The aim of the study is to examine the risk of sickness absence in public sector employees with allergic rhinitis or asthma or both conditions combined. This is a prospective cohort study of 48,296 Finnish public sector employees. Data from self-reported rhinitis and asthma were obtained from survey responses given during either the 2000-2002 or 2004 periods. Follow-up data on sickness absences for the public sector employees surveyed were acquired from records kept by the employers. During the follow-up, mean sick leave days per year for respondents were 17.6 days for rhinitis alone, 23.8 days for asthma alone and 24.2 days for both conditions combined. Respondents with neither condition were absent for a mean of 14.5 days annually. The impact of asthma and rhinitis combined on the risk of sick leave days was marginal compared to asthma alone (RR 1.1; 95% CI 1.0-1.3). In the subgroup analysis (those with current asthma or allergy medication), the risk ratio for medically certified sickness absence (>3 days) was 2.0 (95% CI 1.9-2.2) for those with asthma and rhinitis combined. Rhinitis, asthma and both these conditions combined increased the risk of days off work.
This study examined changes in sleep during the transition from full-time work to statutory retirement. Both the prevalence of any sleep difficulty and the prevalence of specific sleep difficulties, such as difficulties falling asleep, difficulties maintaining sleep, waking up too early in the morning, and nonrestorative sleep, were examined.
Data from the Finnish Public Sector study were used. The study population consisted of 5,807 Finnish public sector employees who retired on statutory basis between 2000 and 2011. The participants responded on the Jenkins Sleep Problem Scale Questionnaire before and after retirement in surveys conducted every 4 years.
At the last study wave before retirement, 30% of the participants had sleep difficulties. Prevalence of any sleep difficulty decreased during the retirement transition: the risk ratio (RR) for having sleep difficulties in the first study wave following retirement compared with the last study wave preceding retirement was 0.89 (95% confidence interval [CI] 0.85-0.94). During the retirement transition, both waking up too early in the morning (RR = 0.76, 95% CI 0.69-0.82) and nonrestorative sleep (RR = 0.47, 95% CI 0.42-0.53) decreased, whereas there was no change in difficulties falling asleep or difficulties maintaining sleep. The decreases in sleep difficulties occurred primarily among those with psychological distress, suboptimal self-rated health, short sleep duration, and job strain before retirement.
These longitudinal data suggest that transition to statutory retirement is associated with a decrease in sleep difficulties, especially waking up too early in the morning and nonrestorative sleep.
This study compared parental smoking with school personnel smoking in relation to adolescents' smoking behaviours, alcohol use, and illicit drug use.
A cross-sectional survey for 24,379 adolescents was linked to a survey for 1946 school employees in 136 Finnish schools in 2004-2005. Surveys included smoking prevalence reported by school staff, adolescents' reports of school staff and parental smoking, adolescents' own smoking behaviours, alcohol use, and illicit drug use. Multilevel analyses were adjusted for individual and school-level confounding factors.
Parental smoking was associated with all health risk behaviours among both sexes (risk range 1.39 to 1.95 for other outcomes; Odds Ratio OR for smoking cessation 0.64, 95% Confidence Interval CI: 0.57, 0.72 among boys, 0.72; 0.64, 0.81 among girls). Among boys, high vs. low smoking prevalence among school personnel was associated with higher probability of smoking (OR 1.19; 95% CI 1.01,1.41), higher frequency of smoking during school time (Cumulative Odds Ratio COR 1.81; 95% CI 1.32, 2.48), frequent alcohol use (OR 1.23; 95% CI 1.01, 1.50), illicit drug use (OR 1.40; 95% CI 1.16, 1.69), and higher odds of reporting adults smoking at school (COR 1.51; 95% CI 1.09, 2.09). Among girls, high smoking prevalence among school personnel was related to higher odds of smoking (OR 1.18; 95% CI 1.02, 1.37) and lower odds of smoking cessation (OR 0.84; 95% CI 0.72, 0.99).
Parental smoking and school personnel smoking are both associated with adolescents' health risk behaviours but the association of parental smoking seems to be stronger.
