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 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.
Clinical hepatitis B among hospital staff in Sweden was studied in a 15-year follow-up, divided into three periods. During the first 5-year period, 1969-1973, 756 cases of hepatitis B were reported among hospital staff, for an attack rate of 102.0 per 100,000 person-years. In the second five-year period, 1974-1978, the attack rate was 30.4, and in the last five-year period, 1979-1983, it was 10.4. The decrease in incidence between the first period and the second was significant (p less than 0.001), as was the difference between the second period and the last (p less than 0.01). The difference between the incidence in medical personnel and that in the general population of working age in the first period was significant at p less than 0.001 and during the last period it was significant at p less than 0.01. No statistical significance was found during the second period, due to the decrease in incidence for both groups, which made the values too scattered. Traditionally high-risk units, such as renal dialysis units, had only three cases reported in the last 5-year period. An overrepresentation of males among nurses and nursing assistants with acute hepatitis B was found.
We conduced a cross sectional study in the period Gen - Dec 2006 to examine the relationship between acute lumbago in health workers and exposition to a moderate level of exposure index Movement and Assistance of Hospital Patients (MAPO). The study ruled 240 health workers (M: 180; F: 60), the mean age was 44,9 years (range 24 - 64); was evaluated the occurrence of acute lumbago in the last 12 months. The objective of this study was to describe the trends over a specific time of the association between the moderate MAPO index and acute lumbago in this sample of health care workers. The results indicate that healthcare workers exposed to moderate MAPO index appear to incur a greater risk of acute lumbago than general population, but lower than that evidenced by Italian and Sweden authors between nursing staffs. Medical surveillance of exposed workers is confirmed as necessary method of secondary prevention and also it is useful in the diagnosis of worker's susceptibilities.