PubDate: 2025-04-11
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Abstract: The human hand represents a highly complex motor system, capable of precisely moving numerous joints via muscles and tendons through finely tuned neuromuscular control, enabling adaptation to a wide range of movement demands and performance of both gross and fine motor tasks. Technological advances have led to a variety of methods for documenting and analyzing hand movements, which encompass various approaches of imaging techniques, such as ultrasound, X‑ray and magnetoencephalography as well as camera-based and sensor-based procedures. Camera-based systems, for example, enable a targeted and detailed documentation of movements but require considerable effort, limiting their applicability in field studies. In contrast, sensor-based systems can be applied in a variety of very different environments but show a level of uncertainty in measurement accuracy. The optimal choice of measurement method greatly depends on the specific field of application. In the future, the combination of imaging, sensory and algorithmic approaches is expected to play a key role in enhancing both precision and practical utility, enabling occupational health questions to be addressed through advanced algorithms and neural interfaces. PubDate: 2025-04-03
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Abstract: Background and objective Hybrid forms of work, in which employees carry out their tasks partly in presence (e.g., in the office) and partly in a flexible mobile way (e.g., working from home), are omnipresent. However, the transition to hybrid forms of work is often associated with challenges such as a strong culture of presence and an inadequate technical infrastructure. Comprehensive scientific findings on the relationship between hybrid working conditions and employee health are still required. This literature review aims to identify the psychosocial job demands and resources in the hybrid work context to support the design of healthy working conditions. Methods In an exploratory literature search, study results are presented on job demands and resources that arise in the context of hybrid working. Based on key terms and predefined inclusion and exclusion criteria, 30 studies were included following a content and method review. Results Study results present numerous psychosocial work requirements in the context of hybrid working, e.g., work organization, special features of the working environment and influences on the organization of social relationships as well as a variety of work resources that can result from hybrid working, e.g. an extended scope for action and decision-making. Conclusion This review offers an insight into the psychosocial work demands and resources of hybrid work, thereby providing a foundation for further research to understand the impact of hybrid working conditions on employee health-related outcomes. The recommendations for action outlined provide a valuable reference point for health-promoting hybrid working conditions that employers should incorporate into the ongoing transition to hybrid work as early as possible. PubDate: 2025-04-02
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Abstract: The promotion of health in the workplace is a pivotal element in the assurance of long-term employment. Nevertheless, it is apparent that individuals with disabilities are more prone to absenteeism than non-disabled counterparts. This presents companies with the challenge of addressing the financial implications. As of 1 January 2018, the law (§§ 215–218 Social Security Code IX, SGB IX) has stipulated that inclusive companies are obliged to implement measures to promote workplace health. This narrative review presents the existing research on evidence-based workplace health promotion programs tailored to inclusive organizations and current recommendations for promoting sustainable health improvements among employees in such settings. The analysis is based on a comprehensive literature search of English and German databases, including PubMed/MEDLINE, Cochrane and Google Scholar. In order to achieve the social objectives of inclusive companies, it is of the utmost importance to create health-promoting framework conditions that are tailored to the individual needs of all employees, irrespective of disabilities. Nevertheless, evidence-based workplace health promotion programs that encompass both employees with and without disabilities remain scarce. Given the paucity of research on such initiatives, it is imperative to further develop this field to facilitate a comprehensive evaluation of the various measures; however, there are now some recommendations that can support a sustainable improvement in the health of employees in inclusive companies. PubDate: 2025-03-05
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Abstract: Background Promoting social resources can help reduce mental stress and significantly promote the mental health of educators. This salutogenic perspective, which focuses on strengthening resources and promoting health, provides an important approach to improving the working conditions of educators. Aim The aim of the study is to obtain a detailed overview of the social resources of the respondents to gain a deeper understanding of the factors that influence the mental health of educators. Methods A qualitative study was used to conduct 10 guided interviews with educators. The interviews were then analyzed using qualitative content analysis according to Kuckartz and Rädiker [16]. Results A multitude of psychological stressors were identified in the day to day activities of the daycare setting. The most frequently mentioned were staff shortages, challenging children, challenging parents and internal conflicts. Both inside and outside the working environment, educators have a wide range of social resources at their disposal. It should be emphasized that the respondents receive the most social support within their working environment. Colleagues play a particularly important and supportive role for early childhood educators. Conclusion Design potential improvements were identified and recommendations for actions to promote the social resources of educators were derived. These include, for example, regular exchange meetings within the team, promotion of private discussion opportunities among educators and management training for appropriate support in everyday care. PubDate: 2025-03-03
