Older workers in the construction industry: results of a routine health examination and a five year follow up

OBJECTIVE: To describe the health status of older construction workers and the occurrence of early retirement due to disability or of mortality within a five year follow up. METHODS: Firstly, a cross sectional study was performed among 4958 employees in the German construction industry, aged 40-64 years, who underwent standardised routine occupational health examinations in 1986-8. The study population included plumbers, carpenters, painters/varnishers, plasterers, unskilled workers, and white collar workers (control group). Job specific prevalence and age adjusted relative prevalence were calculated for hearing loss, abnormal findings at lung auscultation, reduced forced expiratory volume, increased diastolic blood pressure, abnormalities in the electrocardiogram, increased body mass index, hypercholesterolaemia, increased liver enzymes, abnormal findings in an examination of the musculoskeletal system, and abnormalities of the skin. Secondly, follow up for disability and all cause mortality was ascertained between 1992 and 1994 (mean follow up period = 4.5 y). Job specific crude rates were calculated for the occurrence of early retirement due to disability and for all cause mortality. With Cox's proportional hazards model, job specific relative risks, adjusted for age, nationality, and smoking were obtained. RESULTS: Compared with the white collar workers, a higher prevalence of hearing deficiencies, signs of obstructive lung diseases, increased body mass index, and musculoskeletal abnormalities were found among the construction workers at the baseline exam. During the follow up period, 141 men died and 341 men left the labour market due to disability. Compared with white collar workers, the construction workers showed a 3.5 to 8.4-fold increased rate of disability (P < 0.05 for all occupational groups) and a 1.2 to 2.1-fold increased all cause mortality (NS). CONCLUSIONS: This study shows the need and possibilities for further health promotion in workers employed in the construction industry, targeting both work related conditions and personal lifestyle factors. Rehabilitation measures should be enforced to limit the rate of disability among construction workers.     

Do changes in cardiovascular risk factors explain the increasing socioeconomic difference in mortality from ischaemic heart disease in Finland?

STUDY OBJECTIVE: To estimate the extent to which changes in blood pressure, smoking, and serum cholesterol concentration explain the observed increase in socioeconomic differences in mortality from ischaemic heart disease (IHD) in Finland during the past 20 years. DESIGN: Predicted changes in mortality from IHD were calculated using logistic regression models with the risk factor levels assessed by cross sectional population surveys conducted in 1972, 1977, 1982, and 1987. The subjects included white collar and blue collar workers and farmers. The predicted changes were compared with the observed mortality changes in the same socioeconomic groups in the total population of the same geographical area. SETTING: North Karelia and Kuopio provinces, eastern Finland. PARTICIPANTS: 16,741 men and 16,389 women aged 30-59 randomly drawn from the population registers of the study areas. Mortality data were obtained from the total population in the same areas. MAIN RESULTS: In men, the changes in diastolic blood pressure, total serum cholesterol, and smoking predicted a 28% decline in the mortality from IHD among white collar workers, a 30% decline among blue collar workers, and a 33% decline in farmers. Observed declines in the same socioeconomic groups were 61%, 40%, and 37%, respectively. In women, the predicted decline was 41% among white collar workers, 35% among blue collar workers, and 39% among farmers. The respective observed declines were 57%, 43%, and 20%. CONCLUSIONS: Less than half of the decline in IHD mortality among white collar men was explained by the risk factor changes, while they explained 75% of the decline among blue collar men and 89% of the decline among male farmers. Changes in risk factors did not explain the increasing difference in IHD mortality between the socioeconomic groups, especially among men.     

