1. Eur J Public Health. 2009 Oct 22. [Epub ahead of print]

Employment trajectories and changes in sense of coherence.

Liukkonen V, Virtanen P, Vahtera J, Suominen S, Sillanmäki L, Koskenvuo M.

1 Tampere School of Public Health, University of Tampere, Tampere, Finland.

BACKGROUND: Knowledge of the associations between labour market position and
sense of coherence (SOC) comes mainly from cross-sectional studies. We
investigated whether change in employment status is associated with change in SOC
and whether such an association varies when young (<30 years) and older employees
are compared. METHODS: Data were derived from two studies: a cohort of initially 
non-permanent employees (n = 1898) was followed up for four years, and a cohort
representing the national workforce (n = 9623) was followed up for five years.
Labour market position at baseline and at follow-up (permanent/fixed-term
job/unemployed) was used to locate the participants into six or nine different
employment trajectories depending on the cohort. SOC was measured with a 13-item 
questionnaire. Associations of the employment trajectories with changes in SOC
were analysed with general linear models. RESULTS: In both cohorts the change of 
SOC was significantly associated with type of employment trajectory. The results 
supported the hypothesis of more favourable development of SOC among those whose 
trajectories were directed upward: the associations of poor SOC with unemployment
are indisputable, whereas the effects of fixed-term employment seem to be neutral
or even positive. The analysis by age revealed that the effects of employment
trajectory on SOC are particularly strong among individuals aged below 30 years. 
CONCLUSION: This longitudinal study provided evidence for the interpretation that
stabilisation of SOC associates with stabilisation of the labour market position.
Moreover, the fluctuations of SOC seem to depend on the type of trajectory
throughout adult life.

PMID: 19850701 [PubMed - as supplied by publisher]


2. Qual Saf Health Care. 2009 Oct;18(5):336-40.

Estimates of injury risks for healthcare personnel working night shifts and long 
hours.

Dembe AE, Delbos R, Erickson JB.

Center for Health Outcomes, Policy and Evaluation Studies, The Ohio State
University College of Public Health, Columbus, OH 43210, USA. adembe@cph.osu.edu

BACKGROUND: Evidence suggests that working long hours or unconventional shifts
(night, evening and rotating shifts) can induce fatigue and stress in healthcare 
employees that might jeopardise quality of care and patient safety. METHODS: This
study is based on a retrospective analysis of 13 years of occupational data from 
the National Longitudinal Survey of Youth, covering nearly 11,000 American
workers. During the study period, 545 injuries were reported by employees in
healthcare professions. Cox proportional hazard analyses were used to calculate
adjusted hazard ratios comparing the risk of a job-related injury among
healthcare workers in various types of demanding schedules to employees working
conventional schedules. The analyses were stratified to estimate risks within
different occupational classifications and care settings. RESULTS: The greatest
injury risks to healthcare workers were in schedules involving overtime or at
least 60 h per week. Interestingly, an elevated risk of injury was not observed
for healthcare employees working 12 or more hours per day or for those in night, 
evening or rotating shifts. Among employees working overtime and long-hour (>60 h
per week) schedules, those at medical provider offices had a significantly higher
risk of injury (HR 2.86) than at hospitals, rehabilitation clinics or long-term
care facilities. Support personnel, including aids, attendants, technicians,
therapists and dieticians, faced a higher risk of injury than did physicians and 
nurses. CONCLUSION: Healthcare managers responsible for quality improvement and
patient safety programmes should be aware of the possibility for worker fatigue
and injury in particular scheduling arrangements.

PMID: 19812094 [PubMed - in process]


3. Prehosp Disaster Med. 2009 Jul-Aug;24(4):356-9.

Driver-related risk factors in commercial motorcycle (okada) crashes in Benin
City, Nigeria.

Iribhogbe PE, Odai ED.

Department of Surgery, University of Benin Teaching Hospital, Nigeria.
ekalume2002@yahoo.com

INTRODUCTION: There has been global concern regarding road traffic injuries.
Motorcyclists constitute a high proportion of fatalities in road traffic crashes.
Commercial motorcyclists (Okadas) constitute a unique group in this regard. The
purpose of this study was to evaluate driver-related risk factors in Okada
accidents in Benin City, Nigeria. METHODS: This was a prospective study.
Interviewers administered questionnaires which were used to assess Okada drivers 
during a two-month period (November-December 2006). RESULTS: A total of 996 Okada
drivers were interviewed, 995 males and one female. Their ages ranged from 16-80 
years with a mean age of 36.4 +/-2.4 years. In the majority of cases, the maximum
educational level achieved was primary or secondary. The majority of Okada
drivers (82.8%) took to the Okada business as a last resort. Driver's licenses
for Okada operation were possessed by 73.5% of drivers, but only 27.2% had taken 
a road test before being given a license. No form of training on the use of
Okadas was received by 45% of drivers before they commenced operations. Crash
helmets were owned by 56.4%, but they did not use them on a regular basis.
Inconvenience was the reason provided for poor compliance by 52.7% of drivers.
Regular intake of alcohol was present in 39.8% of drivers. CONCLUSIONS: Okada
drivers are mainly young males with a low level of education who are ill-prepared
and ill-equipped for the road. This is a recipe for traffic crash-related
injuries and fatal motorcycle crashes. There is an urgent need for job creation, 
better licensing procedures, road safety education, national legislation, and
enforcement of crash helmet laws as well as alcohol breath tests for Okada
drivers in Nigeria.

PMID: 19806561 [PubMed - indexed for MEDLINE]


4. JAMA. 2009 Sep 23;302(12):1301-8.

Attitudes, training experiences, and professional expectations of US general
surgery residents: a national survey.

Yeo H, Viola K, Berg D, Lin Z, Nunez-Smith M, Cammann C, Bell RH Jr, Sosa JA,
Krumholz HM, Curry LA.

Division of Surgery, Yale University School of Medicine, New Haven, Connecticut, 
USA.

Erratum in:
    JAMA. 2009 Dec 2;302(21):2322.

CONTEXT: General surgery residency programs are facing multiple pressures,
including attracting and retaining residents. Despite the importance of resident 
perspectives in designing effective responses to these pressures, understanding
of residents' views is limited. OBJECTIVE: To profile US general surgery
residents; characterize resident attitudes, experiences, and expectations
regarding training; and examine differences by sex and training year. DESIGN,
SETTING, AND PARTICIPANTS: Cross-sectional study of all general surgery residents
completing a survey in January 2008 following administration of the American
Board of Surgery In-Training Examination. MAIN OUTCOME MEASURES: Resident
satisfaction; perceived supports, strains and concern; career motivations; and
professional expectations. RESULTS: Of 5345 categorical general surgery
residents, 4402 (82.4%) responded, representing 248 of 249 surgical residency
programs. Most respondents expressed satisfaction with training (3686 [85.2%];
95% confidence interval [CI], 84.1%-86.3%) and supportive peer relationships
(3433 [84.2%]; 95% CI, 83.1%-85.3%). However, residents also reported unmet needs
and apprehensions about training and careers. Worry that they will not feel
confident performing procedures independently was reported by 1185 (27.5%; 95%
CI, 26.2%-28.8%), while 2681 (63.8%; 95% CI, 62.4%-65.3%) reported that they must
complete specialty training to be competitive. Perceptions of program support
differ, with men more likely than women to report that their program provides
support (2188 [74.5%] vs 895 [65.6%]; P < .001), and that they can turn to
faculty when having difficulties (2193 [74.5%] vs 901 [66.4%]; P < .001). Reports
of having considered leaving training in the prior year differed significantly
across years (P < .001), highest in postgraduate year 2 (19.2%) and lowest in
postgraduate year 5 (7.2%). CONCLUSIONS: General surgery residents' attitudes,
experiences, and expectations regarding training reflect both high levels of
satisfaction and sources of strain. These factors vary by sex and training year.

PMID: 19773565 [PubMed - indexed for MEDLINE]


5. J Allied Health. 2009 Fall;38(3):e84-91.

Characterizing job satisfaction and intent to leave among nationally registered
emergency medical technicians: an analysis of the 2005 LEADS survey.

Patterson PD, Moore CG, Sanddal ND, Wingrove G, LaCroix B.

Department of Emergency Medicine, University of Pittsburgh School of Medicine,
230 McKee Place, Suite 400, Pittsburgh, PA, USA. pattersond@upmc.edu

The primary purpose of this study was to characterize job satisfaction with
opportunities for advancement, job satisfaction with pay and benefits, and intent
to leave the EMS profession among Nationally Registered EMT-Basics and
EMT-Paramedics. A secondary data analysis was performed on the National Registry 
of EMTs Longitudinal Emergency Medical Technician Attributes and Demographic
Study Project (LEADS) 2005 core survey. We used chi-square and multiple logistic 
regression analyses to test for differences in job satisfaction with
opportunities for advancement, job satisfaction with pay and benefits, and intent
to leave the EMS profession across years of experience and work location. Among
11 measures of job satisfaction, NREMT-Basics and NREMT-Paramedics were least
satisfied with opportunities for advancement and pay and benefits (67.8 and
55.2%, respectively). Nearly 6% of respondents reported intentions of leaving the
profession within 12 months. In univariate analyses, job satisfaction with
advancement opportunities varied across years of experience and work location.
Job satisfaction with pay and benefits varied across years of experience and work
location. The proportion reporting intentions of leaving the profession did not
vary across the two independent variables of interest. In multivariable logistic 
regression, statistical differences observed in univariate analyses were
attenuated to non-significance across all outcome models. Income, personal
health, level of EMS certification, and type of EMS work were significant in
several outcome models. EMS workforce research is at its infancy, thus our study 
adds to a limited but growing body of knowledge. In future and replicated
research, one will need to consider different person and organizational variables
in predicting different measures of job satisfaction among EMS personnel.

PMID: 19753419 [PubMed - indexed for MEDLINE]


6. Radiol Technol. 2009 Sep-Oct;81(1):24-31.

Trends in 3-D CT Postprocessing.

Pierce L, Rosenberg J, Neustel S.

Department of Radiology, Stanford University Palo Alto, California, USA.

PURPOSE: The increasing number of multidetector CT scanners in radiology
departments has intensified demand for 3-D imaging. This study sought to reveal
the frequency and type of postprocessing tasks being performed by computed
tomography (CT) technologists by discussing the longitudinal results of the
American Registry of Radiologic Technologists (ARRT) CT practice analysis surveys
from 1993 to 2007. METHOD: In 1993, 2001 and 2007, the ARRT mailed CT job
analysis surveys to a national randomized sample of 1000 radiologic technologists
per year who were employed full time in CT, for a combined total of 3000. A
usable sample of 1476 responses from the 3 surveys revealed technologists' level 
of responsibility for a variety of CT tasks, including 3-D imaging. RESULTS: The 
proportion of respondents responsible for 3-D imaging increased from 47% in 1993 
to 74% in 2001 and to 82% in 2007 (P< .001). This increase occurred in all
employment settings (P < .001) and department sizes (P < .001), including small
departments. Daily frequency of occurrence grew from 4% in 1993 to 11% in 2001
and 53% in 2007 (P< .001). CONCLUSION: Routine 3-D postprocessing has become
typical practice in radiology CT departments across all employment settings.

PMID: 19738186 [PubMed - indexed for MEDLINE]


7. Scand J Work Environ Health. 2009 Sep;35(5):349-60.

Prospective assessment of neuropsychological functioning and mood in US Army
National Guard personnel deployed as peacekeepers.

Proctor SP, Heaton KJ, Dos Santos KD, Rosenman ES, Heeren T.

Military Performance Division, US Army Research Institute of Environmental
Medicine, Kansas St, Building 42, Natick, MA 01760, United States.
susan.proctor@us.army.mil

OBJECTIVE: The present study examined the impact of deployment on
neuropsychological functioning and mood in Army National Guard personnel. We
hypothesized that deployment on a peacekeeping mission, compared to
non-deployment, would result in reduced proficiencies in neuropsychological
performance and negative mood changes, and that such changes would relate to
working in a high-strain job (high demands/low control), in accordance with
Karasek's demand-control model. METHODS: This prospective cohort study involved
119 male soldiers (67 participants examined before and after deployment to the
Bosnia operational theatre and 52 non-deployed soldiers assessed twice over a
comparable period). RESULTS: Unit-level adjusted, multivariate analyses found
that deployed soldiers, compared to their non-deployed counterparts, demonstrated
reduced proficiency in tasks involving motor speed [unstandardized coefficient B=
-3.88, 95% confidence interval (95% CI) -6.38- -1.39; B= -3.84, 95% CI -5.55-
-2.14; dominant and non-dominant hand, respectively] and sustained attention
(B=0.031, 95% CI 0.009-0.054), along with decreased vigor (B= -2.71, 95% CI
-3.63- -1.77). Deployed soldiers also showed improved proficiency in a
working-memory task (B= -0.098, 95% CI -0.136- -0.060) with less depression
symptomatology (B= -3.19, 95% CI -5.26- -1.13). Work stress levels increased over
time in both deployed and non-deployed groups, but observed deployment effects
remained significant after accounting for a high-strain job. CONCLUSION: The
observed change in performance associated with peacekeeping deployment compared
to non-deployment (slowed processing speed, reduced motor speed and reported
vigor, together with improved proficiency in a working memory task) suggests an
adaptive response to mission occupational stressors. This pattern does not appear
to be influenced by working in a high-strain job. Further study is required to
examine whether these results reflect transient or permanent changes in
functioning.

PMID: 19730757 [PubMed - indexed for MEDLINE]


8. Am J Public Health. 2009 Oct;99(10):1826-32. Epub 2009 Aug 20.

The influence of past unemployment duration on symptoms of depression among young
women and men in the United States.

Mossakowski KN.

Department of Sociology, University of Miami, 5202 University Drive, Coral
Gables, FL 33146, USA. krysia@miami.edu

OBJECTIVES: I examined whether unemployment while looking for a job and being out
of the labor force while not seeking work have distinct effects on symptoms of
depression among young women and men in the United States. I also investigated
whether past unemployment duration predicts depressive symptoms. METHODS: I used 
ordinary least squares regression to analyze data from the 1979-1994 National
Longitudinal Survey of Youth. RESULTS: Cross-sectional results suggested that
current unemployment status and out-of-the-labor-force status were significantly 
associated with depressive symptoms at ages 29 through 37 years. The association 
between being out of the labor force and depressive symptoms was stronger for
men. Longitudinal results revealed that past unemployment duration across 15
years of the transition to adulthood significantly predicted depressive symptoms,
net of demographics, family background, current socioeconomic status, and prior
depressive symptoms. However, duration out of the labor force did not predict
depressive symptoms. CONCLUSIONS: Longer durations of unemployment predict higher
levels of depressive symptoms among young adults. Future research should measure 
duration longitudinally and distinguish unemployment from being out of the labor 
force to advance our understanding of socioeconomic mental health disparities.

PMID: 19696382 [PubMed - indexed for MEDLINE]


9. Scand J Public Health. 2009 Sep;37(7):778-80. Epub 2009 Aug 7.

The impact of job satisfaction on the risk of disability pension. A 15-year
prospective study.

Labriola M, Feveile H, Christensen KB, Bültmann U, Lund T.

Danish National Centre for Social Research, Herluf Trolles Gade 11, DK-2100
Copenhagen, Denmark. mee@sfi.dk

OBJECTIVES: To identify the impact of job satisfaction on the risk of disability 
pension. METHODS: A total of 8,338 employees were sampled from the total working 
population in Denmark. They were interviewed regarding age, gender, job
satisfaction and health behaviour. Interview data were merged with national
register data on granted disability pension for up to 15 years after baseline
data collection. RESULTS: The study found a statistically significant association
between low job satisfaction and disability pension for women when adjusted for
age, smoking status and BMI. CONCLUSIONS: Based on the results, investing in
giving workers a satisfying work environment could be a low-cost way of improving
employee health and prolonging labour market participation.

PMID: 19666670 [PubMed - indexed for MEDLINE]


10. Phys Ther. 2009 Sep;89(9):946-56. Epub 2009 Jul 16.

Job strain in physical therapists.

Campo MA, Weiser S, Koenig KL.

Program in Physical Therapy, School of Health and Natural Sciences, Mercy
College, 555 Broadway, Dobbs Ferry, NY 10522 USA. mcampo@mercy.edu

BACKGROUND: Job stress has been associated with poor outcomes. In focus groups
and small-sample surveys, physical therapists have reported high levels of job
stress. Studies of job stress in physical therapy with larger samples are needed.
OBJECTIVE: The purposes of this study were: (1) to determine the levels of
psychological job demands and job control reported by physical therapists in a
national sample, (2) to compare those levels with national norms, and (3) to
determine whether high demands, low control, or a combination of both (job
strain) increases the risk for turnover or work-related pain. DESIGN: This was a 
prospective cohort study with a 1-year follow-up period. METHODS: Participants
were randomly selected members of the American Physical Therapy Association
(n=882). Exposure assessments included the Job Content Questionnaire (JCQ), a
commonly used instrument for evaluation of the psychosocial work environment.
Outcomes included job turnover and work-related musculoskeletal disorders.
RESULTS: Compared with national averages, the physical therapists reported
moderate job demands and high levels of job control. About 16% of the therapists 
reported changing jobs during follow-up. Risk factors for turnover included high 
job demands, low job control, job strain, female sex, and younger age. More than 
one half of the therapists reported work-related pain. Risk factors for
work-related pain included low job control and job strain. LIMITATIONS: The JCQ
measures only limited dimensions of the psychosocial work environment. All data
were self-reported and subject to associated bias. CONCLUSIONS: Physical
therapists' views of their work environments were positive, including moderate
levels of demands and high levels of control. Those therapists with high levels
of demands and low levels of control, however, were at increased risk for both
turnover and work-related pain. Physical therapists should consider the
psychosocial work environment, along with other factors, when choosing a job.