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Abstract: Background As a result of demographic developments the emergency medical service (EMS) is experiencing a significant shortage of skilled workers. This situation leads to bottlenecks and overloads that can impair the quality of public healthcare, while simultaneously increasing the demands on emergency personnel. The aim of this study was to obtain an up to date assessment of the physical and psychological stress and professional commitment of German emergency medical personnel in the context of changing framework conditions. Methods As part of the EMS health study 2023, a nationwide survey was conducted among German emergency services personnel. Questions based on a study by the Bavarian State Office for Health and Food Safety, supplemented by additional stress factors, were used to gather information on stress factors and potential improvement options. Results The study found that over 40% of respondents are considering a career change, primarily due to the working conditions or have already taken concrete steps in this direction. Additionally, the results indicate that employees in emergency services face numerous stress factors, with the highest stress levels being in the organizational area, which affects the process and structure of emergency services. According to the employees’ knowledge, with respect to the existing measures important prevention and intervention measures are lacking in approximately 50% of the facilities. Conclusion The study data reveal a significant potential for optimizing the working conditions of German prehospital emergency medical services and underline the need to implement corresponding measures. PubDate: 2025-02-19
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Abstract: The fields of activity of professional musicians are diverse, ranging from teaching at music schools, conservatories and universities to playing in orchestras, engagements at opera houses and soloist activities. Musicians often begin their careers at an early age and often play music for the rest of their lives. Medical prevention is a key aspect in ensuring a lifelong healthy involvement with music. Preventive occupational healthcare for professional musicians is essential in order to prevent illnesses and occupational diseases. New technologies, such as the use of artificial intelligence (AI) and digital health, are significantly expanding the possibilities for medical prevention and diagnostics. Holistic preventive occupational healthcare takes comprehensive account of the work-related hazards for professional musicians and can be supported in many ways by new technological developments. Digital health applications can motivate musicians to lead a healthy lifestyle, engage in sufficient physical activity and strengthen their individual health. The prevention of chronic diseases has already become a high priority worldwide and musicians can also benefit from new forms of early preventative measures in medicine. Artificial intelligence and innovative analysis tools enrich the dimensions of preventive occupational healthcare. PubDate: 2025-01-15
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Abstract: Aim Overview of the specific hindering and beneficial (working)conditions and factors encountered by employees who work with people with intellectual disabilities and challenging behavior. Methodology Rapid review in May 2023 on the keywords intellectual disability and challenging behavior. Quantitative as well as qualitative studies and expert reports were included, which could be assigned to the main category of employees. The results were extracted using a differentiated categorization system and presented in tabular and graphical form. Results Of the 38 articles included 25 were research-based and 13 were expert-based. Obstacles and facilitating factors are systematically presented with respect to 1) interaction (team, management, users, relatives), 2) working conditions and organization and 3) skills and qualifications of staff. Elements that provide confidence to act, such as the successful relationship and communication between the actors involved (service providers, beneficiaries and relatives) and the health-promoting design of working conditions and processes, were identified as key impact factors. Conclusion The factors identified are related to the job satisfaction, mental health and ability of employees to act and form concrete fields of action for company actors in the areas of management and control, health management and further training. PubDate: 2025-01-14