Comparison of cardiovascular risk profile between male employees of two automotives companies in France and Sweden. The Coeur Project Group

To determine whether or not the lower rate of coronary disease in France, in comparison with Sweden, might be explained by different cardiovascular risk profiles, a cross-sectional analysis (first step of a longitudinal study) of comparable samples of automotive workers was carried out in corporate occupational health clinics of Renault and Volvo. Traditional cardiovascular risk factors were evaluated and the Framingham coronary risk was estimated for 1000 randomly selected 45-50 years old Caucasian males from each company. Compared with the Frenchmen, the Swedish men consisted of more white collar workers and were slightly older. After adjustment for age and blue/white collar status, the Swedish men showed lower body mass indexes, waist to hip rations and heart rates, lower frequency of treatment of hypercholesterolemia and diabetes than the Frenchmen. The Swedish males also exhibited higher averages of blood cholesterol, low density lipoprotein (LDL) cholesterol and glucose, but lower frequencies of hypercholestrolemia and diabetes, and a higher frequency of family histories of cardiovascular disease. Blood pressure, hypertension prevalence, triglycerides level, and high density lipoprotein (HDL) did not differ between the groups. The average number of traditional risk factors was 1.1/person for the Frenchmen and 0.8/person for the Swedes. However, the coronary risk as estimated using the Framingham index was not different between the groups. This, together with the more frequent family history of cardiovascular disease in Swedish men, suggests a lower susceptibility to risk factors as a possible explanation for the lower cardiovascular disease prevalence reported in France, and/or the possibility that factors not measured were involved.     

Sonographic finding of undescended testes in fetuses at 35-40 weeks: significance and outcome

This paper studies the prevalence of risk factors considered responsible for osteoporosis in women of 4 occupational groups: farmers, blue collar workers, white collar workers/civil servants and housewives. We analyzed nutritional factors associated with osteoporosis in the scientific literature. The total sample comprises of 2185 individuals of which 658 women were taken into the analyses. The data set was based on a health survey conducted in 10 selected rural communities of Styria in Austria between 1995 and 1996. Sociodemographic data, lifestyles, internal and external resources as well as indicators off ill-health were surveyed through standardized personal interviews. The results show that the women of the 4 occupational groups were differently strained regarding nutritional risk factors. Our results suggest that efficient intervention programs to prevent osteoporosis need to specifically focus on the various life contexts of women.     

Gendered Work Conditions, Health, and Work Outcomes.

This cross-sectional study of nonfaculty university employees examined associations among gendered work conditions (e.g., sexism and discrimination), job demands, and employee job satisfaction and health. Organizational responsiveness and social support were examined as effect modifiers. Comparisons were made by gender and by the male-female ratio in each job category. The relationship of gendered conditions of work to outcomes differed on the basis of respondents' sex and the job sex ratio. Although the same predictors were hypothesized for job satisfaction, physical health, and psychological distress, there were some differing results. The strongest correlate of job satisfaction was social support; perceived sexism in the workplace also contributed for both men and women. Organizational factors associated with psychological distress differed between female- and male-dominated jobs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Habitual physical activity in a population residing in the city of Barcelona

OBJECTIVES: To describe the sociodemographic distribution of habitual physical activity and to analyse its relationship with self-perceived health status and occupational status, among the population older that 16 years of age in the city of Barcelona, Spain. METHODS: A sample of 1,885 adult men and 2,196 women answered the Health Interview Survey of Barcelona in 1992. Those whose habitual activity required high physical exertion or walking were considered as active. Bivariate and multivariate analyses adjusting logistic regression models were used to study the relationship between habitual physical activity and the rest of variables, for each occupational situation. RESULTS: Fifty six percent of adults reported being physically active. Physical activity was lower among workers than non workers, although workers reported more physical exertion (14.5% in men and 8.0% in women). Physical activity was associated with occupation and educational level among male workers, but only with occupation among female workers. In the non working population, physical activity was lower among those who perceived their health status as fair or poor, compared with those that described it as good or very good, (ORa in men was 0.2, 95% confidence interval = 0.1-0.5; ORa in women was 0.5, 95% confidence interval = 0.3-0.8). CONCLUSIONS: More than half of the Barcelona population were physically active in an habitual manner. Among workers, this activity was mainly determined by the occupation. Non-workers with a poor self-perceived health status did less physical activity.     