PMCID: PMC2737052 [Available on 2010/3/1]
PMID: 19608632 [PubMed - indexed for MEDLINE]


11. Basic Clin Pharmacol Toxicol. 2009 Aug;105(2):73-83. Epub 2009 Jun 26.

A review of the effect of the psychosocial working environment on physiological
changes in blood and urine.

Hansen AM, Larsen AD, Rugulies R, Garde AH, Knudsen LE.

National Research Centre for the Working Environment (NRCWE), Copenhagen,
Denmark. aamh@nrcwe.dk

The aim of the present survey was to provide a literary review of current
knowledge of the possible association between the psychosocial working
environment and relevant physiological parameters measured in blood and urine.
Literature databases (PubMed, Toxline, Biosis and Embase) were screened using the
key words job, work-related and stress in combination with selected physiological
parameters. In total, 51 work place studies investigated the associations between
the psychosocial working environment and physiological changes, of which 20 were 
longitudinal studies and 12 population-based studies. The studied exposures in
work place/population-based studies included: job demands (26/8 studies), job
control (24/10 studies), social support and/or leadership behaviour (12/3
studies), effort-reward imbalance (three/one studies), occupational changes (four
studies), shift work (eight studies), traumatic events (one study) and other
(five studies). The physiological responses were catecholamines (adrenaline,
noradrenaline) (14 studies), cortisol (28 studies), cholesterol (23 studies),
glycated haemoglobinA(1c) (six studies), testosterone (nine studies), oestrogens 
(three studies), dehydroepiandrosterone (six studies), prolactin (14 studies),
melatonin (one study), thyroxin (one study), immunoglobulin (Ig) A (five
studies), IgG (four studies), IgM (one study) and fibrinogen (eight studies). In 
general, fibrinogen and catabolic indicators, defined as energy releasing, were
increased, whereas the anabolic indicators defined as constructive building up
energy resources were decreased when the psychosocial working environment was
perceived as poor. In conclusion, in this review the association between an
adverse psychosocial working environment and HbA(1c), testosterone and fibrinogen
in serum was found to be a robust and potential candidate for a physiological
effect of the psychosocial working environment. Further, urinary catecholamines
appear to reflect the effects of shift work and monotonous work.

PMID: 19563453 [PubMed - indexed for MEDLINE]


12. Med Trop (Mars). 2009 Feb;69(1):91-6.

[Commercial sexual exploitation of minor girls. A multifocal, exploratory and
prospective study in Cameroon]

[Article in French]

Mbassa Menick D, Dassa KS, Kenmogne JB, Abanda Ngon G.

Clinique universitaire de psychiatrie et de psychologie médicale, Hôpital Jamot
de Yaoundé, Cameroun. menickfr@yahoo.fr

To obtain reliable information on commercial sexual exploitation of minor girls
under the age of 21, a multifocal, exploratry and prospective using a
questionnaire was undertaken in Cameroon. This investigation was initiated and
funded by the Cercle International pour la Promotion de la Création (CIPCRE) and 
carried out by the Cameroon Society for the Prevention of Child Abuse and Neglect
(CASPCAN). The survey was performed during the last quarter of year 2004 in four 
major cities of Cameroon, i.e. Yaoundé, Douala, Bamenca and Bafoussam. Of the 800
questionnaires that were distributed, 722 were considered as suitable for
analysis (90.3%). A total of 291 minor girls were victims of commercial sexual
exploitation, i.e., 40% of the population studied. The mean age of the victims
was 16.6 years (range, 9-20 years). The main reason given for entering
prostitution was poverty. The victims were fairly well educated but the level of 
instruction was not sufficient to find a job paying an income comparable to
prostitution. Many were from large families (mean, 7.1 children). The victims'
family was monogamous in 40.2% of cases, polygamous in 24.4%, and monoparental in
35.4%. Eighty percent of the victims already had run away from home at least once
due to problems in their families ranging from severe corporal punishment (25.8%)
and mistreatment linked to parental alcohol and drug abuse to forced early
marriage (27.5%) and intrafamilial sexual abuse. A large proportion of the
victims (36.4%) were mothers who could not attend school and could not find work.
Many victims were completely neglected by their own parents with 43.4% of parents
being aware of the activities of their daughters but only 10.6% being opposed to 
it. Most (78.5%) had good knowledge of the risk of HIV and used condoms regular. 
These results confirms the general hypothesis of the authors that commercial
exploitation of minor girls is widespread in Cameroon. The authors recommend
development of a national program to combat this plight.

PMID: 19499745 [PubMed - indexed for MEDLINE]


13. Am J Epidemiol. 2009 May 1;169(9):1085-91. Epub 2009 Mar 24.

Changes in perceived job strain and the risk of major depression: results from a 
population-based longitudinal study.

Wang J, Schmitz N, Dewa C, Stansfeld S.

Department of Psychiatry, Faculty of Medicine, University of Calgary, Calgary,
Alberta, Canada. jlwang@ucalgary.ca

Comment in:
    Am J Epidemiol. 2009 Jul 1;170(1):131-2; author reply 132-3.

Major depression is a prevalent mental disorder in the working population.
Improving the work environment may reduce the risk of major depression. The
authors examined data from the longitudinal cohort of the Canadian National
Population Health Survey from 1994-1995 to 2004-2005. Survey participants were
classified into 4 groups by changes in job strain status from 1994-1995 to
2000-2001 (no change in low job strain, no change in high job strain, changing
from high to low job strain, and changing from low to high job strain). The
incidence proportion of major depressive episodes in each of the 4 groups was
4.0%, 8.0%, 4.4%, and 6.9%, respectively. Participants who reported a change from
high to low job strain had a risk of major depression similar to those exposed to
persistently low job strain. Among those exposed to persistent high job strain,
only participants who reported good or excellent health at baseline had a higher 
risk of major depression, but those who reported fair or poor health did not.
Reducing job strain may have positive impacts on the risk of depression.
Self-rated health is a strong predictor of depression and plays an important role
in the relation between job strain and depression.

PMID: 19318611 [PubMed - indexed for MEDLINE]


14. J Gerontol B Psychol Sci Soc Sci. 2009 Jan;64(1):77-86. Epub 2009 Jan 28.

Women's retirement expectations: how stable are they?

Wong JD, Hardy MA.

Department of Human Development and Family Studies, The Pennsylvania State
University, University Park, 18602, USA. jdw276@psu.edu

OBJECTIVE: Using the National Longitudinal Survey of Mature Women, we examine
between- and within-person differences in expected retirement age as a key
element of the retirement planning process. The expectation typologies of 1,626
women born between 1923 and 1937 were classified jointly on the basis of
specificity and consistency. METHODS: Latent class analysis was used to determine
retirement expectation patterns over a 7-year span. Multinomial logistic
regression analyses were employed to estimate the effects of demographic and
status characteristics on the likelihood of reporting 4 distinct longitudinal
patterns of retirement expectations. RESULTS: Substantial heterogeneity in
reports of expected retirement age between and within individuals over the 7-year
span was found. Demographic and status characteristics, specifically age, race,
marital status, job tenure, and recent job change, sorted respondents into
different retirement expectation patterns. CONCLUSIONS: The frequent
within-person fluctuations and substantial between-person heterogeneity in
retirement expectations indicate uncertainty and variability in both expectations
and process of expectation formation. Variability in respondents' reports
suggests that studying retirement expectations at multiple time points better
captures the dynamics of preretirement planning.

PMCID: PMC2654986
PMID: 19176483 [PubMed - indexed for MEDLINE]


15. Am J Community Psychol. 2009 Mar;43(1-2):57-70.

Income volatility and psychological depression.

Prause J, Dooley D, Huh J.

Department of Psychology and Social Behavior, School of Social Ecology,
University of California, Irvine, CA, 92697, USA. japrause@uci.edu

Income volatility appears to be increasing especially among lower income workers.
Such volatility may reflect the ongoing shift of economic risk from employers to 
employees as marked by decreasing job security and employer-provided benefits.
This study tests whether absolute volatility or downward volatility in income
predict depression controlling for prior depression. A sample (n = 4,493) from
the National Longitudinal Survey of Youth (NLSY79) with depression (CESD)
measured at age 40 and prior depression measured eight to 10 years earlier was
utilized. Downward volatility (frequency of income loss) was positively
associated with depression; adjusting for downward volatility and other
covariates, absolute volatility was negatively associated with depression. An
interaction indicated a positive association between downward volatility and
depression only when absolute volatility was high. These findings apply to
respondents in a narrow age range (30 s) and the results warrant replication to
identify the mediators linking absolute volatility and income loss to depression.

PMID: 19130213 [PubMed - indexed for MEDLINE]


16. J Psychosom Res. 2009 Jan;66(1):75-83. Epub 2008 Nov 22.

Effort-reward imbalance at work and risk of sleep disturbances. Cross-sectional
and prospective results from the Danish Work Environment Cohort Study.

Rugulies R, Norborg M, Sørensen TS, Knudsen LE, Burr H.

National Research Centre for the Working Environment, Copenhagen, Denmark.
rer@nrcwe.dk

OBJECTIVES: This study aimed to analyze if adverse psychosocial working
conditions, defined by the model of effort-reward imbalance (ERI), increase the
risk of sleep disturbances in the Danish workforce. METHODS: Analyses were
conducted both cross-sectionally and prospectively in a representative sample of 
Danish employees. The cross-sectional sample included 2614 participants (50%
women) aged 18-59 years, of whom 263 had sleep disturbances. Of the 2351
participants initially free of sleep disturbances, 304 (12.9%) developed sleep
disturbances during the 5-year follow-up. Data were analyzed with
gender-stratified, multivariate logistic and linear regression analyses, adjusted
for numerous covariates. RESULTS: Cross-sectionally, a 1 S.D. increase in the ERI
ratio was associated with sleep disturbances among both men [odds ratio
(OR)=1.65, 95% confidence interval (CI)=1.20-2.27] and women (OR=1.82, 95%
CI=1.46-2.28). In the prospective analysis, a 1 S.D. increase of the ERI ratio at
baseline predicted the onset of sleep disturbances among men (OR=1.39, 95%
CI=1.03-1.87) but not among women (OR=0.97, 95% CI=0.76-1.24). CONCLUSION: Among 
men, ERI is a risk factor for the development of sleep disturbances in the Danish
workforce. Among women, an association between ERI and sleep disturbances was
restricted to the cross-sectional sample. Improving psychosocial working
conditions might reduce the risk of sleep disturbances and subsequently also help
to prevent clinical disorders related to sleep disturbances.

PMID: 19073297 [PubMed - indexed for MEDLINE]


17. Ann Epidemiol. 2009 Jan;19(1):42-8.

A population-based cohort study of occupational exposure to magnetic fields and
cardiovascular disease mortality.

Cooper AR, Van Wijngaarden E, Fisher SG, Adams MJ, Yost MG, Bowman JD.

Department of Community and Preventive Medicine, University of Rochester School
of Medicine and Dentistry, New York 14642, USA.

PURPOSE: This cohort study aims to examine cardiovascular disease (CVD) mortality
risks among workers in occupations potentially exposed to magnetic fields (MF).
METHODS: Risks for major CVD mortality by potential job-related MF exposure were 
examined in a sample of U.S. workers from the National Longitudinal Mortality
Study using multivariate proportional hazards models. RESULTS: After adjustment
for demographic factors, there were no significant excess risks between
individuals with medium (0.15 to <0.20 microT), high (0.20 to < 0.30 microT), or 
very high (>/= 0.30 microT) exposure levels as compared with individuals with
background exposure levels of MF (<0.15 microT) for the CVD mortality outcomes.
Indirect adjustment for potential confounding by current smoking prevalence did
not change the pattern of these results. CONCLUSION: Our study does not provide
evidence for an association between occupational MF exposure and CVD mortality
risk.

PMID: 19064188 [PubMed - indexed for MEDLINE]


18. Psychooncology. 2009 Jul;18(7):691-9.

Effect of cancer diagnosis on patient employment status: a nationwide
longitudinal study in Korea.

Park JH, Park JH, Kim SG.

Division of Cancer Policy and Management, National Cancer Control Research
Institute, National Cancer Center, Goyang-si, Gyeonggi-do, Korea.
jaehyun@ncc.re.kr

BACKGROUND: Cancer diagnosis may adversely affect employment status. Our aim was 
to investigate whether cancer diagnosis effects employment status by comparing
employment status changes in cancer patients with to that of cancer-free workers 
over a 5-6-year period. METHODS: All 25-55-year-old, non-self-employed, Korean
workers who were diagnosed with cancer for the first time in 2001 were identified
as first baseline study subjects (n=4991). Of these, those who lost their jobs
within 1 year of cancer diagnosis were selected as second baseline subjects
(n=1334). Sex- and age-matched cancer-free individuals from the general
population were used as a reference group. We compared the time until job loss
from the first baseline and the time until re-employment from the second baseline
between these two groups during the 5-6-year follow-up period while adjusting for
sex, age group, job-type, and equivalent household income using the National
Health Insurance administrative database. RESULTS: Cancer patients were more
likely to lose their jobs after cancer diagnosis and were less likely to be
re-employed than cancer-free individuals in almost all sex and age groups. Most
major cancer sites were also associated with decreased employment status, with
the exception of thyroid cancer. CONCLUSION: Cancer diagnosis adversely affects
employment status in Korea, and the effects are widespread in almost all sex and 
age groups. Significant efforts are needed to improve the employment status of
cancer patients in Korea, as well as in developing or newly developed countries
that have similar social security systems. (c) 2008 John Wiley & Sons, Ltd.

PMID: 19021127 [PubMed - indexed for MEDLINE]


19. Soc Sci Med. 2009 Jan;68(1):49-59. Epub 2008 Nov 17.

A multi-group cross-lagged analyses of work stressors and health using Canadian
National sample.

Ibrahim S, Smith P, Muntaner C.

Institute for Work and Health, 481 University Avenue, Suite 800, Toronto, Canada 
M5G 2E9. sibrahim@iwh.on.ca

This article examines the reciprocal relationships between work variables and
health outcomes and if these relationships differ by social class (measured by
occupational grouping). We used longitudinal data from the 1994/95--2002/03
Canadian National Population Health Survey (NPHS). Karasek's work stress
variables were measured in the 1994/95 (cycle 1, time 1), 2000/01 (cycle 4, time 
2) and 2002/03 (cycle 5, time 3) surveys. Analyses were limited to 2556
respondents aged 18-56 at time 1 and who remained in the same social class (as
defined by occupational position) for all the three time points. Work variables
used were job strain ratio, work social support and job insecurity. Health
outcomes used were distress, depression and self-rated health. Multi-group path
analyses were used to investigate the reciprocal relationships between work and
health variables and if these relationships differed by social class. Analyses
controlled for age, gender, marital status and work status. We find there is a
differential burden of work psychosocial factors and health outcomes by social
class. The cross-lagged relationships between work and health depended on the
outcome, social class and time lag. More significant paths from work to health
were observed than reverse paths from health to work. More significant
relationships between work and health were observed for the shorter time lag (2
years) compared to longer time lags (6 years). Low work social support and job
insecurity were more detrimental to health for respondents in lower social class 
positions. Findings from this study highlight the importance of time lag, and to 
some extent social class, in the reciprocal relationships between work and
health.

PMID: 19010577 [PubMed - indexed for MEDLINE]


20. Occup Environ Med. 2009 Mar;66(3):175-81. Epub 2008 Sep 19.

Lung cancer mortality and iron oxide exposure in a French steel-producing
factory.

Bourgkard E, Wild P, Courcot B, Diss M, Ettlinger J, Goutet P, Hémon D, Marquis
N, Mur JM, Rigal C, Rohn-Janssens MP, Moulin JJ.