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Abstract: Introduction Professional musicians, especially string players, are at increased risk of health problems due to the intense and continuous physical strain of practicing, rehearsing and performing for several hours. The stress particularly affects the hand, shoulder and neck areas, although this can vary depending on the type of instrument. The strain can affect both professional and private quality of life. The aim of the study was to investigate the hand-specific and arm-specific stresses on string players. Methods From January 2016 to August 2018 a prospective cross-sectional study was conducted with 60 professional string musicians from 6 German orchestras. The stressors and strains of professional musicians in the string group were assessed using a comprehensive catalogue of questionnaires on sociodemographic data, professional situation, sporting activities as well as general health, health measures, hand strain and hand-specific complaints (Michigan Hand Outcome Questionnaire; MHQ), pain coping (Pain Behavior Questionnaire; FSV), fear-related avoidance behavior (Fear Avoidance Belief Questionnaire; FABQ) were recorded and analyzed according to instrument type. Results The average age of the 60 professional musicians was 43.9 ± 13.1 years. There were 61.7% men in the sample. Chronic tension in the shoulder and neck area was found in 34.8% of violinists, while 52.2% suffered from acute shoulder pain. Of the double bass players one half and one third stated that they suffered from acute or chronic tendonitis (self-diagnosis), respectively. The average total score on the MHQ was 56, indicating moderate hand strain. There were significant differences in complaints between the instrument groups: violinists reported more neck tension and shoulder pain, while double bass players and cellists complained more about problems in their wrists and thumbs. The FABQ results showed that 7 musicians had an increased risk of avoidance chronicity due to pain. Discussion The results underline the significant instrument-specific health risks that professional string musicians are exposed to, particularly in the area of the upper extremities and illustrate the need for compensatory and preventive measures to ensure long-term health and ability to work. More intensive occupational medical care in orchestras could also help to reduce the risk of chronic symptoms and improve the musicians’ quality of life. PubDate: 2025-01-14
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Abstract: Background As a preventive measure, particularly to avoid cardiovascular diseases, medical care was supported in the Medical Support Center (SanUstgZ) in Cochem by introducing a nutritional advice concept. The study aimed to answer the question of how nutritional counseling can be standardized in the German Armed Forces (Bundeswehr) Regional Medical Service (RegSanVers) and how initial insights into preventative medical benefits can be gained. Methods Included in the study were 59 participants (15 female/44 male). A verum group/participation in nutritional advice: 31 (8 female/23 male) and a control group: 28 (7 female/21 male). The variables gender, age, height, weight, waist circumference, waist to height ratio (WHtR) and body mass index (BMI) were collected. The measurement times were the start and end of the nutritional advice (verum group) or comparable periods (control group). Results The WHtR decreased by more than 6% in the verum group over the period of the study and increased by around 0.5% in the control group (p PubDate: 2025-01-08
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Abstract: Introduction A limited number of studies have indicated that individuals with disabilities or health impairments are more prone to musculoskeletal disorders; however, the survey procedure is problematic in this context. Due to the lack of transferability, it was necessary to develop a questionnaire that is adapted to the needs of employees with disabilities (e.g., who work in inclusive companies) and people with a low level of education or poor knowledge of German, using easy to read language and supportive communication. The objective of this questionnaire is to record any subjective complaints in the musculoskeletal system as well as the causes and resulting work impairment. Methods The German version of the Nordic Musculoskeletal Questionnaire from the Federal Institute for Occupational Safety and Health (BAuA) was employed as a template for the questionnaire on subjective musculoskeletal complaints in people with disabilities. Additionally, elements from the German Pain Questionnaire and the Multidimensional Pain Questionnaire in Professional Dance were incorporated. The new questionnaire was developed following a cognitive interview with five respondents with mental disabilities. The following cognitive techniques were employed. In order to elicit the desired responses, respondents were asked to demonstrate an understanding of the questions, to provide information that was relevant to the topic under discussion, and to employ a sorting technique. Results The German version of the Nordic Musculoskeletal Questionnaire was translated into easy to read language and adapted by enlarging the illustrations and labelling the front and back of the people depicted. In addition, an explanatory sentence was added to all illustrations. Furthermore, questions on the duration, cause and handling of complaints at work from the German Pain Questionnaire and the Multidimensional Pain Questionnaire in Professional Dance were used and shortened by reducing the number of possible answers. Discussion The questionnaire was adapted to the needs of people with disabilities (including employees in inclusion companies) or people with a low level of education or poor knowledge of German. As the variety of disabilities and the degrees vary among employees with disabilities, the general applicability of the questionnaire is therefore limited; however, the knowledge gained can be used to develop specially adapted health promotion measures and improve health in the long term. PubDate: 2024-12-12
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