BACKGROUND: Previous studies of the risk of heart disease after shift work reached different estimates and review authors disagree about the validity of some of the studies. A cross sectional study showed that shift workers had a higher prevalence of nearly every unfavourable work environment factor investigated. Conflicts at work and low decision latitude were more frequent among shift workers, and all-day walking or standing work and part-time jobs were more often found among female shift workers. OBJECTIVES: To estimate the risk of circulatory disease in a prospective follow up of a representative sample of gainfully employed Danes, considering known or suspected confounding factors. METHODS: A cohort of 5517 people who were gainfully employed in 1990 were followed up for all hospital treatments due to circulatory diseases (390-458, ICD-8; I00-I99, ICD-10) from 1991 to 2002 inclusive. A log linear Poisson regression model was applied to control confounding factors and calculate the relative risk for 927 men and women working nights, evenings, or other non-day shifts compared to 4579 day workers. RESULTS: Non-day workers compared to day workers had a relative risk (RR) for all circulatory diseases of 1.31 (95% CI 1.06-1.63). Without control for BMI and smoking, the RR estimate was 1.33 (95% CI 1.07-1.65). For a subgroup of workers with at least three years' seniority, the RR was 1.40 (95% CI 1.09-1.81). The population based aetiological fraction of shift work was estimated to 5%. CONCLUSION: This study adds to a growing body of evidence suggesting that shift work carries an excess risk of circulatory diseases.
The purpose of this study was to describe the rate and distribution of treatment visits provided in an on-site, automotive plant, physiotherapy clinic over a 13-year period.
A retrospective cohort study was conducted using data collected at an on-site physiotherapy clinic (1990-2002, 65,977 visits; n = 2,636 workers).
The average age of workers was 43 +/- 9 years; most remained at work (85%) when treated. Disorders most commonly affected the shoulder, lumbar, and cervical regions; the median number of visits for these was 7, 6, and 5, respectively. Elbow disorders occurred commonly only for work-related complaints and required a median of eight visits. Rate of utilization was higher for women, with 47% of the plant's female workers attending physiotherapy in 1 year. Women had higher rates of cervical spine (12 vs. 22%) and wrist (5 vs. 10%) disorders. The two most common causes of injury reported by workers with an industrial injury were "frank injury arising out of normal employment" (51%) and "gradual onset/no frank injury" (37%). The diagnosis most often reported by the physiotherapist after initial assessment was "strain" which was similar for both industrial (43%) and non-industrial (49%) injuries. The six main departments in this automotive plant account for 93% of all industrial injuries reported. Final Assembly accounted for the largest number and highest rate of injury, although shift variability was noted in utilization rates (13 vs. 26%), despite the same tasks, shift schedules, and demographics. Although there was no control group, the number of visits to discharge was lower than reported in the literature for off-site physical therapy; there was a large reduction in claims (441-275) following introduction of the clinic and reduced duration/costs of lost time were identified by the employer as a rationale to continue and enhance the service over time.
On-site physiotherapy services can provide early, cost-effective management of WRMSD in the automotive sector. Service utilization reflects the influence of gender, job task, and shift-dynamics on rates and location of WRMSD.
OBJECTIVE: To estimate the hazard ratio for disability pension associated with shift work. METHODS: Cohorts of shift and day workers were identified in three waves of the Danish Work Environment Cohort Study and followed up for incidence of disability pension in a national register of social transfer payment. A total of 3980 female and 4025 male employees were included in the cohorts. Information about shift work status, age, smoking habits, body mass index and ergonomic work environment were updated according to responses in subsequent waves of the survey when possible. Respondents reporting shift work were classified as shift workers in the following waves as well. Respondents were followed in the register from the time of first interview and were censored at the time of their 60th birthday, emigration, death or end of follow-up (18 June 2006). The authors used the Cox proportional hazards model to estimate hazard ratios for incidence of disability pension and 95% confidence intervals. RESULTS: The authors observed 253 new disability pensions among women and 173 among men during 56 903 and 57 886 person-years at risk respectively, Among women, shift work predicted disability after adjustment for age, general health and socioeconomic status HR 1.39 (95% CI 1.07 to 1.82). After further adjustment for body mass index, smoking habits, socioeconomic status and ergonomic exposures the association remained statistically significant HR 1.34 (95% CI 1.02 to 1.75). Shift work was not associated with disability among men. CONCLUSION: Shift work might be moderately associated with disability pension among women; however, more powerful studies are needed to establish the possible association.