Job characteristics and the incidence of myocardial infarction

In Sweden, there are large differences in the incidence of myocardial infarction (MI) among occupational groups. These differences may to some extent be due to work environment factors, including psychosocial job strain. The aim of the present study was to estimate the relative risk (RR) of MI for Swedish men and women in high strain occupations as compared to those in low strain occupations. The association between job strain and MI was studied by case-control methods. The study base comprised the population of four Swedish counties from 1976-1981 and of Stockholm county from 1976-1984. Incident cases of MI were identified through hospital discharges together with deaths. Information about occupation was obtained from the 1970 and the 1975 censuses and individuals were characterized with regard to job strain on the basis of their job title. In all, 9295 cases and 26 101 controls with unchanged type of occupation from 1970 to 1975 were included in the analyses. Men and women aged < 65 in high strain occupations showed an RR of 1.1-1.4, and men age < 55 an RR of 1.2-1.6 compared to those in low strain occupations. Similar results were obtained in analyses of male white and blue collar workers respectively. If the association between job strain and MI is causal this could be of great importance in explaining differences in MI incidence among occupational groups in Sweden.     

Burnout as a clinical entity--its importance in health care workers

Burnout, viewed as the exhaustion of physical or emotional strength as a result of prolonged stress or frustration, was added to the mental health lexicon in the 1970s, and has been detected in a wide variety of health care providers. A study of 600 American workers indicated that burnout resulted in lowered production, and increases in absenteeism, health care costs, and personnel turnover. Many employees are vulnerable, particularly as the American job scene changes through industrial downsizing, corporate buyouts and mergers, and lengthened work time. Burnout produces both physical and behavioural changes, in some instances leading to chemical abuse. The health professionals at risk include physicians, nurses, social workers, dentists, care providers in oncology and AIDS-patient care personnel, emergency service staff members, mental health workers, and speech and language pathologists, among others. Early identification of this emotional slippage is needed to prevent the depersonalization of the provider-patient relationship. Prevention and treatment are essentially parallel efforts, including greater job control by the individual worker, group meetings, better up-and-down communication, more recognition of individual worth, job redesign, flexible work hours, full orientation to job requirements, available employee assistance programmes, and adjuvant activity. Burnout is a health care professional's occupational disease which must be recognized early and treated.     

Retinoic acid syndrome: a case report

The objective of this study was to investigate the impact of allergy to hymenoptera venom on the occupational activities of patients undergoing immunologic treatment for insect sting anaphylaxis. The design was a cross-sectional study conducted in a sample of 500 out of 1,500 patients undergoing venom immunotherapy for insect sting reaction in 13 allergy clinics in Israel. A self-administered questionnaire was used to collect data about demographic characteristics of patients, severity of the allergic reaction and adverse effects on occupational activities. Of the 204 respondents who were part of the labour force, 48.5% reported adverse effects on routine occupational activities. The factors with a significant influence on the probability of adverse occupational effects were: (1) patient's type of work (blue collar vs. white collar: OR = 3.22, p < 0.001: army vs. white collar: OR = 5.28, p = 0.001); (2) severity of the allergic reaction (severe reaction vs. mild/moderate reaction: OR = 2.34, p = 0.007). Our findings suggest that severe insect sting allergy has an adverse impact on patients' occupational activities. This factor requires special attention by the medical community. Social workers and occupational physicians should collaborate in the assessment and management of these patients.     

The Disability Rating Index: an instrument for the assessment of disability in clinical settings

The purpose of this study was to evaluate an instrument for assessment of physical disability, mainly intended for clinical settings, the Disability Rating Index (DRI). Healthy persons (n = 1092), both white and blue collar workers, and patients (n = 366) with different levels of physical capacity, were assessed. Most of the patients (n = 303) underwent rehabilitation programmes for neck/shoulder/low-back pain but some (n = 47) were arthritis patients waiting for hip or knee replacement surgery, or wheelchair patients with multiple sclerosis (n = 16). The reliability was investigated by test-retest studies, intra- and inter-rater and internal consistency studies. Five construct validity tests were carried out: a discrimination study; a converging validity test; a test for sensitivity to small alterations in health status; and two correlational validity tests. Correlation of the self-reported DRI to the actual performance in similar activities was carried out. Responsiveness was tested by correlation of the DRI before/after replacement surgery for arthritis. The test-retest correlations were 0.83-0.95 in the studies, including correlation of different versions. The intra- and inter-rater reproducibility was 0.98 and 0.99 respectively. The Kruskal-Wallis test in the discrimination study yielded p < 0.0001. More than 90% of the respondents completed the questionnaire correctly. Correlation of the DRI to the Functional Status Questionnaire was 0.46. The responsiveness was excellent, p = 0.0001. The DRI proved to be a robust, practical clinical and research instrument with good responsiveness and acceptability for assessment of disability caused by impairment of common motor functions.     