Département Epidémiologie en Entreprise, Institut National de Recherche et de
Sécurité, Vandoeuvre Cedex, France. eve.bourgkard@inrs.fr

OBJECTIVE: To study the possible association between iron oxide exposures and
lung cancer risk among workers in a French carbon steel-producing factory.
METHODS: 16 742 males and 959 females ever employed for at least 1 year between
1959 and 1997 were followed up for mortality from January 1968 to December 1998. 
Causes of death were ascertained from death certificates. Job histories and
smoking habits were available for 99.7% and 72.3% of subjects, respectively.
Occupational exposures were assessed by a factory-specific job-exposure matrix
(JEM) validated with atmospheric measurements. Standardised mortality ratios
(SMRs) were computed using local death rates (external references). Poisson
regressions were used to estimate the relative risks (RRs) for occupational
exposures (internal references), adjusted on potential confounding factors.
RESULTS: Among males, observed mortality was lower than expected for lung cancer 
compared to the local population (233 deaths, SMR 0.89, 95% CI 0.78 to 1.01) and 
higher than expected compared to the French population (SMR 1.30, 95% CI 1.15 to 
1.48) No lung cancer excess was observed for exposure to iron oxides (RR 0.80,
95% CI 0.55 to 1.17) and no dose-response relationship with intensity, duration
of exposure or cumulative index was found. A significant bladder cancer excess
was observed among workers exposed to oil mist (RR 2.44, 95% CI 1.06 to 5.60),
increasing significantly with intensity, duration of exposure and cumulative
index. CONCLUSION: This study did not detect any relationship between exposure to
iron oxides and lung cancer mortality. An excess of mortality from bladder cancer
was found among workers exposed to oil mist.

PMID: 18805881 [PubMed - indexed for MEDLINE]


21. Handchir Mikrochir Plast Chir. 2008 Oct;40(5):342-7. Epub 2008 Aug 25.

[Severe course of a rare non-tuberculous Mycobacteriosis (M. haemophilum) of the 
hand - case report and strategic comments]

[Article in German]

Schumacher O, Dabernig J, Nenadic I, Ingianni G, Cedidi C.

Die Institutsangaben sind am Ende des Beitrags gelistet. oschum@yahoo.de

INTRODUCTION: Mycobacterium haemophilum belongs to the group of atypical
mycobacteria and is rarely reported as a cause of upper extremity and hand
infections. It is of low virulence. The bacterium seems to be ubiquitous. Sources
and mechanism of infection are poorly defined. CASE REPORT: A 48-year-old female 
patient was admitted with chronic flexor tendon synovitis of the left palm and
distal forearm site. Three debridements were carried out and wound swabs were
taken. No proof of bacterial colonisation was found. Histologically a
granulomatous infection with Langerhans cells was revealed. Effectively
calculated monotherapy with ciprofloxacin was begun. Six weeks postoperatively
Mycobacterium haemophilum was cultivated in a colaboration with the National
Reference Centre for Mycobacteria in Borstel. Medication was changed to triple
therapy with clarithromycin, ethambutol and rifabutin. The patient could carry
out her daytime job three months postoperatively. One year after first admission 
functional impairment needed to be treated by scar excision and radical flexor
tendon tendolysis. The palmar defect was resurfaced by using a transmetacarpal
DMCA 2 flap at the same time. An almost full range of motion was achieved with
intensive hand and physiotherapy after a total treatment period of 15 months.
DISCUSSION: Patients with upper extremity infections caused by atypical
Mycobacteria need qualified hand-surgical care. The decision about need and kind 
of medicamentous treatment is based on germ differentiation and should be made in
cooperation with the National Reference Centre for Mycobacteria in Borstel. To
shorten the diagnostic gap between first admission and detection of Mycobacteria 
in hand infections with a non-typical course of disease we suggest a standardised
approach.

PMID: 18726875 [PubMed - indexed for MEDLINE]


22. Work. 2008;30(4):473-82.

Workplace health interventions in small enterprises: a Swedish longitudinal
study.

Vinberg S.

National Institute for Working Life, SE-831 40 Ostersund, Sweden.
stig.vinberg@niwl.se

This article has a two-fold approach. First, it investigates relationships
between work organizational factors, and health and performance outcomes. Second,
it compares two change strategy approaches in workplace health interventions by
studying changes of these factors and outcomes. The sample consisted of ten
Swedish small enterprises including 102 individuals, who answered a before and
after questionnaire about organizational factors and outcomes. The leaders were
interviewed and answered a questionnaire about performed workplace health
interventions. Statistical methods used were reliability tests, correlation
analyses and t-tests. Results indicate rather strong links between indicators of 
respectful leadership, creative work and team spirit, and the outcome indicators 
self-assessed health and judged workplace adaptability in association with
customer satisfaction. The results concerning changes of determinants and
outcomes (after workplace health interventions) showed significant differences
between enterprises using a broad change strategy and those using an
expert/problem-based strategy with the former having more favourable results. The
leader interview results also point at obstacles concerning workplace change
processes as lack of resources, insufficient competence and influence of external
factors. The study results suggest that work organizational factors and
integrated models for workplace health intervention are of importance for health 
and performance outcomes in small enterprises.

PMID: 18725710 [PubMed - indexed for MEDLINE]


23. Ann Epidemiol. 2008 Oct;18(10):743-5. Epub 2008 Aug 9.

Job loss and broken partnerships: do the number of stressful life events
influence the risk of ischemic heart disease in men?

Kriegbaum M, Christensen U, Lund R, Prescott E, Osler M.

Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
M.Kriegbaum@pubhealth.ku.dk

PURPOSE: The aim of this study was to investigate the effects of the accumulated 
number of job losses and broken partnerships (defined as the end of cohabitation)
on the risk of fatal and nonfatal events of ischemic heart disease (IHD).
METHODS: Prospective birth cohort study with follow-up of events of IHD from 1993
to 2004. Participants were 8365 men born in the metropolitan area of Copenhagen, 
Denmark, in 1953. Events of IHD were retrieved from the Danish National Patient
Register and the Cause of Death Registry. Job losses and broken partnerships were
identified in the Social Registers. We included mother's marital status and
father's occupation at birth, body mass index at 18 years, and own educational
attainment as covariates. RESULTS: We found that only broken partnerships were
associated with IHD (1.28 95% confidence interval 1.02-1.58) and the subdiagnoses
of other IHD (1.37 95% confidence interval 1.02-1.85). We found no indication of 
dose-response relationship between number of events and risk of IHD. CONCLUSION: 
In this study of middle-aged men, we found only weak support for the effect of
psychosocial stress on IHD measured with register based life events; we found
that IHD was associated with broken partnerships but not with job loss. We did
not find that the risk of incident IHD varied with the number of these stressful 
life events.

PMID: 18693037 [PubMed - indexed for MEDLINE]


24. J Trauma Nurs. 2008 Apr-Jun;15(2):34-42.

The trauma nurse coordinator in Australia and New Zealand: a progress survey of
demographics, role function, and resources.

Curtis K, Donoghue J.

St George Hospital, Gray St, Kogarah, New South Wales, Australia.
Kate.Curtis@sesiahs.health.nsw.gov.au

An initial profile of the demographics and current practice of Australian trauma 
nurse coordinators (TNCs) was conducted in 2003. The study identified common and 
differing role components, provided information to assist with establishing
national parameters for the role, and identified the resources perceived
necessary to enable the role to be performed effectively. This article compares
the findings of the 2003 study with a 2007 survey, expanded to include New
Zealand trauma coordinators. Forty-nine people, identified as working in a TNC
capacity in Australia and New Zealand, were invited to participate in February
2007. The survey consisted of a 3-part questionnaire of respondents'
demographics, the percentage of time allocated to 10 defined role functions
(components), and the TNCs' perceived required resources to fulfill their role
effectively. Feedback from the 2003 survey was incorporated in the redesign.
Participation in the research enabled an update of the previously compiled
Australia/New Zealand trauma network list. Thirty-six surveys (71.5% response
rate) were returned. Descriptive statistics were undertaken for each item, and
comparisons were made among states, territories, and countries. The mean age of
respondents was 41+/-7.7, range 27 to 57, and 92% were female. They averaged 11.1
years of postregistration critical care or trauma experience, and 50% (n=18)
reported working unpaid overtime (decreased from 56% (n=19) since 2003).
Participants reported that most of their time was spent fulfilling the trauma
registry component of the role (27% of total hours), followed by quality and
clinical activities (19% of total hours), education, and administration. The
component associated with the least amount of time was outreach (3% of total
hours). Although the proportion of time has almost halved since 2003, TNCs still 
spend the most time maintaining trauma registries. Compared to the 2003 survey,
Australian and New Zealand TNCs are working more unpaid overtime, spending more
time performing quality and clinical activities and less time doing data entry.
Despite where one works, the role components identified are fulfilled to a
certain extent. However, trauma centers need to provide the TNC with adequate
resources if trauma care systems are to be optimally effective.

PMID: 18690131 [PubMed - indexed for MEDLINE]


25. Am J Psychiatry. 2008 Nov;165(11):1482-6. Epub 2008 Aug 1.

Overcrowding in hospital wards as a predictor of antidepressant treatment among
hospital staff.

Virtanen M, Pentti J, Vahtera J, Ferrie JE, Stansfeld SA, Helenius H, Elovainio
M, Honkonen T, Terho K, Oksanen T, Kivimäki M.

Finnish Institute of Occupational Health, Helsinki, Finland.
marianna.virtanen@ttl.fi

OBJECTIVE: This report assessed whether hospital ward overcrowding predicts
antidepressant use among hospital staff. METHOD: The extent of hospital ward
overcrowding was determined using administrative records of monthly bed occupancy
rates between 2000 and 2004 in 203 somatic illness wards in 16 Finnish hospitals 
providing specialized health care. Information on job contracts for personnel was
obtained from the employers' registers. Comprehensive daily data on purchased
antidepressant prescriptions (World Health Organization's Anatomical Therapeutic 
Chemical classification code N06A) for nurses (N=6,699) and physicians (N=641)
was derived from national registers. Cox proportional hazards models were used to
examine the association between bed occupancy rate and subsequent antidepressant 
treatment. Monthly bed occupancy rates were used as a time-dependent exposure
that could change in value over the course of observation. Hazard ratios were
adjusted for sex, age, occupation, type and length of employment contract,
hospital district, specialty, and calendar year. RESULTS: Exposure over 6 months 
to an average bed occupancy rate over 10% in excess of the recommended limit was 
associated with new antidepressant treatment. This association followed a
dose-response pattern, with increasing bed occupancy associated with an
increasing likelihood of antidepressant use. There was no evidence of reverse
causality; antidepressant treatment among employees did not predict subsequent
excess bed occupancy. CONCLUSIONS: The increased risk of antidepressant use
observed in this study suggests that overcrowding in hospital wards may have an
adverse effect on the mental health of staff.

PMID: 18676590 [PubMed - indexed for MEDLINE]


26. West J Nurs Res. 2009 Feb;31(1):24-43. Epub 2008 Jul 25.

A profile of Colorado nurse--midwives: implications for health care.

Hastings-Tolsma M, Tasaka Y, Burton A, Goodman S, Emeis CL, Patterson E, Bennett 
P, Koschoreck K, Ruyak S, Tanner T, Vaughn T, Williams A.

College of Nursing Education 2 North, University of Colorado-Denver, Aurora, CO
80045, USA. marie.hastingstolsma@UCDenver.edu

Nurse-midwives provide significant health care to underserved and vulnerable
women, yet there is limited information about the nature of nurse-midwifery
practices and compensation for services. This study reports the results of a
Colorado statewide survey of nurse-midwives (N = 217). Electronic survey was
utilized to detail practice in seven areas: demographics, type of practice,
compensation, leadership, legislative priorities,teaching involvement, and
practice satisfaction. Responses (N = 114) were analyzed using SPSS 13.0. Results
found wide variation in compensation and practice types. Respondents largely
worked in urban settings, cared for low to moderate risk patients, and were
generally older and White. Restriction from medical staff membership,
prescriptive authority constraints, and liability issues were practice
limitations. While teaching a wide variety of learners, nurse-midwives do limited
mentoring of nurse-midwifery students, a finding which is concerning given the
decreasing numbers of nurse-midwives. Findings are compared to known national
data, with implications for the provision of health care services detailed.

PMID: 18660490 [PubMed - indexed for MEDLINE]


27. J Appl Psychol. 2008 Jul;93(4):849-63.

How the rich (and happy) get richer (and happier): relationship of core
self-evaluations to trajectories in attaining work success.

Judge TA, Hurst C.

Department of Management, Warrington College of Business, University of Florida, 
Gainesville, FL 32606, USA. timothy.judge@cba.ufl.edu

In this study, the authors linked core self-evaluations to job and work success. 
Utilizing a dynamic design from participants in the National Longitudinal Surveys
of Youth (NLSY79), core self-evaluations were hypothesized to predict
individuals' intercepts (starting levels of success), and their growth
trajectories (slope of individuals' success over time) with respect to job
satisfaction, pay, and occupational status. Results indicated that higher core
self-evaluations were associated with both higher initial levels of work success 
and steeper work success trajectories. Education and health problems that
interfere with work mediated a portion of the hypothesized relationships,
suggesting that individuals with high core self-evaluations have more ascendant
jobs and careers, in part, because they are more apt to pursue further education 
and maintain better health.

PMID: 18642988 [PubMed - indexed for MEDLINE]


28. Epidemiol Rev. 2008;30:118-32. Epub 2008 Jun 27.

The relation between work-related psychosocial factors and the development of
depression.

Netterstrøm B, Conrad N, Bech P, Fink P, Olsen O, Rugulies R, Stansfeld S.

Clinic of Occupational Medicine, Hillerød Hospital, Helsevej 2, DK 3400 Hillerød,
Denmark. bone@noh.regionh.dk

This review is based on a literature search made in January 2007 on request by
the Danish National Board of Industrial Injuries. The search in PubMed, EMBASE,
and PsycINFO resulted in more than 1,000 publications. This was reduced to 14
after the titles, abstracts, and papers were evaluated by using the following
criteria: 1) a longitudinal study, 2) exposure to work-related psychosocial
factors, 3) the outcome a measure of depression, 4) relevant statistical
estimates, and 5) nonduplicated publication. Of the 14 studies, seven used
standardized diagnostic instruments as measures of depression, whereas the other 
seven studies used self-administered questionnaires. The authors found moderate
evidence for a relation between the psychological demands of the job and the
development of depression, with relative risks of approximately 2.0. However,
indication of publication bias weakens the evidence. Social support at work was
associated with a decrease in risk for future depression, as all four studies
dealing with this exposure showed associations with relative risks of about 0.6. 
Even if this literature study has identified work-related psychosocial factors
that in high-quality epidemiologic studies predict depression, studies are still 
needed that assess in more detail the duration and intensity of exposure
necessary for developing depression.

PMID: 18587142 [PubMed - indexed for MEDLINE]


29. BMC Public Health. 2008 May 19;8:164.

The longitudinal relationship between job mobility, perceived organizational
justice, and health.

Liljegren M, Ekberg K.

National Centre for Work and Rehabilitation, Department of Medicine and Health
Sciences, Linköping University, SE-581 83 Linköping, Sweden.
mats.liljegren@ihs.liu.se

BACKGROUND: The main purpose of the present study was to examine the 2-year
longitudinal and reciprocal relationship between job mobility and health and
burnout. A second aim was to elucidate the effects of perceived organizational
justice and turnover intentions on the relationship between job mobility (non-,
internally and externally mobile), and health (SF-36) and burnout (CBI). METHODS:
The study used questionnaire data from 662 Swedish civil servants and the data
were analysed with Structural Equation Modeling statistical methods. RESULTS: The
results showed that job mobility was a better predictor of health and burnout,
than health and burnout were as predictors of job mobility. The predictive
effects were most obvious for psychosocial health and burnout, but negligible as 
far as physical health was concerned. Organizational justice was found to have a 
direct impact on health, but not on job mobility; whereas turnover intentions had
a direct effect on job mobility. CONCLUSION: The predictive relationship between 
job mobility and health has practical implications for health promotive actions
in different organizations.

PMCID: PMC2408581
PMID: 18489747 [PubMed - indexed for MEDLINE]


30. Soc Networks. 2007 May;29(2):231-248.

Advances in Exponential Random Graph (p*) Models Applied to a Large Social
Network.

Goodreau SM.

University of Washington, Dept. of Anthropology and Center for Studies in
Demography and Ecology.

Recent advances in statistical network analysis based on the family of
exponential random graph (ERG) models have greatly improved our ability to
conduct inference on dependence in large social networks (Snijders 2002, Pattison
and Robins 2002, Handcock 2002, Handcock 2003, Snijders et al. 2006, Hunter et
al. 2005, Goodreau et al. 2005, previous papers this issue). This paper applies
advances in both model parameterizations and computational algorithms to an
examination of the structure observed in an adolescent friendship network of
1,681 actors from the National Longitudinal Study of Adolescent Health
(AddHealth). ERG models of social network structure are fit using the R package
statnet, and their adequacy assessed through comparison of model predictions with
the observed data for higher-order network statistics.For this friendship
network, the commonly used model of Markov dependence leads to the problems of
degeneracy discussed by Handcock (2002, 2003). On the other hand, model
parameterizations introduced by Snijders et al (2006) and Hunter and Handcock
(2006) avoid degeneracy and provide reasonable fit to the data. Degree-only
models did a poor job of capturing observed network structure; those that did
best included terms both for heterogeneous mixing on exogenous attributes (grade 
and self-reported race) as well as endogenous clustering. Networks simulated from
this model were largely consistent with the observed network on multiple
higher-order network statistics, including the number of triangles, the size of
the largest component, the overall reachability, the distribution of geodesic
distances, the degree distribution, and the shared partner distribution. The
ability to fit such models to large datasets and to make inference about the
underling processes generating the network represents a major advance in the
field of statistical network analysis.