Cites: Cent Eur J Public Health. 2002 Sep;10(3):79-8712298346
The aim of this study was to examine the co-occurrence of obesity and sleep problems among employees and workplaces.
We obtained data from 39 873 men and women working in 3040 workplaces in 2000-2002 (the Finnish Public Sector Study). Individual- and workplace-level characteristics were considered as correlates of obesity and sleep problems, which were modelled simultaneously using a multivariate, multilevel approach.
Of the participants, 11% were obese and 23% reported sleep problems. We found a correlation between obesity and sleep problems at both the individual [correlation coefficient 0.048, covariance 0.047, standard error (SE) 0.005) and workplace (correlation coefficient 0.619, covariance 0.068, SE 0.011) level. The latter, but not the former, correlation remained after adjustment for individual- and workplace-level confounders, such as age, sex, socioeconomic status, shift work, alcohol consumption, job strain, and proportion of temporary employees and manual workers at the workplace.
Obese employees and those with sleep problems tend to cluster in the same workplaces, suggesting that, in addition to targeting individuals at risk, interventions to reduce obesity and sleep problems might benefit from identifying "risky" workplaces.
Social determinants of sleep may prove to be as important as health status. In this study we examined the extent to which persistent and changing economic difficulties are associated with sleep problems in two prospective occupational cohorts.
We used data from Finnish (baseline 2000-2002; follow-up 2007; n=6328) and British (baseline 1997-1999; follow-up 2003-2004; n=5002) public sector employees. Economic difficulties, sleep problems, and a variety of covariates were assessed at baseline and follow-up.
Prevalence of frequent sleep problems at follow-up was 27% and 20% among women and men in the Finnish cohort, and 34% and 27% in the British cohort, respectively. Odds for sleep problems were higher among those with persistent economic difficulties (frequent economic difficulties at baseline and follow-up) compared to those with no difficulties. This association remained after multiple adjustments, including parental and current socioeconomic position, in the Finnish (OR 1.72, 95% CI 1.35-2.18) cohort. Increases in economic difficulties were similarly associated with sleep problems in the Finnish and the British cohort.
Evidence from two occupational cohorts suggests strong associations between economic difficulty and poor sleep. Awareness of this association will help health care professionals identify and prevent sleep problems.
Cites: Int J Epidemiol. 2009 Jun;38(3):831-719264846
Cites: J Epidemiol Community Health. 2009 Jun;63(6):439-4619221110
To evaluate the effect of a 4-week primary prevention programme on health-risk behaviours amongst employees at increased risk of work incapacity.
Based on survey data and health records from 53,416 public sector employees in Finland, we identified 872 employees who participated in early rehabilitation after the baseline survey. We selected 2,440 propensity-score-matched controls for these rehabilitants. Changes in the prevalence of physical inactivity, obesity, heavy drinking, and smoking, as well as in the intensity of leisure-time physical activity, weight, and alcohol consumption after the intervention were examined between the baseline and two subsequent surveys representing short-term (mean follow-up 1.7 years) and long-term (mean 5.8 years) follow-ups.
There were no statistically significant differences between the rehabilitants and controls in terms of changes in weight, alcohol consumption, intensity of leisure-time physical activity, or prevalence of obesity, heavy drinking and physical inactivity during short-term or long-term follow-ups. During short-term follow-up, a higher rate of smoking cessation was observed for rehabilitants than controls (31.7% vs. 20.2%, p?=?0.037).
Vocationally oriented multidisciplinary early rehabilitation had little effect on health risk behaviours.
To study participation in occupational and individual-focused interventions in relation to burnout.
We used data from a questionnaire, structured interview, national register of psychopharmacological prescriptions, and the Composite International Diagnostic Interview in a nationally representative Finnish sample of 3276 employees (30 to 64 years).
When compared with employees free of burnout, the odds ratio of severe burnout for participation in occupational interventions was 0.41 (95% confidence interval [CI] = 0.26 to 0.65) and in individual-focused interventions 5.36 (95% CI = 3.14 to 9.17). Antidepressant prescriptions were 2.53 (95% CI = 1.04 to 6.15) times more common among those with severe burnout than among those without burnout after adjustment for depressive and anxiety disorders.