Stable predictors of job satisfaction, psychological strain, and employee retention: An evaluation of organizational change within the New Zealand Customs Service.

Recent changes in employment conditions have resulted in the increased exposure of workers to unfavorable job characteristics and to consequential increases in adverse individual and organizational health outcomes. In this article the authors evaluate the steps undertaken by one proactive employer to reduce these adverse outcomes. Three organization-wide surveys (n = 350, 316, and 405) were conducted over a 3-year period within the New Zealand Customs Service to determine the influence of perceived job conditions on individual and organizational health outcomes. Staff retention and employee satisfaction significantly improved over time and these increases were attributable to workplace improvements. Stable predictors of job satisfaction included minor daily stressors, positive work experiences, job control, and perceived supervisor support. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patterns of tobacco smoking in Australia. 2

Australian smoking patterns have been surveyed in 1974 and 1976. There appears to be a slight downward trend in male smoking and a slight increase in female smoking. Smoking is more prevalent in the cities than in the country, and among blue collar workers than among white collar workers. Usage of "low tar" cigarettes is also increasing.     

Theories of job stress and the role of traditional values: A longitudinal study in China.

This study examines how traditionality influences the relationships between job stressors and health. A sample of 496 Chinese employees provided longitudinal questionnaire data, and their health was assessed by collecting blood samples and monitoring blood pressure. The results indicated that the positive relationship between job control and health was stronger among the less traditional workers, whereas the positive relationship between distributive justice and health was stronger among the more traditional workers. Furthermore, traditionality moderated the interactive effects of job demands and perceived control/justice on health. Perceiving higher control mitigated the effects of job demands on upper respiratory infections among low traditionalists, but it exacerbated the effects among the high traditionalists. Perceptions of higher justice mitigated the effects of job demands on emotional exhaustion and immunoglobulin A for high traditionalists but not for low traditionalists. These results suggest that, in the relationship between job demands and psychological and physiological health, concern for equity is an important moderator for individuals with more traditional values, whereas perceived personal control is salutary for health primarily among people with less traditional values. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Collective efficacy versus self-efficacy in coping responses to stressors and control: A cross-cultural study.

This study examined how cultural differences and efficacy perceptions influence the role of job control in coping with job demands. Perceiving higher control mitigated the effects of demands on psychological health symptoms and turnover intentions only among American bank tellers reporting high job self-efficacy. Among American tellers reporting low job self-efficacy, perceived control exacerbated the effects of demands. However, in a matched Hong Kong sample, collective efficacy interacted in the same way with control and demands as job self-efficacy had in the American sample. These differences appear to be explained by the individual attributes of idiocentrism and allocentrism that are linked to the societal norms of individualism and collectivism, respectively. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Job strain, social support and mental health: a study on the male heavy manufacturing workers

OBJECT: The aim of this study is to explore the influence of work experience on workers' psychological function. Specifically, the researchers will examine the effect of job demand, decision latitude, job strain, and social support at worksite on the mental health status of male heavy manufacturing workers. METHOD: By purposive sampling, from October 1994 to March 1995, the present investigators implemented a self-administered questionnaire survey on the workers in southern Taiwan. The Karasek job strain model and its measure were embedded in the questionnaire to evaluate workers' perceptions of their job conditions. In addition, Chinese Health Questionnaire (CHQ) was utilized to evaluate the workers' status of mental health. RESULT: Totally, 1,117 workers were selected for this survey. An unviriate analysis showed the younger the workers, the lower their monthly income, and the newer their employment, were more likely to be classified as high risk in mental health status. The workers with more decision latitude and higher social support would be better in mental health status. In addition, it also showed that workers under high job strain were more likely to be in poor mental health status. Result from multivariate logistic regression showed those who served longer, had more decision automony, and had higher social support, were less likely to be in poor mental health status. Instead, those who sustained high job strain were more likely to be in poor mental health status. DISCUSSION: The implication from those findings for the implementation of health promotion program. would be raised, and the limitation of this inference would also be discussed.     