PMCID: PMC2031833
PMID: 18449326 [PubMed]


31. Int J Nurs Stud. 2009 Jul;46(7):940-56. Epub 2008 Apr 2.

Predictors of RNs' intent to work and work decisions 1 year later in a U.S.
national sample.

Brewer CS, Kovner CT, Greene W, Cheng Y.

University at Buffalo, School of Nursing, 918 Kimball Tower, 3435 Main Street,
Buffalo, NY 14214-3079, United States. csbrewer@buffalo.edu

BACKGROUND: Many studies have examined predictors of nurses' intention to work in
their job, including desire to quit. Intent has been a good predictor of actual
turnover. Few longitudinal studies exist that consider regional variables.
OBJECTIVES: To extend the conceptual framework of turnover research to the whole 
nursing workforce and determine: (1) how do demographics, region (metropolitan
statistical area: MSA), movement opportunities, and work setting variables affect
registered nurses' (RNs) intent to work and desire to quit; and (2) how do
demographics, MSA variables, movement opportunities, and work setting variables
affect RNs' work behavior at time 2? DESIGN: Panel study using Dillman's design
method. SETTINGS AND PARTICIPANTS: Randomly selected national cluster sample from
40 urban geographic regions (MSAs) in 29 states of the United States. METHODS:
Four thousand surveys were sent. There were 1907 female RNs under 65 (48%
response rate) from year 1 of which 1348 responded at year 2 (70% response rate).
RESULTS: The first analyses used desire to quit (explained 65% of the variance)
and intent to work from year 1 as dependent variables. Satisfaction and
organizational commitment were significant negative predictors of desire to quit.
In the logistic regression on intent to work, the work motivation and work-family
conflict were positive and significant as well as wages (negative) and three
benefit variables. In year 2, the dependent variable was working or not and if
working, full-time or not. For this bivariate probit regression no attitudes
influenced the work/not work decision, but MSA level variables, wages (positive) 
and benefits (positive) did. Organizational commitment and higher workload
increased the probability of working FT. CONCLUSIONS: Regional differences across
markets need to be controlled and their influence investigated. In addition,
attitudes as well as wages and benefits were important in certain decisions:
these factors are clearly under the influence of employers.

PMID: 18377910 [PubMed - indexed for MEDLINE]


32. Contact Dermatitis. 2008 Apr;58(4):210-6.

Clinical characteristics and consequences of hand eczema - an 8-year follow-up
study of a population-based twin cohort.

Lerbaek A, Kyvik KO, Ravn H, Menné T, Agner T.

National Allergy Research Centre, Gentofte Hospital, University of Copenhagen,
Copenhagen, Denmark. anne.lerbaek@dadlnet.dk

BACKGROUND: Few population-based clinical follow-up studies on hand eczema are
reported. Objectives: The aim of this study was to characterize clinical symptoms
and to examine occupational and medical consequences as well as persistence of
hand eczema in a population-based twin cohort. PATIENTS/METHODS: A total of 274
individuals with and without hand eczema were examined, patch tested, and
interviewed in 1997-1998 and 2005-2006. Data on 188 individuals with hand eczema 
in 2005-2006 were analysed. RESULTS: Erythema and scaling were the most frequent 
symptoms, and fingers and palms were most often affected. Mean hand eczema
severity index score in individuals with clinical symptoms was 12.0. Sick leave
was reported by 12.4%; job change by 8.5%. Being in the lowest socio-economic
group and atopic dermatitis were risk factors for sick leave [odds ratio (OR) =
5.6; 95% confidence interval (95% CI) 1.5-22.9 and OR = 2.9; 95% CI 1.0-8.1]. The
majority (63.4%) had seen a doctor at least once, and atopic dermatitis was a
risk factor for more than 1 visit (OR = 3.0; 95% CI 1.4-6.4). Duration of >10
years was a risk factor for persistence of symptoms, which was reported by 67.7%.
CONCLUSIONS: The clinical picture and consequences of hand eczema vary; however, 
the majority experience chronic symptoms.

PMID: 18353028 [PubMed - indexed for MEDLINE]


33. Scand J Psychol. 2008 Apr;49(2):169-77.

Psychometric evaluation and further validation of the Hagedoorn et al. modified
EVLN measure.

Liljegren M, Nordlund A, Ekberg K.

National Centre for Work and Rehabilitation, Department of Health and Society,
University of Linköping, Sweden. mats.liljegren@ihs.liu.se

The aim of the present study was to evaluate and further validate a modified
Exit, Voice, Loyalty and Neglect (EVLN) instrument (Hagedoorn, Van Yperen, Van de
Vliert & Buunk, 1999), in a Swedish sample (n= 792). To test the underlying
scaling assumptions, the convergent and divergent validity, a
multitrait/multi-item analysis was conducted and factor analyses were used to
evaluate the factor structure. The concurrent validity was tested by using the
modified EVLN instrument as predictor and three different forms of justice as
criteria in the analysis. The criterion-related validity was tested and an
association between exit behavioral response and actual exit behavior was found
(predictive validity). The results showed that the instrument may be considered
to be a valid measure with the exception of the aggressive voice scale.

PMID: 18352987 [PubMed - indexed for MEDLINE]


34. Occup Med (Lond). 2008 Jun;58(4):302-4. Epub 2008 Mar 15.

Shift work and sickness absence.

Tüchsen F, Christensen KB, Lund T.

National Research Center for the Working Environment, Lersø Parkallé 105, DK-2100
Copenhagen, Denmark. ftu@nrcwe.dk

BACKGROUND: Sickness absence is increasing in public work places in Denmark where
shift work is common. AIMS: The aim of this prospective study was to predict the 
hazard ratio (HR) of short- and long-term sickness absence due to shift work in
Danish shift workers. METHODS: A total of 1008 shift workers and 4009 day workers
were followed up for short- and long-time sickness absence. RESULTS: Among shift 
workers, the HR of sickness absence lasting >or=2 weeks was 0.92 (95% CI:
0.71-1.18) for men and 0.90 for women (95% CI: 0.71-1.14). For sickness absence
lasting >or=8 weeks, the HR was 1.33 (95% CI: 0.91-1.94) for men and 1.13 (95%
CI: 0.81-1.59) for women. CONCLUSION: This study was inconclusive in proving any 
link between shift work and absenteeism after controlling for age, education,
body mass index, smoking status, alcohol consumption, leisure time physical
activity, psychosocial and physical work environment factors.

PMID: 18346952 [PubMed - indexed for MEDLINE]


35. J Clin Oncol. 2008 Mar 10;26(8):1302-9.

Job loss and re-employment of cancer patients in Korean employees: a nationwide
retrospective cohort study.

Park JH, Park EC, Park JH, Kim SG, Lee SY.

Division of Cancer Policy and Management, National Cancer Control Research
Institute, National Cancer Center, Gyeonggi-do 410-769, Korea.

PURPOSE: The aim of this study was to investigate whether a diagnosis of cancer
has an impact on the cancer patients' job loss and re-employment and to identify 
the factors affecting job loss and re-employment during 6 years of follow-up of
Korean employees with cancer. PATIENTS AND METHODS: All employees except for the 
self-employed in Korea who were diagnosed with cancer during the 2001 calendar
year (n = 5,396) were identified as the first baseline patients and were followed
every 3 months over 6 years to estimate the time taken to job loss. Patients who 
lost their job within the first year after a diagnosis of cancer (n = 1,398) were
identified as the second baseline patients and were followed up over 5 years to
estimate the time taken to re-employment using the National Health Insurance
claims data. Patient demographic, socioeconomic, and clinical variables were
investigated as factors that affected job loss and re-employment. RESULTS: Among 
the first baseline cancer patients, 47.0% lost their job, and among the second
baseline patients, 30.5% were re-employed over 69 to 72 months of follow-up.
Female sex, younger age and older age, company employee, lower income, blood
cancer, and brain and CNS, lung, and liver cancer were significant predictors of 
early job loss or delayed re-employment. CONCLUSION: The diagnosis of cancer
affects cancer patients' employment status differently according to different
factors: sex, age, type of job, income, and cancer site. Efforts should be made
to support re-employment and reduce unnecessary work cessation and disparity
between different demographic and socioeconomic groups of cancer survivors.

PMID: 18323554 [PubMed - indexed for MEDLINE]


36. J Occup Environ Med. 2008 Feb;50(2):172-81.

Perceived job insecurity, job predictability, personality, and health.

Lau B, Knardahl S.

National Institute of Occupational Health, Oslo, Norway. Bjorn.Lau@stami.no

OBJECTIVE: The present study sought to determine whether job insecurity is
associated with personality traits and beliefs. In addition, it was tested
whether aspects of personality confounded the relationships between job
insecurity and health, or moderated this association. METHODS: At the first data 
collection, 5163 persons participated, and at the second data collection, 1946
persons of a random sample participated. Data were obtained from Oslo Health
Study. RESULTS: The job insecurity aspect concerning confidence in having a good 
job in 2 years was more strongly related to the health variables, and
particularly with mental distress, compared with other aspects of job insecurity.
Type-A behavior predicted an increase in upper back pain (beta 0.07), while
optimism predicted a change in lower back pain (beta -0.07). CONCLUSIONS: Job
insecurity is associated with health; this association is strongest for mental
distress and self-reported health, and weaker for back-pain.

PMID: 18301174 [PubMed - indexed for MEDLINE]


37. Minerva Med. 2007 Dec;98(6):773-82.

[Experimental formative tools for the personnel and organizing models for a
Nuclear Medicine Service of the public healthcare in Italy]

[Article in Italian]

Marcolongo A, Mazzetti MD, Rubello D.

Azienda ULSS 18 Rovigo, Regione Veneto, Italia.
marcolongo.adriano@azisanrovigo.it

In the present prospective study started in 2004, we evaluated the potential role
of the ''job on site'' model as a formative tool previously proposed by the
''Ministero della Salute'' in Italy and at the moment it is yet in an
experimental phase in our Country. We applied this ''job on site'' model for the 
development of a new Nuclear Medicine Service in Rovigo Hospital (ULSS 18 of
Veneto Region Italy). Moreover, there were planned, experimented and applied
different organizing working models involving both physicians, technicians and
nurses. The indicators of productivity realised in the period August 2004 to June
2007 were taken as end points. In our experience, the ''job on site'' model was
particularly useful as a formative tool, and allowed a qualified preparation of
the Service personnel as well as a rapid achievement of standard Regional and
National indicators of productivity. Moreover, from a cost-effectiveness point of
view, the daily working model we applied, that is based on a prolongation of the 
daily work per operator, proved to be highly effective in our Hospital. The data 
reported here may be of interest for the future planning of similar Services in
the Public National and Regional Healthcare.

PMID: 18299689 [PubMed - indexed for MEDLINE]


38. J Occup Health. 2008 Jan;50(1):31-40.

Association of physical job demands, smoking and alcohol abuse with subsequent
premature mortality: a 9-year follow-up population-based study.

Bourgkard E, Wild P, Massin N, Meyer JP, Otero Sierra C, Fontana JM, Benamghar L,
Mur JM, Ravaud JF, Guillemin F, Chau N; Lorhandicap Group.

Institut National de Recherche et de Sécurité (INRS), WHO Collaborative Centre,
Département d'Epidémiologie en Entreprises, France.

This study assessed the relationships of physical job demands (PJD), smoking, and
alcohol abuse, with premature mortality before age 70 (PM-70) among the working
or inactive population. The sample included 4,268 subjects aged 15 or more
randomly selected in north-eastern France. They completed a mailed questionnaire 
(birth date, sex, weight, height, job, PJD, smoking habit, alcohol abuse (Deta
questionnaire)) in 1996 and were followed for mortality until 2004 (9 yr). PJD
score was defined by the cumulative number of the following high job demands at
work: hammer, vibrating platform, pneumatic tools, other vibrating hand tools,
screwdriver, handling objects, awkward posture, tasks at heights, machine tools, 
pace, working on a production line, standing about and walking. The data were
analyzed using the Poisson regression model. Those with PM-70 were 126 (3.81 per 
1,000 person-years). The leading causes of death were cancers (46.4% in men,
57.1% in women), cardiovascular diseases (20.2% and 11.9%), suicide (9.5% and
7.1%), respiratory diseases (6.0% and 4.8%), and digestive diseases (2.4% and
4.8%). PJD3, smoker, and alcohol abuse had adjusted risk ratios of 1.71 (95% CI
1.02-2.88), 1.76 (1.08-2.88), and 2.07 (1.31-3.26) respectively for all-cause
mortality. Manual workers had a risk ratio of 1.84 (1.00-3.37) compared to the
higher socio-economic classes. The men had a two-fold higher mortality rate than 
the women; this difference became non-significant when controlling for job, PJD, 
smoker and alcohol abuse. For cancer mortality the factors PJD3, smoker, and
alcohol abuse had adjusted risk ratios of 2.00 (1.00-3.99), 2.34 (1.19-4.63), and
2.22 (1.17-4.20), respectively. Health promotion efforts should be directed at
structural measures of task redesign and they should also concern lifestyle.

PMID: 18285642 [PubMed - indexed for MEDLINE]


39. J Epidemiol Community Health. 2008 Mar;62(3):245-50.

Job insecurity, chances on the labour market and decline in self-rated health in 
a representative sample of the Danish workforce.

Rugulies R, Aust B, Burr H, Bültmann U.

National Research Centre for the Working Environment, Lerso Parkallé 105, DK-2100
Copenhagen, Denmark. rer@nrcwe.dk

OBJECTIVE: To investigate if job insecurity and poor labour market chances
predict a decline in self-rated health in the Danish workforce. DESIGN: Job
insecurity, labour market chances, self-rated health and numerous covariates were
measured in 1809 women and 1918 men who responded to a questionnaire in 1995 and 
again in 2000. Multivariate logistic regression analyses were used to analyse the
impact of job insecurity and labour market chances measured in 1995 on decline in
health in 2000. SETTING: Prospective cohort study with a representative sample of
the Danish workforce using the Danish Work Environment Cohort Study (DWECS). All 
participants were employed at baseline. MAIN RESULTS: Women with job insecurity
had an increased risk of a decline in health at follow-up, after adjustment for
all covariates (OR = 1.78, 95% CI: 1.24 to 2.54). Effect estimates were strongest
among women 50 years of age or younger with poor labour market chances (OR =
2.13, 95% CI: 1.32 to 3.45). Among men, there was no main effect for job
insecurity. However, men aged 50 years or younger with poor labour market chances
showed an OR of 1.64 (95% CI: 0.95 to 2.84) for a decline in health. CONCLUSION: 
Job insecurity is a predictor for a decline in health in employed women in
Denmark. Among men, a suggestive effect of job insecurity was found in employees 
aged 50 years or younger with poor labour market chances.

PMID: 18272740 [PubMed - indexed for MEDLINE]


40. Am J Public Health. 2008 Dec;98(12):2258-63. Epub 2008 Jan 30.

Racial/ethnic and gender differences in individual workplace injury risk
trajectories: 1988-1998.

Berdahl TA.

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and
Quality, Rockville, MD 20850, USA. terceira.berdahl@ahrq.hhs.gov

OBJECTIVES: I examined workplace injury risk over time and across racial/ethnic
and gender groups to observe patterns of change and to understand how
occupational characteristics and job mobility influence these changes. METHODS: I
used hierarchical generalized linear models to estimate individual workplace
injury and illness risk over time ("trajectories") for a cohort of American
workers who participated in the National Longitudinal Survey of Youth
(1988-1998). RESULTS: Significant temporal variation in injury risk was observed 
across racial/ethnic and gender groups. At baseline, White men had a high risk of
injury relative to the other groups and experienced the greatest decline over
time. Latino men demonstrated a pattern of lower injury risk across time compared
with White men. Among both Latinos and non-Latino Whites, women had lower odds of
injury than did men. Non-Latino Black women's injury risk was similar to Black
men's and greater than that for both Latino and non-Latino White women.
Occupational characteristics and job mobility partly explained these differences.
CONCLUSIONS: Disparities between racial/ethnic and gender groups were dynamic and
changed over time. Workplace injury risk was associated with job dimensions such 
as work schedule, union representation, health insurance, job hours, occupational
racial segregation, and occupational environmental hazards.

PMID: 18235072 [PubMed - indexed for MEDLINE]


41. Soc Sci Med. 2008 Mar;66(6):1346-55. Epub 2008 Jan 25.

The physical strenuousness of work is slightly associated with an upward trend in
the BMI.

Böckerman P, Johansson E, Jousilahti P, Uutela A.