Sverdlovsk Regional Occupational Center based on the Research Institute has highly qualified staff, incorporates ambulatory department, hospital with modern diagnostic and therapeutic equipment. The Center performs multiple tasks, being an organizational and methodic, diagnostic and occupational examination institution using up-to-date advances in industrial medicine.
The objective of this cross-sectional study was to investigate the prevalence of abdominal symptoms and the abdominal medical history among sewage workers. 142 male sewage workers and 137 male referents in 11 Swedish municipalities were addressed with a questionnaire about abdominal symptoms, medical history, occupational history and life style factors. The sewage workers suffered less from nausea [adjusted odds ratio (adjOR) = 0.18, 95% confidence interval (Cl) 0.04-0.84] than the referents. There was no significant difference in the three months prevalence of diarrhoea (adjOR = 1.7, 95% Cl = 0.79-3.4), dyspepsia (adjOR = 0.85, 95% Cl = 0.49-1.5) or irritable bowel syndrome (adjOR = 1.4, 95% Cl = 0.53-3.5). The sewage workers were affected more often by peptic ulcers during their present jobs than the referents, although the increased risk was not significant (adjOR = 1.4, 95% Cl = 0.31-6.1). The odds ratios were adjusted for age, use of tobacco products and alcohol consumption. The conclusion of this study was that sewage workers are less affected by nausea than comparable referents.
Sick-leave between 1984 and 1989 was higher among both female (n = 515) and male (n = 304) fish-processing workers [observed/expected (O/E) 2.24 and 1.69, respectively] than among non-exposed groups (0.62 and 0.89). Diagnoses in the musculoskeletal system dominated (i.e., neck/upper limbs; females, exposed vs. non-exposed workers: 30 vs. 12%; males: 11 vs. 5.8%). In subjects who left employment, the O/E-ratio decreased (females: 3.02 vs. 1.55; males: 2.40 vs. 1.55). Among those women hired before the start of the observation period, exposed subjects had higher frequencies of sick-leave than non-exposed, for both total illness and musculoskeletal diagnoses. In the men, there were corresponding differences, though not fully statistically significant. Reported occupational diseases [O/E: females: 4.5; (95% confidence interval) CI = 3.2-6.1; males: 2.3; CI = 1.3-3.9] and accidents (females: 4.3; CI = 3.0-5.9; males: 1.8; CI = 1.2-2.7) were also higher in female than in male fish-processing workers, and much higher than in non-exposed workers. In conclusion, work in the fish-processing industry was associated with increased frequencies of sick-leave, especially because of diagnoses of the musculoskeletal system, and occupational disorders and accidents, in particular among female workers.
Are absenteeism indicators usefull as predictor of serious morbidity in a working population? To seek an answer was the objective of a double case-control study carried out in a large company (17000 workers) of Quebec Province. In the first study, 64 cases of myocardial infarction (incidence density = 1.66% +/- 0.35) were compared with 64 controls matched for sex, age and type of work. In the second one, 142 cases of labor accident were compared with 142 controls sampled in a similar way. Absenteeism frequency and length were analysed during the period of 6 to 12 years prior to the onset of the health problem. Ratios were calculated on an individual basis for all causes of absence and for sick leave; they were adjusted for length of service. A four classes interval scale was used for the comparison. An excess of absence length exists in the two studies. The excess is not significant for the myocardial infarction cases (+ 33%, with a statistical power = 51%). It is significant for the labor accident cases (+ 52%, p less than 0.01). The corresponding odds ratio calculated in reference to the lowest absence group were 2.4 (0.9-6.6) and 2.7 (1.5-4.9). The cumulative absence length can be considered as a predictor of serious disease. A conceptual framework of the relationship between absence and natural disease history is presented. The epidemiological approach to the phenomenon of absence is certainly usefull in spite of the controversy underlined by the social sciences.
The article contains results concerning spectral analysis of biologic materials (blood and hair) for heavy metals content. These results helped to reveal health risk factors for workers engaged into chromium ores extraction and for nearby residents.