Employees with burnout were less often targets of occupational interventions but participated more in individual-focused interventions when compared with other employees. The use of antidepressants among employees with severe burnout was not fully explained by coexisting depressive or anxiety disorders.
Whether low occupational class amplifies the risk of disability retirement among employees with cardiovascular disease (CVD) is unknown. We examined this issue in two prospective cohort studies.
In the Finnish Public Sector Study and the Helsinki Health Study (n=50.799 employees), prevalent CVD (coronary heart disease or stroke, n=1269) was ascertained using records from national health registers, self-reported doctor-diagnosed diseases, and Rose Angina Questionnaire. Data linkage to national pension registers allowed the follow up of disability retirement among the participants for a mean of six years. We analysed the associations of occupational class and CVD with disability retirement using Cox regression, tested interactions between occupational class and prevalent CVD in predicting disability retirement by calculating the Synergy Index, and pooled the results from the two studies using fixed-effect meta-analysis.
Compared with the participants from high occupational class and no CVD, the participants from the low occupational class without CVD had a 2.13-fold (95% CI 1.97-2.30), those with high occupational class and CVD a 2.18-fold (1.73-2.74); and those with both low occupational class and CVD a 4.49-fold (3.83-5.26) risk of disability retirement. A Synergy Index of 1.55 (1.16-2.06) suggested a greater than additive effect for low occupational class and CVD in combination.
Individuals with both low occupational class and CVD are at a particularly high risk of premature exit from the labour market due to work disability. These findings suggest that better preventive strategies are needed to improve prognosis in this risk group.
To investigate whether low perceived organisational injustice predicts heavy drinking among employees.
Data from a prospective occupational cohort study, the 10-Town Study, on 15 290 Finnish public sector local government employees nested in 2432 work units, were used. Non-drinkers were excluded. Procedural, interactional and total organisational justice, heavy drinking (>/=210 g of absolute alcohol per week) and other psychosocial factors were determined by means of questionnaire in 2000-2001 (phase 1) and 2004 (phase 2). Multilevel logistic regression analyses taking into account the hierarchical structure of the data were conducted and adjustments were made for sex, age, socio-economic status, marital status, baseline heavy drinking, psychological distress and other psychosocial risk factors such as job strain and effort/reward imbalance.
After adjustments, participants who reported low procedural justice at phase 1 were approximately 1.2 times more likely to be heavy drinkers at phase 2 compared with their counterparts reporting high justice. Low perceived justice in interpersonal treatment and low perceived total organisational justice were associated with increased prevalence of heavy drinking only in the model adjusted for sociodemographics.
This is the first longitudinal study to show that low procedural justice is weakly associated with an increased likelihood of heavy drinking.
Occupational burnout is a common problem in working populations, but its association with sickness absence is poorly understood. The contribution of occupational burnout to medically certified sickness absence was examined in a population-based sample of employees.
A representative sample of 3151 Finnish employees aged 30-60 years participated in a comprehensive health study in 2000-2001, including an assessment of physician-diagnosed physical illnesses and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) mental disorders based on the Composite International Diagnostic Interview. Burnout was measured with the Maslach Burnout Inventory-General Survey. Sickness absences longer than 9 days in 2000-2001 were extracted from a register of the Social Insurance Institution of Finland.
The occurrence of medically certified sickness absence was more prevalent among employees with burnout than among those without burnout. After adjusting for sociodemographic factors and mental and physical disorders, the odds ratio of sickness absence for severe burnout was 6.9 [95% confidence interval (95% CI)=2.7-17.8] for men and 2.1 (95% CI=1.1-4.0) for women. Among employees with mental or physical disorders, severe burnout was associated with a 7.7-fold risk of sickness absence among men and with a 2.6-fold risk among women. The duration of absence was related to burnout among men with absences, for whom severe burnout accounted for 52 excess sickness absence days during the 2-year period after adjusting for sociodemographic factors, mental disorders, and physical illnesses.
Severe burnout is associated with a substantial excess risk of medically certified sickness absence among both men and women. This association is independent of prevalent mental disorders and physical illnesses.