Labour Institute for Economic Research, Pitkansillanranta 3A, 6. krs., FIN-00530 
Helsinki, Finland. petri.bockerman@labour.fi

This paper examines the relationship between the physical strenuousness of work
and the BMI in Finland, using individual microdata at 5-year intervals over the
period 1972--2002. Data came from the National FINRISK Study which contains
self-reported information on the physical strenuousness of a respondent's
occupation. Our estimates show that the changes in the physical strenuousness of 
work explain around 7% at most of the increase in BMI for Finnish males observed 
over a period of 30 years. The main reason for this appears to be the effect of
the physical strenuousness of work on BMI which is rather moderate. According to 
the point estimates, BMI is 2.4% lower when a male's occupation is physically
very demanding and involves lifting and carrying heavy objects compared with a
sedentary job (reference group of the estimations), other things being equal.
Furthermore, it is very difficult to associate the changes in the occupational
structure with the upward trend in BMI for females, and the contribution of the
changes in the occupational structure is definitely even smaller for females than
it is for males. All in all, we show that the changes in self-reported occupation
show a slight association with the changes in the logarithm of the BMI scores.

PMID: 18222024 [PubMed - indexed for MEDLINE]


42. J Appl Psychol. 2008 Jan;93(1):217-24.

Job performance over time is a function of latent trajectories and previous
performance.

Zyphur MJ, Chaturvedi S, Arvey RD.

Department of Management and Organization, National University of Singapore,
Singapore. bizmjz@nus.edu.sg

Previous literature addressing job performance over time notes that past
performance can affect future performance and that individuals often have
distinct latent performance trajectories. However, no research to date has
modeled these 2 aspects of job performance in tandem. Drawing on previous
literature, the authors note that current performance may act as performance
feedback, influencing future performance directly (i.e., autoregression), and
that individuals differ in their performance trajectories due to
individual-difference factors (i.e., latent trajectories). The authors
demonstrate an autoregressive latent trajectory (ALT) model to show how both
autoregressive and latent trajectory parameters may be incorporated in modeling
job performance over time. Also discussed are the implications of the ALT model
for future studies examining job performance longitudinally. 2008 APA

PMID: 18211147 [PubMed - indexed for MEDLINE]


43. Eur J Public Health. 2008 Jun;18(3):235-7. Epub 2008 Jan 17.

The impact of psychosocial work environment factors on the risk of disability
pension in Denmark.

Christensen KB, Feveile H, Labriola M, Lund T.

National Research Centre for the Working Environment, Lersø Parkallé 105, 2100
Copenhagen Ø, Denmark. KBC@NRCWE.DK

This study quantifies the impact of psychosocial work environment factors on the 
risk of disability pension. Differences in risk of disability pension were
estimated in a representative sample of Danish employees followed for a total of 
118 117 person-years of risk time. After control for smoking, BMI and ergonomic
work environment, low decision authority and low variation in work showed a
statistically significant association with disability pension. Adverse
psychosocial work environment factors accounted for 10-15% of disability pension 
cases.

PMID: 18202086 [PubMed - indexed for MEDLINE]


44. Br J Gen Pract. 2008 Jan;58(546):8-14.

Effect of the new contract on GPs' working lives and perceptions of quality of
care: a longitudinal survey.

Whalley D, Gravelle H, Sibbald B.

National Primary Care Research and Development Centre, University of Manchester, 
Manchester. diane.whalley@manchester.ac.uk

Comment in:
    Br J Gen Pract. 2008 Jan;58(546):5-6.
    Br J Gen Pract. 2008 Feb;58(547):126.
    Br J Gen Pract. 2008 Mar;58(548):204.

BACKGROUND: An ambitious pay-for-performance system was implemented in UK general
practice in 2004 amid doubts that it could improve both the working lives of
doctors and quality of care. AIM: To evaluate doctors' perceptions of their
working lives and quality of care before and after the new contract. DESIGN OF
STUDY: Longitudinal questionnaire survey. SETTING: England, UK. METHOD: A
longitudinal postal survey of English GPs in February 2004 and September 2005.
Measures included reported job satisfaction (7-point scale), hours worked,
income, and impact of the contract. RESULTS: Responses were available from 2105
doctors in 2004 and 1349 in 2005. Mean overall job satisfaction increased from
4.58 out of 7 in 2004 to 5.17 in 2005. The greatest improvements in satisfaction 
were with remuneration and hours of work. Mean reported hours worked fell from
44.5 to 40.8. Mean income increased from an estimated 73,400 pounds in 2004 to
92,600 pounds in 2005. Most GPs reported that the new contract had increased
their income (88%), but decreased their professional autonomy (71%), and
increased their administrative (94%) and clinical (86%) workloads. After the
introduction of the contract doctors were more positive than they had anticipated
about its impact on quality of care. CONCLUSION: GPs' job satisfaction increased 
after the introduction of the new contract, despite perceptions of negative
consequences for workload and autonomy. GPs reported working fewer hours with a
higher income, and their expectations regarding the impact of the contract on
quality of care had been exceeded.

PMCID: PMC2148232
PMID: 18186990 [PubMed - indexed for MEDLINE]


45. Psychosom Med. 2008 Jan;70(1):85-91. Epub 2007 Dec 24.

Do changes in job control predict differences in health status? Results from a
longitudinal national survey of Canadians.

Smith P, Frank J, Bondy S, Mustard C.

Institute for Work and Health, 481 University Avenue, Suite 800, Toronto, ON,
Canada M5G 2E9. psmith@iwh.on.ca

OBJECTIVE: To examine the effect of changes in job control on health behaviors,
psychological distress and health status. METHODS: Using a path analysis model,
we examined the effects of change in job control over a 4-year period on levels
of physical activity, smoking, and psychological distress; and on self-rated
health over an additional 2 years, among a representative sample of 2221
Canadians. RESULTS: Over the 4-year period, 280 respondents reported decreases in
job control, and 256 reported increases in job control. Health at baseline was
not associated with the likelihood of changes in job control. We found a graded
relationship between change in job control and levels of physical activity and
psychological distress over a 4-year period; and levels of self-rated health over
a 6-year period, with positive change in job control associated in higher levels 
of physical activity and self-rated health and lower levels of distress.
CONCLUSIONS: The results of this study suggest that both level of job control and
changes in job control have direct and indirect effects on health status over
time. Future research should focus on developing precise measures of work
exposures, and examine differences between changes in job control due to only
changes in perceptions and changes due to work redesign.

PMID: 18158374 [PubMed - indexed for MEDLINE]


46. J Epidemiol Community Health. 2008 Jan;62(1):42-7.

The relationship between work stress and mental disorders in men and women:
findings from a population-based study.

Wang JL, Lesage A, Schmitz N, Drapeau A.

Department of Psychiatry and of Community Health Sciences, Faculty of Medicine,
University of Calgary, Calgary, Alberta, Canada. jlwang@ucalgary.ca

OBJECTIVES: [corrected] This analysis estimated the gender-specific associations 
between work stress, major depression, anxiety disorders and any mental disorder,
adjusting for the effects of demographic, socioeconomic, psychological and
clinical variables. METHODS: Data from the Canadian national mental health survey
were used to examine the gender-specific relationships between work stress
dimensions and mental disorders in the working population (n = 24,277). Mental
disorders were assessed using a modified version of the World Mental Health -
Composite International Diagnostic Interview. RESULTS: In multivariate analysis, 
male workers who reported high demand and low control in the workplace were more 
likely to have had major depression (OR 1.74, 95% CI 1.12 to 2.69) and any
depressive or anxiety disorders (OR 1.47, 95% CI 1.05 to 2.04) in the past 12
months. In women, high demand and low control was only associated with having any
depressive or anxiety disorder (OR 1.39, 95% CI 1.05 to 1.84). Job insecurity was
positively associated with major depression in men but not in women. Imbalance
between work and family life was the strongest factor associated with having
mental disorders, regardless of gender. CONCLUSIONS: Policies improving the work 
environment may have positive effects on workers' mental health status. Imbalance
between work and family life may be a stronger risk factor than work stress for
mental disorders. Longitudinal studies incorporating important workplace health
research models are needed to delineate causal relationships between work
characteristics and mental disorders.

PMID: 18079332 [PubMed - indexed for MEDLINE]


47. Occup Environ Med. 2008 Aug;65(8):525-33. Epub 2007 Dec 4.

Effort-reward imbalance and incidence of low back and neck injuries in San
Francisco transit operators.

Rugulies R, Krause N.

National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100
Copenhagen, Denmark. rer@nrcwe.dk

OBJECTIVES: Effort-reward imbalance (ERI) has been associated with
musculoskeletal disorders in cross-sectional and case-control studies, but no
longitudinal studies have been published yet. The effect of ERI on the incidence 
of compensated low back and neck injuries was examined in a 7.5-year follow-up
study among 1179 San Francisco transit operators. METHODS: Data from medical
examination and a survey on working conditions and health were linked to
administrative workers' compensation databases. HRs for first low back and first 
neck injury were calculated with multivariate Cox regression models. Additional
analyses accounted for severity of injury based on medical diagnosis. RESULTS: A 
1 SD increase in ERI was associated with compensated low back (HR 1.13, 95% CI
1.02 to 1.26) and neck injuries (HR 1.14, 95% CI 1.02 to 1.27) after adjusting
for gender, age, height, weight, years of professional driving, weekly driving
hours, vehicle type, ergonomic problems, pain at baseline and job strain. The
highest quartile of ERI showed an HR of 1.32 (95% CI 0.94 to 1.86) for low back
injuries and an HR of 1.66 (95% CI 1.16 to 2.38) for neck injuries after
adjustment for all covariates. The associations between ERI and low back injury
were stronger for more severe injuries (HR 1.23, 95% CI 1.03 to 1.46 for a 1 SD
increase in ERI) than for less severe injuries (HR 1.11, 95% CI 0.96 to 1.28).
For neck injuries, stronger relationships were found for less severe injuries (HR
1.15, 95% CI 1.02 to 1.29) than for more severe injuries (HR 1.10, 95% CI 0.86 to
1.41). CONCLUSIONS: ERI is associated with low back and neck injuries in San
Francisco transit operators independently of individual worker characteristics,
physical workload, ergonomic problems, baseline pain and job strain. Effect sizes
differ by injury severity.

PMID: 18056748 [PubMed - indexed for MEDLINE]


48. J Occup Rehabil. 2007 Dec;17(4):641-51. Epub 2007 Oct 12.

Associations between employees' work schedules and the vocational consequences of
workplace injuries.

Dembe AE, Delbos R, Erickson JB, Banks SM.

Division of Health Services, Management and Policy, College of Public Health, The
Ohio State University, Columbus, OH 43210, USA. adembe@cph.osu.edu

INTRODUCTION: This study examines the effect of long-hour work schedules and
nonstandard shift work (e.g., night and evening shifts) on the ability of injured
workers to maintain productive employment following a workplace injury. METHODS: 
Analyses were based on 13 years of data from the National Longitudinal Survey of 
Youth. Multivariate logistic regression analyses were performed with one of ten
nonstandard schedules as the independent variable and a particular vocational
consequences as the dependent variable. Vocational consequences included being
unable to perform normal job duties, temporary job reassignment, working less
than full time, filing a workers' compensation claim, and quitting or being fired
because of the injury. Covariates in the regression model included age, gender,
occupation, industry, and region. RESULTS: The most prominent effects of working 
a nonstandard schedule were a increased risk of being fired (OR = 1.81; 1.15-2.90
CI 95%), quitting (OR = 1.68; 1.20-2.36 CI 95%), or being unable to work full
time (OR = 1.33; 1.08-1.64 CI 95%) following an injury, compared to injured
workers in conventional schedules. Schedules involving overtime and long working 
hours generally had a greater impact on vocational consequences following a
workplace injury than did schedules involving night, evening, and other
nonstandard shift work. CONCLUSIONS: Occupational rehabilitation professionals
need to consider the specific type of work schedule when developing effective
return-to-work plans for injured workers. Special precautions need to be taken
for workers returning to schedules that involve more than 12 h per day, 60 h per 
week, and long commutes.

PMID: 17932731 [PubMed - indexed for MEDLINE]


49. Int Arch Occup Environ Health. 2008 May;81(6):777-85. Epub 2007 Oct 10.

Cancer mortality risk among biology research workers in France: first results of 
two retrospective cohorts studies.

Guseva Canu I, Rogel A, Samson E, Benhamou S, Laplanche A, Tirmarche M.

Institut de Radioprotection et de Sûreté Nucléaire, Service de Radiobiologie et
d'Epidémiologie IRSN/DRPH/SRBE/LEPID, BP 17, 92262 Fontenay-aux-Roses, France.
irina.canu@irsn.fr

OBJECTIVE: To investigate all-cause and cancer mortality of biological research
laboratories workers of the French Atomic Energy Commission (CEA) and the
National Institute of Health and Medical Research (INSERM). METHODS: Two cohorts,
bioCEA (N = 3,509) and bioINSERM (N = 4,966) were followed from 1968 to 1994 and 
1980 to 1993, respectively. The mortality of each cohort was compared with that
of the French population by computation of the standardized mortality ratio (SMR)
with their 90% confidence interval (90% CI). Trend and heterogeneity tests were
computed in order to study SMRs variation by job characteristics. In the bioCEA
cohort individual dosimetry data being available, a trend test was also computed 
according to ionizing radiation cumulative dose. RESULTS: The SMRs were
significantly below one in both cohorts for all-cause mortality (bioCEA: SMR =
0.52 [0.46-0.59], bioINSERM: SMR = 0.56 [0.46-0.67]) and for all-cancer mortality
(bioCEA: SMR = 0.66 [0.54-0.80], bioINSERM: SMR = 0.55 [0.39-0.75]). There were
some specific cancer sites for which the SMR was higher than 1, but not
significantly. In the bioCEA cohort a positive trend was observed between
ionizing radiation cumulative doses and all-cause as well as all-cancer SMRs.
CONCLUSION: This study on two French cohorts of biological research workers found
a favorable mortality pattern. These findings are consistent with recent
publications. The positive trend of cancer mortality according to ionizing
radiation exposure among bioCEA cohort needs to be confirmed with more precise
assessment of exposures and information on individual risk factors.

PMID: 17929049 [PubMed - indexed for MEDLINE]


50. Am J Ind Med. 2007 Dec;50(12):921-31.

On the job illness and injury resulting in lost work time among a national cohort
of emergency medical services professionals.

Studnek JR, Ferketich A, Crawford JM.

National Registry of Emergency Medical Technicians, Columbus, Ohio 43230, USA.
jons@nremt.org

BACKGROUND: The objective of this study was to estimate the prevalence and
incidence of job-related illness or injury resulting in lost work time among a
national cohort of Emergency Medical Services (EMS) professionals. Also, it was
hypothesized that individual and work life characteristics were associated with
the occurrence of illnesses or injury. METHODS: Data for this analysis were
obtained from the Longitudinal Emergency Medical Technician Attributes and
Demographics Study (LEADS), a prospective study of EMS professionals. The outcome
variable of interest was self-reported absence from their EMS job due to an EMS
work related illness or injury. The prevalence and incidence of injury with lost 
work time was estimated using cross-sectional and follow-up data. Multivariable
logistic regression analyses were performed to determine if individual and work
life characteristics were associated with occupational injury. RESULTS: The
prevalence of job-related illness or injury with time away from work was
estimated at 9.4%, while the 1-year incidence was estimated at 8.1 per 100 EMS
providers. The results from the logistic regression model fit to follow-up data
indicate that increasing call volume (OR=3.12 for very high vs. moderate, 95% CI 
1.40-6.97), an urban work environment (OR=2.79, 95% CI 1.65-4.72) and a history
of back problems (OR=1.72, 95% CI 1.06-2.78) were associated with reporting
job-related illness or injury. CONCLUSIONS: Results from this analysis provide
estimates of the prevalence and incidence of on the job illness and injury
resulting in lost work time among a national cohort of EMS professionals.

PMID: 17918231 [PubMed - indexed for MEDLINE]


51. J Occup Environ Med. 2007 Sep;49(9):990-6.

Job strain, life events, and sickness absence: a longitudinal cohort study in a
random population sample.

Suominen S, Vahtera J, Korkeila K, Helenius H, Kivimäki M, Koskenvuo M.

Department of Public Health, University of Turku, Lemminkäisenkatu 1, FIN 20014
University of Turku, Finland. sakari.suominen@utu.fi

OBJECTIVE: To examine job strain, adverse life events, and their co-occurrence as
predictors of sickness absence. METHODS: Random sample-based mail survey data on 
1806 Finns in gainful employment were linked to sickness absence records
(1987-1998) from national health registers. Generalized linear models with
negative binomial distribution assumption were applied. RESULTS: After adjustment
for demographic characteristics and health behavior, job strain (rate ratio [RR] 
1.73; 95% confidence interval [CI] = 1.21-2.48), but not life events,
independently predicted increased rate of sickness absence among men. The
opposite was true for women, (RR for life events 1.39; 95% CI = 1.10-1.75). No
statistically significant interaction between job strain and life events was
detected. CONCLUSION: In addition to job strain, strain originating in private
life should be kept in mind when the need for sickness absence of women employees
is evaluated within health care.

PMID: 17848855 [PubMed - indexed for MEDLINE]


52. Occup Environ Med. 2008 Feb;65(2):120-5. Epub 2007 Aug 6.

Mortality, morbidity and occupational exposure to airway-irritating agents among 
men with a respiratory diagnosis in adolescence.

Wiebert P, Svartengren M, Lindberg M, Hemmingsson T, Lundberg I, Nise G.

