The purpose of the study was to find out whether there is an association between use of enzyme-inducing antiepileptic medicines and cancer.
: A cohort of 14,487 male and 13,932 female patients who received reimbursement for antiepileptic drugs (AEDs) in 1979-1981 in Finland was followed for subsequent cancers up to 1997 through the Finnish Cancer Registry.
During the follow-up, 2242 cancer cases were observed, while the expected number based on national incidence rates was 1743. Over 40% of the excess was attributable to cancer of the brain and nervous system [standardised incidence ratio (SIR) 4.30, 95% confidence interval (CI) 3.81, 4.82]. The relative risk of meningiomas was very high (SIR 46.6, 95% CI 22.3, 85.6) only during the first year of reimbursement, while the risk of gliomas remained tenfold or higher for 7 years and was significantly increased for 19 years in patients taking AEDs. Also cancers of the larynx (SIR 1.77), liver (1.71), pancreas (1.35), colon (1.32), stomach (1.30) and lung (1.29) showed statistically increased risks.
As epilepsy can be a symptom of cancers of the nervous system, the role of AEDs in their occurrence is speculative albeit possible. The excess of some cancers might be attributable to enzyme-inducing antiepileptic drugs, but the excess is not very high compared with the benefits obtained with these drugs.
The aim of this study was to determine how employee well-being, psychosocial factors at work, leadership and perceived occupational health services predict entering rehabilitation as modelled in the Job Well-being Pyramid.
A random population of 967 civil servants participated in a survey on psychosocial factors and health at work in 2000 in Finland. A total of 147 employees entered rehabilitation during the median follow-up time of 7 years.
Permanent employment, large organizations, feedback from supervisors, client violence and physically monotonous work were associated with an increased rate of entering rehabilitation, whereas physical jobs, clear aims, high appreciation, job satisfaction and job enjoyment were associated with a decreased rate of entering rehabilitation. Employee well-being in general was also associated with entering rehabilitation, and this was decreased by good work ability, good health, mental well-being and physical fitness and increased by constant musculoskeletal symptoms. On the other hand, support from supervisors, job control, work pressure, team climate at work, communication, bullying and discrimination, physical work environment, and sense of coherence appeared to have no association.
Various psychosocial factors at work and job well-being predict entering rehabilitation. The association between employee health and entering rehabilitation refers to the fact that the selection process for rehabilitation works reasonably well and those in need of rehabilitation are also granted it. In general, these findings coincide well with the Job Well-being Pyramid model. Improving job conditions and well-being at work is likely to decrease the need for rehabilitation.
To study the association between employee well-being and sick leave, occupational accident, and disability pension.
A random population of 967 civil servants participated in a survey on psychosocial factors and health at work in 2000 in Finland. The median follow-up time was 7.3 years.
The risks of sick leave and disability pension were decreased by job satisfaction (RR = 0.78, 95% CI = 0.58 to 1.05; RR = 0.47, CI = 0.20 to 1.06; respectively), good work ability (RR = 0.35, CI = 0.22 to 0.56; RR = 0.11, CI = 0.04 to 0.33), good health (RR = 0.42, CI = 0.27 to 0.64; RR = 0.32, CI = 0.11 to 0.98), and strong sense of coherence (RR = 0.53, CI = 0.36 to 0.79; RR = 0.17, CI = 0.07 to 0.37). Employee well-being was also associated with occupational accident but somewhat less consistently.
Employee well-being is associated with sick leave, occupational accident, and disability pension. It is important to find means to support employee well-being both in general and at work.
Statins (HMG-CoA-reductase inhibitors) are suggested to act as a predisposing factor for autoimmune diseases, have immunomodulatory effects, and possibly prevent some cancer types - the sum of these effects is unknown in cancers of viral aetiology, such as Merkel cell carcinoma (MCC). Aim of our study was to find out whether statin users in Finland have an increased incidence of MCC.
A cohort of 224715 male and 230220 female statin users during 1994-2007 was identified from the Prescription Register of the National Social Insurance Institution. This cohort was followed up through the Finnish Cancer Registry for MCC up to 2009.
There were altogether 50 cases of MCCs, while the expected number of cases, calculated on the basis of the MCC incidence in comparable Finnish population, was 39.9 (SIR 1.25, 95% CI 0.93-1.65). The standardized incidence ratio (SIR) for MCC in ages
To study associations between psychosocial work factors (PWF) and sick leave, occupational accident, and disability pension.
A random population of 967 civil servants participated in a survey on PWF and health. The median follow-up time was 7 years.
Frequent feedback from supervisor, good opportunities for mental growth, good team climate, and high appreciation were associated with a decrease in the risk of sickness absences and shift/period work, monotonous movements, and crowdedness of workplace were associated with an increase in the risk of sickness absences. Good communication at work was associated with a decrease in client violence and high work pressure was associated with an increased risk of occupational accidents. High work control and good team climate were associated with a decreased and shift/period work and client violence was associated with an increased risk of disability pensions.
Psychosocial work factors can predict health outcomes with economic impact.
Purpose: To introduce the Finnish practice of collaboration aiming to enhance work participation, to ask supervisors about its reasons and usefulness, to study supervisors' needs when they face work disability, and to compare the experiences of supervisors whose profiles differ. Materials and methods: An online questionnaire based on the Finnish practice of collaboration between supervisor and occupational health services (OHS) went to supervisors in six public and private organizations. A total of 254 supervisors responded, of whom, 133 (52%) had collaborated in work disability negotiations, representing a wide variety with differing professional profiles. Results: In their role of managing work disability, supervisors appeared to benefit from three factors: an explicit company disability management (DM) policy, supervisors' training in DM, and collaboration with OHS. Reasons for work disability negotiations were long or repeated sick-leaves and reduced work performance. Expectations for occupational health consultations focused on finding vocational solutions and on obtaining information. Supervisors assessed the outcomes of collaboration as both vocational and medical. Supervisors with differing professional profiles prioritized slightly different aspects in collaboration. Conclusions: Collaboration with OHS is an important option for supervisors to enhance work modifications and the work participation of employees with work disability. Implications for Rehabilitation Work disability negotiation between supervisor, employee, and occupational health services (OHS) is an effective method to enhance work participation. Collaboration with occupational health can advance work modifications and also lead to medical procedures to improve work performance. Supervisor training, companies' explicit disability management policy, and collaboration with OHSs all advance employee's work participation. Collaboration with OHSs may serve as training for supervisors in their responsibility to support work participation.