Workers' perceptions of how jobs affect health: A social ecological perspective.

A national sample of 2,048 workers was asked to rate the impact of their job on their physical and mental health. Ordered logistic regression analyses based on social ecology theory showed that the workers' responses were significantly correlated with objective and subjective features of their jobs, in addition to personality characteristics. Workers who had higher levels of perceived constraints and neuroticism, worked nights or overtime, or reported serious ongoing stress at work or higher job pressure reported more negative effects. Respondents who had a higher level of extraversion, were self-employed, or worked part time or reported greater decision latitude or use of skills on the job reported more positive effects. These findings suggest that malleable features of the work environment are associated with perceived effects of work on health, even after controlling for personality traits and other sources of reporting bias. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Motivational Implications of Construction Work

A survey was conducted of unionized construction workers in a major midwestern city to collect data on their perceptions of the jobs and environment within which they perform their jobs. Construction workers have growth needs that are similar in strength to other blue collar workers. The individuals with stronger needs should respond to jobs that are high in motivating potential. Contractors need to improve worker satisfation with job context. The qualifications of the workers appears to be more than adequate for the great majority of construction tasks. Contractors need to structure jobs to improve their motivating potential. As currently structured, construction jobs are low in motivating potential.     

Psychosocial safety climate: Development of the PSC-12.

Psychosocial risks in the workplace have the potential for causing psychological and social harm that contributes toward the mental health disability burden. Psychosocial risks are influenced by macrolevel factors such as the psychosocial safety climate within the organization. This paper concerns the development and evaluation of a short instrument to measure psychosocial safety climate (PSC). PSC is conceived as an up-stream resource, and concerns senior management values and attitudes toward care and practices in relation to employee psychosocial well being. In a pilot sample (N = 78) we used an iterative procedure incorporating regression analysis to reduce 26 items down to a parsimonious 12 item, four-factor scale (PSC-12). The PSC-12 was then assessed using confirmatory factor analysis and the scale validated in a second representative sample of Australian workers (N = 398). The PSC-12 showed expected relationships with psychosocial risk factors (e.g., job demands, job resources), worker engagement and health, and work related outcomes (e.g., job satisfaction). We further confirmed the invariance of the factor coefficients and factor covariance across the two multioccupational samples using multigroup analysis. In a third organizational study (N = 16 teams, 106 health care workers) we found that PSC showed group like psychometric properties, and team level PSC was associated with individual level psychological distress and work engagement. PSC showed incremental value beyond a physical safety measure. The results provide initial indications that the PSC-12 can be used across a range of occupations, and within organizations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Localization of heparin binding activity in recombinant laminin G domain

BACKGROUND: Smoking regulations at the workplace have been found to be acceptable and effective in many studies conducted in the United States. There is limited knowledge, however, on acceptance and effects of smoking regulations in European countries, particularly among blue collar employees. METHODS: We conducted a survey on smoking behaviour and attitude toward smoking regulations and passive smoking in a South German metal company. A self-administered questionnaire was mailed to 1,500 predominantly blue collar employees of whom 974 participated in the study (response rate 64.9%). RESULTS: About 30% of the employees were not allowed to smoke at their immediate work area. Among them, about 95% of both smokers and nonsmokers agreed with this smoking policy. More than 60% of nonsmoking blue collar workers were bothered by passive smoking at work whether or not smoking was allowed at their immediate work area. In contrast, the proportion of nonsmoking white collar employees who were bothered by passive smoking varied from 52% if smoking was allowed at their immediate work area to 18% if smoking was not allowed. Prevalence of active smoking and average amount of smoking among active smokers were considerably lower among employees who were not allowed to smoke at work than among other employees. These differences were partly due to confounding by occupation, however, which was strongly related to both smoking habits and smoking policy. CONCLUSIONS: Our results, which confirm and extend previous findings, give further support to the acceptability and potential effectiveness of smoking regulations at the workplace. Particular efforts should be devoted to limit both active and passive smoking among blue collar employees.