Dr P Wiebert, Department of Occupational and Environmental Health, Norrbacka,
Karolinska Hospital, SE-171 76 Stockholm, Sweden; pernilla.wiebert@sll.se.

OBJECTIVES: To examine the influence of an airway diagnosis in adolescence on
future health and occupation in Swedish men. METHODS: Data were collected from
the linkage of four Swedish national registers: the Military Service Conscription
Register, the Population and Housing Censuses, the Inpatient Care Register and
the National Cause of Death Register. A job-exposure matrix for airway-irritating
substances was developed for application on the conscription cohort. The cohort
included 49 321 Swedish men born 1949-51. Three groups-(1) healthy, (2)
asthmatics (mild and severe asthma) and (3) subjects with allergic rhinitis
without concurrent asthma-were identified at conscription and analysed for
mortality, in-patient care and strategies for choice of occupation with emphasis 
on airway-irritating job exposure. Analyses were adjusted for smoking and
childhood socioeconomic position. RESULTS: The prevalence of total asthma was
1.8%, severe asthma 0.45% and allergic rhinitis 2.7%. Mortality for all causes
was significantly higher in total asthma, hazard ratio (HR) 1.49 (95% CI 1.00 to 
2.23), and lower in allergic rhinitis, HR 0.52 (95% CI 0.30 to 0.91). Asthma was 
a risk factor for inpatient care while allergic rhinitis was associated with less
in-patient care (odds ratio (OR) for total asthma 1.16 (95% CI 1.00 to 1.34),
severe asthma 1.38 (95% CI 1.04 to 1.85), allergic rhinitis 0.92 (95% CI 0.82 to 
1.03)). Those with asthma tended to avoid jobs with a high probability for
airway-irritating exposure (OR 0.88, 95% CI 0.71 to 1.09), but not to the same
extent as subjects with allergic rhinitis (OR 0.58, 95% CI 0.47 to 0.70) (ORs
from 1990). CONCLUSION: Subjects with asthma did not change their exposure
situation to the same extent as subjects with allergic rhinitis. Further,
asthmatics had an increased risk for morbidity and mortality compared to healthy 
subjects and subjects with allergic rhinitis.

PMID: 17681997 [PubMed - indexed for MEDLINE]


53. BMC Musculoskelet Disord. 2007 Jul 14;8:68.

Prevalence of complaints of arm, neck and shoulder among computer office workers 
and psychometric evaluation of a risk factor questionnaire.

Eltayeb S, Staal JB, Kennes J, Lamberts PH, de Bie RA.

Maastricht University, Department of Epidemiology and Caphri Research Institute, 
Maastricht, The Netherlands. s_eltyeb@hotmail.com

BACKGROUND: Complaints of Arm Neck and Shoulder (CANS) represent a wide range of 
complaints, which can differ in severity from mild, periodic symptoms to severe, 
chronic and debilitating conditions. They are thought to be associated with both 
physical and psychosocial risk factors. The measurement and identification of the
various risk factors for these complaints is an important step towards
recognizing (a) high risk subgroups that are relevant in profiling CANS; and (b) 
also for developing targeted and effective intervention plans for treatment. The 
purpose of the present study was to investigate the prevalence of CANS in a Dutch
population of computer workers and to develop a questionnaire aimed at measuring 
workplace physical and psychosocial risk factors for the presence of these
complaints. METHODS: To examine potential workplace risk factors for the presence
of CANS, the Maastricht Upper Extremity Questionnaire (MUEQ), a structured
questionnaire, was developed and tested among 264 computer office workers of a
branch office of the national social security institution in the Netherlands. The
MUEQ holds 95 items covering demographic characteristics, in addition to seven
main domains assessing potential risk factors with regard to (1) work station,
(2) posture during work, (3) quality of break time, (4) job demands, (5) job
control, and (6) social support. The MUEQ further contained some additional
questions about the quality of the work environment and the presence of
complaints in the neck, shoulder, upper and lower arm, elbow, hand and wrist. The
prevalence rates of CANS in the past year were computed. Further, we investigated
the psychometric properties of the MUEQ (i.e. factor structure and reliability). 
RESULTS: The one-year prevalence rate of CANS indicated that 54% of the
respondents reported at least one complaint in the arm, neck and/or shoulder. The
highest prevalence rates were found for neck and shoulder symptoms (33% and 31%
respectively), followed by hand and upper arm complaints (11% to 12%) and elbow, 
lower arm and wrist complaints (6% to 7%). The psychometric properties of the
MUEQ were assessed using exploratory factor analysis which resulted in the
identification of 12 factors. The calculation of internal consistency and cross
validation provided evidence of reliability and lack of redundancy of items.
CONCLUSION: Neck and shoulder complaints are more frequently reported among Dutch
computer workers than arm, elbow and hand complaints. The results further
indicate that the MUEQ has satisfactory reliability and internal consistency when
used to document CANS among computer workers in the Netherlands.

PMCID: PMC1952062
PMID: 17629925 [PubMed - indexed for MEDLINE]


54. J Occup Environ Med. 2007 May;49(5):574-83.

Chronic bronchitis among nonsmoking farm women in the agricultural health study.

Valcin M, Henneberger PK, Kullman GJ, Umbach DM, London SJ, Alavanja MC, Sandler 
DP, Hoppin JA.

Epidemiology, National Institute of Environmental Health Sciences, NIH, DHHS,
Research Triangle Park, NC 27709-2233, USA.

OBJECTIVE: The purpose of this study was to examine agricultural risk factors for
chronic bronchitis among nonsmoking farm women. METHODS: We used self-reported
enrollment data from the 21,541 nonsmoking women in the Agricultural Health Study
to evaluate occupational risk factors for prevalent chronic bronchitis among farm
women. Odds ratios (ORs) for chronic bronchitis for occupational exposures were
adjusted for age, state, and related agricultural exposures. RESULTS: Applying
manure and driving combines were independently associated with chronic
bronchitis. Off-farm job exposures associated with chronic bronchitis were
organic dusts, asbestos, gasoline, and solvents. Five pesticides were associated 
with chronic bronchitis after multivariate adjustment and sensitivity analyses:
dichlorvos (OR=1.63, 95% CI=1.01, 2.61), DDT (OR=1.67, 95% CI=1.13, 2.47),
cyanazine (OR=1.88, 95% CI=1.00, 3.54), paraquat (OR=1.91, 95% CI=1.02, 3.55),
and methyl bromide (OR=1.82, 95% CI=1.02, 3.24). CONCLUSION: Pesticides as well
as grain and dust exposures were associated with chronic bronchitis among
nonsmoking farm women.

PMCID: PMC2074236
PMID: 17495700 [PubMed - indexed for MEDLINE]


55. Eval Health Prof. 2007 Jun;30(2):150-69.

Task analysis revisited: refining the phlebotomy technician scope of practice and
assessing longitudinal change in competencies.

Fidler JR.

American Medical Technologists, Rosemont, IL 6018, USA. james.fidler@amt1.com

A random sample of 500 phlebotomy technicians certified by a national
organization was queried regarding perceptions of importance of 53 specific
practice-related tasks representative of various departmental areas. The sample
was surveyed via a mail questionnaire. Role centrality was assessed by
considering mean importance ratings and by applying the Rasch measurement model
to assigned importance ratings. Approximately 36% of the questionnaires received 
by respondents were returned. The results revealed which tasks were fundamental
to the phlebotomy technician scope of practice. To assess longitudinal change in 
core duties, task saliency was considered with respect to similar data collected 
a decade earlier. Task importance may be considered by agencies that educate,
credential, or employ phlebotomy technicians in providing current job function
descriptions. The longitudinal methodology employed may be applicable to other
job roles for which the assessment of change is of interest.

PMID: 17476028 [PubMed - indexed for MEDLINE]


56. Am J Ind Med. 2007 Jun;50(6):464-9.

Factors associated with back problems among emergency medical technicians.

Studnek JR, Crawford JM.

National Registry of Emergency Medical Technicians, Columbus, OH 43230, USA.
jons@nremt.org

INTRODUCTION: Back problems are a common complaint among emergency medical
technicians (EMTs). It is hypothesized that the likelihood of reporting back
problems will be associated with the individual and work-related characteristics 
of a national sample of EMTs. METHODS: A case-control analysis was performed on
579 EMTs wherein cases were the 104 subjects who reported new back problems in
2004. Controls were 475 subjects who reported no back problems in 2003 and 2004. 
RESULTS: EMTs dissatisfied with their current assignment were significantly more 
likely to report back problems (OR = 9.33; 95% CI = 3.04-28.67), as were EMTs
reporting good or fair fitness when compared to excellent fitness (OR = 3.39; 95%
CI = 1.54-7.45, OR = 3.43; 95% CI = 1.37-8.56). CONCLUSIONS: Results from this
analysis suggest that there are two modifiable factors associated with
self-reported back problems among EMTs, satisfaction with current assignment and 
self-reported physical fitness.

PMID: 17471509 [PubMed - indexed for MEDLINE]


57. Work. 2007;28(3):225-30.

Who is at risk for long-term sickness absence? A prospective cohort study of
Danish employees.

Lund T, Labriola M, Villadsen E.

National Institute of Occupational Health, Copenhagen, Denmark.

AIM: The aim of this study was to identify who is at risk for long-term sickness 
absence according to occupation, gender, education, age, business sector, agency 
size and ownership. METHODS: The study is based on a sample of 5357 employees
aged 18-69, interviewed in 2000. The cohort was followed up in a national
register from January 1st 2001 to June 30th 2003, to identify cases with sickness
absences that exceeded 8 weeks. RESULTS: During follow-up 486 persons (9.1%)
experienced one or more periods of absence that exceeded 8 weeks. Higher risk of 
long-term sickness absence was associated with gender, age, educational level,
and the municipal employment sector. Kindergarten teachers and people employed in
day care, health care, janitorial work, food preparation, and unskilled workers
were at greatest risk. Managers, computer professionals, technicians and
designers, and professionals had lower risks. The health care and social service 
sectors were also in the high risk category, whereas the private administration
sector had a lower risk. CONCLUSIONS: The study identifies specific occupational 
target populations and documents the need to perform job-specific research and
tailor interventions if the intended policy of decreasing long-term sickness
absence within the Danish labour market is to be realized.

PMID: 17429148 [PubMed - indexed for MEDLINE]


58. Scand J Public Health. 2007;35(1):78-85.

Predictors of disability pension over a 10-year period for men and women.

Albertsen K, Lund T, Christensen KB, Kristensen TS, Villadsen E.

National Institute of Occupational Health, Copenhagen, Denmark. ka@ami.dk

AIMS: The number of people leaving the labour market with a disability pension is
high and knowledge regarding risk factors is limited. The aim of this study was
to explore work- and non-work-related predictors of disability pension among men 
and women and to estimate to what extent the gender difference in retirement rate
could be explained by factors in and outside work. METHODS: A random sample of
5,940 employees registered in the Danish National Work Environment Cohort Study
in 1995 was followed up with regard to labour market status in 2005 using the
DREAM register, which contains data on all social transfer payments in the Danish
population. Associations between disability pension and measures of ergonomic and
psychosocial work environment, public employment, family status, and lifestyle
were analysed by Cox regression and the difference in retirement rates adjusted
separately for each group of variables. RESULTS: The results showed (a) that both
men and women had a higher risk of disability pension when they had work that
involved standing or if they smoked; (b) that women in addition had a higher
likelihood if they were public employees, had low job security, or low social
support at work; (c) that the higher rate of disability pension among women
compared with men could not be explained by work environmental factors,
lifestyle, or family situation. Public employment was the single factor that
explained most of the difference. CONCLUSIONS: Gender differences in exposures
and predictors of disability pension were found, but few explanations of the
higher rate of disability pension among women.

PMID: 17366091 [PubMed - indexed for MEDLINE]


59. Scand J Public Health. 2007;35(1):23-30.

Influence of health, lifestyle, working conditions, and sociodemography on early 
retirement among nurses: the Danish Nurse Cohort Study.

Friis K, Ekholm O, Hundrup YA, Obel EB, Grønbaek M.

National Institute of Public Health, Copenhagen, Denmark. kfr@niph.dk

AIMS: The aim of the study was to analyze the relationship between health,
lifestyle, work-related and sociodemographic factors, and older nurses' exit from
the labor market to Post-Employment Wage (PEW). PEW is an early retirement scheme
to make it possible for workers to retire at the age of 60. METHODS: The study
was based on 5,538 nurses in the age of 51-59 who in 1993 completed a
questionnaire on health, lifestyle, working environment, and sociodemographic
factors. The survey information was combined with longitudinal data from the
Danish Integrated Database for Labor Market Research compiled by Statistics
Denmark. The follow-up period was from 1993 to 2002. RESULTS: Nurses who had poor
self-rated health were more likely to join PEW compared with nurses who
considered their health as good (HR 1.28, 95% CI 1.16-1.41). Low job influence,
high workload, and physical job demands only marginally increased the probability
of retiring. Nurses who have relatively low gross incomes had an increased
probability of entering PEW compared with nurses with relatively high gross
incomes (HR 1.60, CI 1.43-1.79). Having a spouse increased the probability of
joining PEW, especially having a spouse who had retired or was unemployed.
CONCLUSIONS: The retirement age among nurses is influenced by a number of
sociodemographic, work-related, and health-related factors. Poor health, low
income, living outside the Copenhagen area, being married, having a spouse who is
outside the labor force, and working in the daytime are all predictors of early
retirement among nurses. Poor working environment only marginally increased the
probability of retiring early.

PMID: 17366084 [PubMed - indexed for MEDLINE]


60. J Occup Rehabil. 2007 Jun;17(2):171-9. Epub 2007 Mar 6.

Incidence and risk factors of neck discomfort: a 6-month sedentary-worker cohort 
study.

Tsauo JY, Jang Y, Du CL, Liang HW.

School & Graduate Institute of Physical Therapy, College of Medicine, National
Taiwan University, Taipei, Taiwan.

INTRODUCTION: This study aimed to evaluate the six-month incidence and possible
risk factors of neck discomfort among sedentary workers. METHODS: Data, including
demographic characteristics, work history, psychological characteristics and
prevalent neck discomfort of 157 sedentary workers was collected by a
questionnaire. A follow-up questionnaire was administered six months later to
calculate the incidence of symptoms and related disability. RESULTS: The
six-month incidence of neck discomfort was 23.5% (12/51). The two groups of
prevalent and non-prevalent subjects showed no difference in demographic data and
work characteristics except for work load (p<0.05) and score in "job control" in 
the Job Content Questionnaire (JCQ) (p<0.05). In logistic regression, light-load 
work (versus no-load work, OR = 0.10, p = 0.023) and higher score of 'job
control' in JCQ (OR = 0.86, p = 0.031) were significant protecting factors.
CONCLUSION: The six-month incidence rates of neck discomfort in our subjects were
high. Light-load work and a higher score of 'job control' were important
preventive factors. The results provide an epidemiological basis for prevention
of neck discomfort in different working populations.

PMID: 17340188 [PubMed - indexed for MEDLINE]


61. Pharm World Sci. 2007 Jun;29(3):205-12. Epub 2007 Jan 23.

Maternal vaccination and preterm birth: using data mining as a screening tool.

Orozova-Bekkevold I, Jensen H, Stensballe L, Olsen J.

Danish Transport Research Institute, Knuth-Winterfeldts Allé, Bygning, Lyngby,
Denmark. iob@dtf.dk

OBJECTIVE: The main purpose of this study was to identify possible associations
between medicines used in pregnancy and preterm deliveries using data mining as a
screening tool. SETTINGS: Prospective cohort study. METHODS: We used data mining 
to identify possible correlates between preterm delivery and medicines used by
92,235 pregnant Danish women who took part in the Danish National Birth Cohort
(DNBC). We then evaluated the association between one of the identified exposures
(vaccination) and the risk for preterm birth by using logistic regression. The
women were classified into groups according to their exposure to vaccination. The
regression analyses were adjusted for the following covariates: parity, infant's 
gender, maternal Body-Mass Index (BMI), age, smoking, drinking, job, number of
inhabitants in the place of residence, infections, diabetes, high blood pressure 
and preeclampsia. MAIN OUTCOME MEASURE: Preterm birth, a delivery occurring
before the 259th day of gestation (i.e., less than 37 full weeks). RESULTS: Data 
mining had indicated that maternal vaccination (among other factors) might be
related to preterm birth. The following regression analysis showed that, the
women who reported being vaccinated shortly before or during gestation had a
slightly higher risk of giving preterm birth (O.R. = 1.14; 95% CI 1.04-1.25) as
compared to the non-vaccinated group. CONCLUSION: Whether the association between
maternal vaccination and the risk for preterm birth found here is causal or not
deserves further studies. Data mining, especially with additional refinements,
may be a valuable and very efficient tool to screen large databases for relevant 
information which can be used in clinical and public health research.

PMID: 17242856 [PubMed - indexed for MEDLINE]


62. Spine (Phila Pa 1976). 2007 Jan 15;32(2):269-74.

Emotional distress as a predictor for low back disability: a prospective 12-year 
population-based study.

Brage S, Sandanger I, Nygård JF.

Department of General Practice and Community Medicine, University of Oslo, Oslo, 
Norway. soren.brage@medisin.uio.no

STUDY DESIGN: A population-based, prospective cohort. OBJECTIVE: To study
associations between emotional distress and long-term low back disability in a
general population. SUMMARY OF BACKGROUND DATA: In primary and hospital care
studies, emotional, cognitive, and personality factors have been associated with 
low back disability, while the association between distress and novel back pain
episodes has been uncertain. METHODS: A randomly drawn cohort of 1152
occupationally active persons aged 20-55 years was interviewed with a
comprehensive psychosocial questionnaire in 1990, and was followed for 12 years
in national registers over sickness, rehabilitation, and disability benefits.
Data on emotional distress, earlier low back pain (LBP), education, life style,
psychosocial, and work-related factors were collected at baseline. RESULTS:
Long-term benefits due to low back disability were granted to 131 persons (11.4%)
in the follow-up period. In multivariate analysis, earlier LBP, emotional
distress, low grade of education, and high physical job stress were associated
with low back disability. Persons with both emotional distress and earlier back
pain were most at risk for disability (hazard ratio 2.91, 95% confidence interval
1.60-5.29). Persons with emotional distress but no earlier episodes of LBP had no
increased risk for low back disability (hazard ratio 0.71, 95% confidence
interval 0.34-1.45). CONCLUSIONS: Emotional distress is a predictor for low back 
disability in persons with earlier LBP, but not in persons without. To prevent
low back disability, emotional distress should be considered and treated in
persons with LBP.

PMID: 17224825 [PubMed - indexed for MEDLINE]


63. Soc Sci Med. 2007 Mar;64(6):1178-91. Epub 2006 Dec 12.

Workplace harassment patterning, gender, and utilization of professional
services: findings from a US national study.

Shannon CA, Rospenda KM, Richman JA.

University of Illinois at Chicago, Chicago, IL, USA. cshannon@psych.uic.edu

This study constitutes the first national longitudinal survey to address the
relationship between workplace harassment and service utilization. We examine how
patterns of sexual harassment and generalized workplace harassment are linked to 
utilization of mental health, health, legal, spiritual, and work-related
services, and whether and how gender influences these relationships. Data derive 
from a random digit dial telephone survey with a continental US sample of
employed adults. Eligibility criteria were being 18 years of age or over, and
being employed at least 20 h per week at some time in the 12 months prior to the 
wave 1 survey. Out of 4116 households with eligible individuals, 2151 agreed to
participate at wave 1. At wave 2, 1418 participated, thus, the overall response
rate was 34.5%. We show that the patterning of workplace harassment over two time
points (chronic, remission, onset, never harassed) is associated with the use of 
different types of services. Gender partially moderated the relationship between 
workplace harassment and services.

PMCID: PMC1865113
PMID: 17166642 [PubMed - indexed for MEDLINE]


64. Stroke. 2007 Jan;38(1):27-33. Epub 2006 Nov 30.

The socioeconomic gradient in the incidence of stroke: a prospective study in
middle-aged women in Sweden.

Kuper H, Adami HO, Theorell T, Weiderpass E.

Clinical Research Unit, London School of Hygiene & Tropical Medicine, Keppel
Street, London WC1E 7HT, U.K. hannah.kuper@lshtm.ac.uk

Comment in:
    Stroke. 2007 Jan;38(1):4-5.

BACKGROUND AND PURPOSE: A socioeconomic gradient in stroke has been demonstrated 
in a variety of settings, but mostly in men. Our purpose was to establish whether
a socioeconomic gradient in stroke existed in a group of Swedish women and
whether this gradient could be explained by established stroke risk factors or
psychosocial factors. METHODS: The Women's Lifestyle and Health Cohort Study
includes 49 259 women from Sweden aged 30 to 50 years at baseline (1991 to 1992).
The women completed an extensive questionnaire and were traced through linkages
to national registries until the end of 2002. Among the 47 942 women included in 
these analyses, there were 200 cases of incident stroke during follow up (121
ischemic stroke, 47 hemorrhagic stroke, and 32 of unknown origin). Statistical
analysis was through the Cox proportional hazards model. RESULTS: The risk of
stroke was significantly inversely related to years of education completed, our
proxy for socioeconomic status (hazard ratio comparing lowest with highest
education group=2.1, 95% CI: 1.4 to 2.9, P for trend <0.001). This association
was reduced after adjustment for established risk factors, although remaining
significant (1.5, 1.0 to 2.2, P for trend=0.04). The gradient was more pronounced
for ischemic stroke (2.9, 1.8 to 4.7, P for trend <0.001) than for hemorrhagic
stroke (1.4, 0.7 to 2.9, P for trend=0.35). Job strain and social support were
unrelated to risk of stroke. Self-rated health was strongly related to risk of
stroke mediated by established risk factors. Psychosocial factors did not
contribute toward the socioeconomic gradient in stroke. CONCLUSIONS: There was a 
strong gradient in risk of stroke by years of education, especially for ischemic 
stroke. Most of the social gradient was explained by established risk factors,
particularly smoking and alcohol, but not by psychosocial factors.

PMID: 17138948 [PubMed - indexed for MEDLINE]


65. Health Rep. 2006 Oct;17(4):11-29.

Stress and depression in the employed population.

Shields M.

Health Statistics Division, Statistics Canada, Ottawa, Ontario, K1A 0T6.
Margot.Shields@statcan.ca

OBJECTIVES: This article describes stress levels among the employed population
aged 18 to 75 and examines associations between stress and depression. DATA
SOURCES: Data are from the 2002 Canadian Community Health Survey: Mental Health
and Well-being and the longitudinal component of the 1994/95 through 2002/03
National Population Health Survey. ANALYTICAL TECHNIQUES: Stress levels were
calculated by sex, age and employment characteristics. Multivariate analyses were
used to examine associations between stress and depression in 2002, and between
stress and incident depression over a two-year period, while controlling for age,
employment characteristics, and factors originating outside the workplace. MAIN
RESULTS: In 2002, women reported higher levels of job strain and general
day-to-day stress. When the various sources of stress were considered
simultaneously, along with other possible confounders, for both sexes, high
levels of general day-to-day stress and low levels of co-worker support were
associated with higher odds of depression, as was high job strain for men. Over a
two-year period, men with high strain jobs and women with high personal stress
and low co-worker support had elevated odds of incident depression.

PMID: 17111591 [PubMed - indexed for MEDLINE]


66. Int J Rehabil Res. 2006 Sep;29(3):229-35.

Return to work among sickness-absent Danish employees: prospective results from
the Danish Work Environment Cohort Study/National Register on Social Transfer
Payments.

Lund T, Labriola M, Christensen KB, Bültmann U, Villadsen E.

National Institute of Occupational Health, Copenhagen Denmark. tl@ami.dk

This study investigates the determinants within socio-demography, health
behaviour, employer characteristics, and psychosocial and physical work
environment for return to work. In 2000, a total of 5357 employees were
interviewed regarding age, gender, family status, education, health behaviour,
employer characteristics and work environment. They were followed in a national
register for 18 months in order to identify subjects with 2 weeks or more of
sickness absence. They were followed for an additional 12 months in order to
establish associations between baseline measurements and time to first return to 
work. A total of 930 (17.4%) employees experienced sickness absence in the 18
months after baseline. During the 12-month follow-up, 856 (92.0%) returned to
work, the mean absence period being 6.6 weeks. Prolonged time to first return to 
work was associated with female gender, increased age, no post-school education, 
being employed by a public employer, working at a workplace with 20 or more
employees, high emotional demands in work, high job insecurity and sedentary
work. There were no associations between health behaviour variables and return to
work. The study indicates a potential for promoting return to work through
interventions targeting emotional job demands, job insecurity and decreasing the 
risks associated with sedentary work.

PMID: 16900044 [PubMed - indexed for MEDLINE]


67. Psychooncology. 2007 Mar;16(3):205-13.

Job loss and reemployment after a cancer diagnosis in Koreans - a prospective
cohort study.

Choi KS, Kim EJ, Lim JH, Kim SG, Lim MK, Park JG, Park EC.

Research Institute for National Cancer Control and Evaluation, National Cancer
Center, 809, Madu-dong, Ilsandong-gu, Goyang-si, Gyeonggi-do 411-769, Korea.

Patients undergoing treatment for cancer have reported a variety of work-related 
problems. The aim of this study was to investigate the impact of a cancer
diagnosis on employment status, and to identify relevant associated factors. This
prospective cohort study was conducted at the National Cancer Center in Korea.
Male patients newly diagnosed with stomach, liver, or colorectal cancers were
recruited. Patients were interviewed and asked to complete an employment
questionnaire every 3 months for 24 months. Clinical, sociodemographic and
work-related factors were assessed. There were 305 male patients who had a
primary diagnosis of cancer and underwent appropriate treatment. Of the 305 male 
patients who were employed at the time of diagnosis, 53% lost their job, and of
these 23% later reemployed. In a multivariate Cox regression analysis, job loss
was significantly associated with years of education, job characteristics and
disease stage. Reemployment was significantly associated with disease stage and
cancer site. Change of employment was common among cancer patients in Korea. With
an understanding of the factors involved, it should be possible to reduce
unnecessary work cessation, and increase the rate of employment of cancer
survivors. Copyright 2006 John Wiley & Sons, Ltd.

PMID: 16894641 [PubMed - indexed for MEDLINE]


68. J Psychosom Res. 2006 Aug;61(2):271-4.

Justice at work and cardiovascular mortality: a prospective cohort study.

Elovainio M, Leino-Arjas P, Vahtera J, Kivimäki M.

National Research and Development Center for Welfare and Health, P.O. Box 220,
FIN-00531 Helsinki, Finland. marko.elovainio@stakes.fi

OBJECTIVES: Previous studies have suggested that the extent to which employees
are treated with justice at the workplace contributes to their health. We
examined whether justice at work predicted incidence of deaths from
cardiovascular disease. METHODS: Participants were 804 factory workers whose
mortality data were collected from the Finnish national mortality register (73
deaths; mean follow-up, 25.6 years). Justice perceptions of the participants were
measured using a postal survey at baseline year 1973. RESULTS: Cox proportional
hazards models adjusted for conventional risk factors and other psychosocial
factors at work showed that employees reporting high justice at work had a 45%
lower risk of cardiovascular death than their counterparts experiencing low or
intermediate justice (P=.05). CONCLUSIONS: Justice at work, fair decision-making 
procedures, and managerial skills are important factors in an effort to develop
healthy and well-functioning workplaces.

PMID: 16880031 [PubMed - indexed for MEDLINE]


69. Scand J Work Environ Health. 2006 Jun;32(3):232-40.

Nonstandard shift schedules and the risk of job-related injuries.

Dembe AE, Erickson JB, Delbos RG, Banks SM.

University of Massachusetts Medical School, Shrewbury, Massachusetts, USA.
adembe@sph.osu.edu

OBJECTIVES: This study assessed the extent to which working various types of
nonstandard shift schedules (eg, night and evening shifts) is associated with the
risk of occupational injuries or illnesses. METHODS: Multivariate analyses were
conducted using data from 13 years (1987 to 2000) of the National Longitudinal
Survey of Youth (NLSY) encompassing 110 236 job records and over 82 000
person-years of work experience. Cox proportional hazard regression techniques
were used to derive hazard ratios comparing the relative risk of suffering a
work-related injury among people working night, evening, rotating, split, and
irregular shifts to the risks for those working conventional day shifts, after
adjustment for age, gender, occupation, industry, and region. Incidence rates
were normalized using a common denominator of 100 person-years of "at-risk time" 
to obtain valid comparisons. RESULTS: All of the nonstandard shift schedules,
except split shifts, were found to have a higher risk for occupational injuries
and illnesses than conventional day shifts. After control for the selected
covariates, the calculated hazard ratios were 1.43 for evening shifts [95%
confidence interval (95% CI) 1.26-1.62], 1.36 for rotating shifts (95% CI
1.17-1.58), 1.30 for night shifts (95% CI 1.12-1.52), 1.15 for irregular shifts
(1.03-1.30), and 1.06 for split shifts (0.71-1.58). CONCLUSIONS: These findings
suggest that nonstandard shifts are not more risky merely because of the
concentration of hazardous jobs in those types of schedules or because of
underlying differences in the characteristics of employees working nonstandard
shifts. The results point to the need to extend targeted injury prevention
programs not only to people working night shifts, but also to those who work
evenings.

PMID: 16804627 [PubMed - indexed for MEDLINE]


70. Subst Use Misuse. 2006;41(8):1125-38.

Predictors of engagement in vocational counseling for methadone treatment
patients.

Kang SY, Magura S, Blankertz L, Madison E, Spinelli M.

National Development and Research Institutes, Inc., New York, New York 10010,
USA.

Employment enhances the outcomes of substance dependency treatment.
Unfortunately, although unemployed methadone treatment patients frequently state 
they are interested in a job, many fail to participate in vocational services
when available. Unless patients become engaged, vocational services do not have
an opportunity to be effective. This is the first study to explore a broad array 
of factors that may be associated with differential engagement in vocational
services among methadone patients. The study was conducted in two methadone
programs in New York City during 2001-2004. Unemployed methadone patients (n =
211) were voluntarily randomly assigned to either of two vocational counseling
programs (standard vs. experimental) and followed for 6 months. The sample was
59% male, 75% minority group, aged 45 years on average, and in methadone
treatment for 5 years on average. Being engaged in the vocational counseling
programs was defined as five or more sessions with the counselor in the first 6
months after study entry. In multivariate analysis, the factors associated with
higher engagement in vocational counseling were being non-Hispanic, having more
education, a drug injection history, a crack use history, having chronic
emotional/mental problems, better work attitudes, and assignment to the
experimental vocational program. The results indicate that it is often the most
"needy" unemployed methadone patients who become more engaged in vocational
counseling. A vocational counseling model which emphasizes assertive outreach and
attends to nonvocational clinical issues as well is more likely to engage
patients.

PMID: 16798680 [PubMed - indexed for MEDLINE]


71. Aging Ment Health. 2006 Jul;10(4):368-77.

Predicting mental health outcomes in female working carers: a longitudinal
analysis.

Lyonette C, Yardley L.

Dept. of Sociology, City University, Northampton Square, London, UK.
C.Lyonette@city.ac.uk

This study investigated the factors contributing to psychological distress and
positive affect over time in female working carers of older people.
Questionnaires (including measures of work-related, care-related, interpersonal
and psychological aspects of working and caring) were distributed to 275 female
working carers in the UK, the majority of whom were working as nurses in the
National Health Service. In cross-sectional analyses, higher work stress and work
demands predicted higher psychological distress among respondents. Better carer
health, lower external pressures to care and higher work satisfaction predicted
greater positive affect. The combined effects of greater work stress and work
demands also predicted higher levels of psychological distress at follow-up
(after one year), whereas younger age and lower work stress predicted greater
positive affect over time. We conclude that more stressful and demanding work
roles appear detrimental to carers' mental health, while lower stress
occupational roles may be beneficial, providing satisfaction and fulfilment
outside of the caring role. Older female carers may be especially at risk of
psychological distress, possibly due in part to increasing health problems of
their own.

PMID: 16798629 [PubMed - indexed for MEDLINE]


72. Am J Epidemiol. 2006 Aug 15;164(4):349-57. Epub 2006 Jun 20.

Psychosocial determinants of coronary heart disease in middle-aged women: a
prospective study in Sweden.

Kuper H, Adami HO, Theorell T, Weiderpass E.

Clinical Research Unit, London School of Hygiene and Tropical Medicine, London,
United Kingdom. hannah.kuper@lshtm.ac.uk

A social gradient in coronary heart disease (CHD) has been documented in a
variety of settings, predominantly among men. This study aimed to establish
whether a social gradient in CHD existed in a group of Swedish women and whether 
it could be explained by established coronary risk factors or psychosocial
factors. The Women's Lifestyle and Health Cohort Study includes 49,259 women from
Sweden aged 30-50 years at baseline (1991-1992), when an extensive questionnaire 
was completed. There was complete follow-up through linkages to national
registries until the end of 2002, during which time 210 cases of incident fatal
CHD or nonfatal myocardial infarction occurred. Risk of CHD was significantly
inversely related to years of education, the socioeconomic status proxy (hazard
ratio comparing the lowest with the highest education group = 3.3, 95% confidence
interval: 2.2, 4.7). This association was reduced after adjustment for
established coronary risk factors (smoking, body mass index, alcohol consumption,
diabetes, hypertension, exercise; hazard ratio = 1.9, 95% confidence interval:
1.3, 2.8). Job strain and social support were weakly related to CHD and did not
explain the gradient by years of education. Self-rated health was strongly
related to CHD, mediated by established coronary risk factors. Results show a
strong gradient in CHD by years of education explained by established coronary
risk factors but not by job strain or social support.

PMID: 16787994 [PubMed - indexed for MEDLINE]


73. Adm Policy Ment Health. 2007 Jan;34(1):45-56. Epub 2006 Jun 10.

Predictors of workforce turnover in a transported treatment program.

Sheidow AJ, Schoenwald SK, Wagner HR, Allred CA, Burns BJ.

Family Services Research Center, Department of Psychiatry and Behavioral
Sciences, Medical University of South Carolina, 67 President Street, 250861,
Charleston, SC, USA. sheidoaj@musc.edu

This study examined relations between workforce turnover and select clinician
(demographic and professional characteristics and perceptions of treatment model 
features and job requirements) organizational (perceptions of organizational
climate and structure) and program level (salary, case mix) variables in a sample
of 453 clinicians across 45 organizations participating in a transportability
study of an empirically supported adolescent treatment (i.e., MST). At 20%
annually, turnover was lower than in the national mental health workforce (i.e., 
50-60%). Clinician demographic, professional background, and perceptions of the
treatment model and demands did not predict turnover. Perceptions of an
emotionally demanding organizational climate, program salary level, and program
case mix of youth did predict turnover.

PMID: 16767507 [PubMed - indexed for MEDLINE]


74. Psychosom Med. 2006 May-Jun;68(3):402-7.

Is incomplete recovery from work a risk marker of cardiovascular death?
Prospective evidence from industrial employees.

Kivimäki M, Leino-Arjas P, Kaila-Kangas L, Luukkonen R, Vahtera J, Elovainio M,
Härmä M, Kirjonen J.

Department of Psychology, Finnish Institute of Occupational Health,
Topeliuksenkatu 41 aA, FI-00250 Helsinki, Finland. mika.kivimaki@ttl.fi

OBJECTIVE: A chronic lack of recovery from work during leisure time is
hypothesized to indicate a health risk among employees. We examined whether
incomplete recovery from work predicted cardiovascular mortality. METHODS: This
prospective cohort study involved 788 industrial employees (534 men, 254 women,
mean age 37.3, SD = 12.0) who were initially free from cardiovascular diseases.
The baseline examination in 1973 determined cases of cardiovascular disease,
cardiovascular risk factors, and the extent of recovery from work. Data on
mortality in 1973 to 2000 were derived from the national mortality register.
RESULTS: Sixty-seven cardiovascular deaths and 102 deaths from noncardiovascular 
causes occurred during the mean follow-up of 25.6 years. Employees who seldom
recovered from work during free weekends had an elevated risk of cardiovascular
death (p = .007) but not of other mortality (p = .82). The association between
incomplete recovery and cardiovascular death remained after adjustment for age,
sex, and 16 conventional risk factors, including occupational background,
cholesterol, systolic pressure, body mass index, smoking, alcohol consumption,
physical inactivity, depressive symptoms, fatigue, lack of energy, and job
stress. The association was not explained by deaths that occurred close to the
assessment of recovery from work. CONCLUSIONS: This study suggests that
incomplete recovery from work is an aspect of the overall risk profile of
cardiovascular disease mortality among employees.

PMID: 16738071 [PubMed - indexed for MEDLINE]


75. Environ Health. 2006 May 22;5:13.

Update: cohort mortality study of workers highly exposed to polychlorinated
biphenyls (PCBs) during the manufacture of electrical capacitors, 1940-1998.

Prince MM, Hein MJ, Ruder AM, Waters MA, Laber PA, Whelan EA.

Centers for Disease Control and Prevention, National Institute for Occupational
Safety and Health, Division of Surveillance, Hazard Evaluation and Field Studies,
Industrywide Studies Branch, Cincinnati, Ohio 45226, USA.
mmprince12@earthlink.net

BACKGROUND: The National Institute for Occupational Safety and Health previously 
reported mortality for a cohort of workers considered highly exposed to
polychlorinated biphenyls (PCBs) between 1939 and 1977 at two electrical
capacitor manufacturing plants. The current study updated vital status, examined 
liver and rectal cancer mortality previously reported in excess in this cohort
and evaluated mortality from non-Hodgkin's lymphoma (NHL) and cancers of the
stomach, intestine, breast, prostate, skin (melanoma) and brain reported to be in
excess in other cohort and case-control studies of PCB-exposed persons. METHODS: 
Mortality was updated through 1998 for 2572 workers. Age-, gender-, race- and
calendar year-adjusted standardized mortality ratios (SMRs) and 95% confidence
intervals (CI) were calculated using U.S., state and county referent rates. SMRs 
using U.S. referent rates are reported. Duration of employment was used as a
surrogate for exposure. RESULTS: Consistent with the previous follow-up,
mortality from biliary passage, liver and gall bladder cancer was significantly
elevated (11 deaths, SMR 2.11, CI 1.05 - 3.77), but mortality from rectal cancer 
was not (6 deaths, SMR 1.47, CI 0.54 - 3.21). Among women, mortality from
intestinal cancer (24 deaths, SMR 1.89, CI 1.21 - 2.82) and from "other diseases 
of the nervous system and sense organs", which include Parkinson's disease and
amyotrophic lateral sclerosis, (15 deaths, SMR 2.07, CI 1.16 - 3.42) were
elevated. There were four ALS deaths, all women (SMR 4.35, CI 1.19-11.14).
Mortality was elevated for myeloma (7 deaths, SMR 2.11, CI 0.84 - 4.34),
particularly among workers employed 10 years or more (5 deaths, SMR 2.80, CI 0.91
- 6.54). No linear associations between mortality and duration of employment were
observed for the cancers of interest. CONCLUSION: This update found that the
earlier reported excess in this cohort for biliary, liver and gall bladder cancer
persisted with longer follow-up. Excess mortality for intestinal cancer among
women was elevated across categories of duration of employment; myeloma mortality
was highest among those working 10 years or more. The small numbers of deaths
from liver and intestinal cancers, myeloma and nervous system diseases coupled
with the lack of an exposure-response relationship with duration of employment
preclude drawing definitive conclusions regarding PCB exposure and these causes
of death.

PMCID: PMC1524943
PMID: 16716225 [PubMed - indexed for MEDLINE]


76. Soc Sci Med. 2006 Aug;63(3):566-74. Epub 2006 Mar 31.

The relationship between nonstandard working and mental health in a
representative sample of the South Korean population.

Kim IH, Muntaner C, Khang YH, Paek D, Cho SI.

School of Public Health and Institute of Health and Environment, Seoul National
University, Republic of Korea. kihsdh2003@yahoo.com

In light of escalating job insecurity due to increasing numbers of nonstandard
workers, this study examined the association between nonstandard employment and
mental health among South Korean workers. We analyzed a representative weighted
sample of 2086 men and 1194 women aged 20-64 years, using data from the 1998
Korean National Health and Nutrition Examination Survey. Nonstandard employment
included part-time work, temporary work, and daily work. Mental health was
measured with indicators of self-reported depression and suicidal ideation. Based
on age-adjusted prevalence of mental health, nonstandard employees were more
likely to be mentally ill compared to standard employees. Furthermore,
nonstandard work status was associated with poor mental health after adjusting
for socioeconomic position (education, occupational class, and income) and health
behaviors (smoking, alcohol consumption, and exercise). However, the pattern of
the relationship between nonstandard work and mental health differed by gender.
Female gender was significantly associated with poor mental health. Although
males tended to report more suicidal ideation, this difference was not
statistically significant. Considering the increasing prevalence of nonstandard
working conditions in South Korea, the results call for more longitudinal
research on the mental health effects of nonstandard work.

PMID: 16580108 [PubMed - indexed for MEDLINE]


77. Am J Nurs. 2006 Apr;106(4):60-71, quiz 72.

How long and how much are nurses now working?

Trinkoff A, Geiger-Brown J, Brady B, Lipscomb J, Muntaner C.

University of Maryland School of Nursing, Baltimore, MD, USA.
trinkoff@son.umaryland.edu

OBJECTIVE: Extended work schedules-those that vary from the standard eight hours 
per day, 35 to 40 hours per week-are common in nursing and contribute to problems
with nursing recruitment and retention, in addition to compromising patient
safety and the health and well-being of nurses. This study describes the nature
and prevalence of such schedules across nursing settings. METHODS: Quantitative
survey data collected as part of the Nurses Worklife and Health Study were
analyzed. The sample consisted of 2,273 RNs. Demographic data, information about 
respondents' primary jobs (position, workplace, and specialty), and specific work
schedule variables were analyzed, including data on off-shifts, breaks, overtime 
and on-call requirements, time off between shifts, and how often respondents
worked more than 13 hours per day and on scheduled days off and vacation days.
Respondents were also asked about activities outside of work, commuting time, and
other non-nursing activities and chores. RESULTS: More than a quarter of the
sample reported that they typically worked 12 or more hours per day, as did more 
than half of hospital staff nurses and more than a third of those with more than 
one job. A third of the total sample worked more than 40 hours per week, and more
than a third worked six or more days in a row at least once in the preceding six 
months. Nearly a quarter rotated shifts. Almost one-quarter of nurses with more
than one job worked 50 or more hours per week, and they were more likely to work 
many days consecutively, without sufficient rest between shifts, and during
scheduled time off. Single parents were as likely as those with more than one job
to work 13 to 15 hours per day, 50 to 60 hours or more per week, and many days
consecutively. Seventeen percent of all nurses worked mandatory overtime, as did 
almost a quarter of the single parents. Nearly 40% of the total sample and more
than 40% of hospital staff nurses had jobs with on-call requirements.
CONCLUSIONS: The proportion of nurses who reported working schedules that exceed 
the recommendations of the Institute of Medicine should raise industry-wide
concerns about fatigue and health risks to nurses as well as the safety of
patients in their care.

PMID: 16575241 [PubMed - indexed for MEDLINE]


78. Am J Epidemiol. 2006 May 15;163(10):877-87. Epub 2006 Mar 29.

Psychosocial work environment and incidence of severe depressive symptoms:
prospective findings from a 5-year follow-up of the Danish work environment
cohort study.

Rugulies R, Bültmann U, Aust B, Burr H.

National Institute of Occupational Health, Copenhagen, Denmark. rer@ami.dk

Comment in:
    Am J Epidemiol. 2006 May 15;163(10):888-90; discussion 891-2.

The authors analyzed the impact of psychosocial work characteristics on the
incidence of severe depressive symptoms among 4,133 (49% women) employees from a 
representative sample of the Danish workforce between 1995 and 2000. Psychosocial
work characteristics at baseline included quantitative demands, influence at
work, possibilities for development, social support from supervisors and
coworkers, and job insecurity. Severe depressive symptoms were measured with the 
five-item Mental Health Inventory of the 36-item Short-Form Health Survey, with a
cutoff point of 52. Women with low influence at work (relative risk (RR) = 2.17, 
95% confidence interval (CI): 1.23, 3.82) and low supervisor support (RR = 2.03, 
95% CI: 1.20, 3.43) were at increased risk for severe depressive symptoms after
exclusion of cases at baseline and adjustment for sociodemographic factors,
baseline depression score, and health behaviors. Further adjustments for
socioeconomic position did not change the result substantially. Additional
analyses showed that a one-standard deviation increase on the influence scale
resulted in a 27% decreased risk of severe depressive symptoms. Among men, job
insecurity predicted severe depressive symptoms (RR = 2.04, 95% CI: 1.02, 4.07). 
The findings indicate that the work environment influences the risk of developing
severe depressive symptoms and that different factors play a role for men and
women.

PMID: 16571741 [PubMed - indexed for MEDLINE]


79. Arch Dermatol. 2006 Mar;142(3):305-11.

Prognosis of occupational hand eczema: a follow-up study.

Cvetkovski RS, Zachariae R, Jensen H, Olsen J, Johansen JD, Agner T.

Department of Dermatology, Gentofte Hospital, University of Copenhagen, Hellerup,
Denmark.

Comment in:
    Arch Dermatol. 2006 Mar;142(3):362-4.

OBJECTIVE: To identify prognostic risk factors in patients with occupational hand
eczema (OHE). DESIGN: Cohort study with 1-year follow-up. SETTING: Danish
National Board of Industrial Injuries Registry. PATIENTS: All patients with newly
recognized OHE (758 cases) from October 1, 2001, through November 10, 2002.
INTERVENTIONS: Participants received a questionnaire covering self-rated
severity, sick leave, loss of job, depression, and health-related quality of
life. One year after the questionnaire was returned, all responders (N = 621)
received a follow-up questionnaire, and 564 (91%) returned it. MAIN OUTCOME
MEASURES: Persistently severe or aggravated OHE, prolonged sick leave, and loss
of job after 1-year follow-up. RESULTS: During the follow-up period, 25% of all
patients with OHE had persistently severe or aggravated disease, 41% improved,
and 34% had unchanged minimal or mild to moderate disease. Patients with atopic
dermatitis fared poorly compared with other patients. Patients younger than 25
years fared clearly better than older groups. Furthermore, severe OHE, age 40
years or greater, and severe impairment of quality of life at baseline appeared
to be important predictors of prolonged sick leave and unemployment. Patients
with lower socioeconomic status also had a high risk of prolonged sick leave, job
change, and loss of job. Contact allergy was not found to be a risk factor for
poor prognosis. CONCLUSIONS: Atopic dermatitis, greater age, and low
socioeconomic status may be reliable prognostic factors in early OHE. Quality of 
life and standardized severity assessment may also be valuable tools to identify 
patients at high risk of prolonged sick leave and unemployment.

PMID: 16549705 [PubMed - indexed for MEDLINE]


80. J Occup Environ Med. 2006 Mar;48(3):252-63.

The association between health risk change and presenteeism change.

Burton WN, Chen CY, Conti DJ, Schultz AB, Edington DW.

Department of Environmental and Occupational Sciences, University of Illinois at 
Chicago, USA.

OBJECTIVE: This prospective study investigates whether changes in health risks
are associated with changes in presenteeism (on-the-job productivity loss).
METHOD: A total of 7026 employees of a national financial services company
responded to a health risk appraisal (HRA), which included a modified version of 
the Work Limitation Questionnaire (WLQ) in both 2002 and 2004. The association
between changes in health risks and changes in self-reported presenteeism was
examined. RESULTS: Changes in perceptual/psychologic health risks had a strong
association with changes in presenteeism. Individuals who reduced their risks
generally saw an improvement in productivity, whereas those who gained risks or
remained high-risk status saw deterioration in productivity. Each risk factor
increased or reduced was associated with a commensurate change in 1.9%
productivity loss over time and estimated to be 950 dollars per year per risk
changed. CONCLUSIONS: Positive and negative changes in health risks are
associated with same-direction changes in presenteeism.

PMID: 16531829 [PubMed - indexed for MEDLINE]


81. Br J Gen Pract. 2006 Feb;56(523):134-6.

Workforce trends in general practice in the UK: results from a longitudinal study
of doctors' careers.

Jones L, Fisher T.

National Collaborating Centre for Women's and Children's Health, Royal College of
Obstetricians and Gynaecologists, 27 Sussex Place, Regent's Park, London NW1 4RG,
UK. ljones@ncc-wch.org.uk

The career paths of 544 UK medical school graduates were followed for 10 years.
Although general practice was not attractive to graduates initially, it became
popular in subsequent years, mainly because it was seen as offering a superior
quality of life. Once in general practice both men and women chose to work
reduced hours and/or in non-principal posts. The findings suggest the need to
look more closely at the nature of these trends and the implications for patient 
care and service provision.

PMCID: PMC1828220
PMID: 16464328 [PubMed - indexed for MEDLINE]


82. Scand J Public Health. 2006;34(1):49-58.

Burnout among employees in human service work: design and baseline findings of
the PUMA study.

Borritz M, Rugulies R, Bjorner JB, Villadsen E, Mikkelsen OA, Kristensen TS.

National Institute of Occupational Health, Denmark. mb@ami.dk

AIM: To present the theoretical framework, design, methods, and baseline findings
of the first Danish study on determinants and consequences of burnout, and the
impact of workplace interventions in human service work organizations. METHOD: A 
5-year prospective intervention study comprising 2,391 employees from different
organizations in the human service sector: social security offices, psychiatric
prison, institutions for severely disabled, hospitals, and homecare services.
Data were collected at baseline and at two follow-ups. The authors developed a
new burnout tool (the Copenhagen Burnout Inventory) covering work-related,
client-related, and personal burnout. The study includes potential determinants
of burnout (e.g. the psychosocial work environment, social relations outside
work, lifestyle factors, and personality aspects) and consequences of burnout
(e.g. poor health, low job satisfaction, turnover, and absenteeism). Here, the
focus is on the description of the study population at baseline, including
associations of work burnout with psychosocial work environment scales and
absence. RESULTS: Response rate at baseline was 80.1%. Midwives and homecare
workers had high levels on both work- and client-related burnout. Prison officers
had the highest level on client-related burnout. Supervisors and office
assistants had low levels on both scales. Work burnout showed the highest
correlations with job satisfaction (r = -0.51), quantitative demands (r = 0.48), 
role-conflicts (r = 0.44), and emotional demands (r = 0.42). Sickness absence was
13.9 vs 6.0 days among participants in the highest and lowest work burnout
quartile, respectively. CONCLUSION: The findings indicate that study design and
methods are adequate for the upcoming prospective analyses of aetiology and
consequences of burnout and of the impact of workplace interventions.

PMID: 16449044 [PubMed - indexed for MEDLINE]


83. J Prev Med Public Health. 2005 Feb;38(1):107-16.

[Changes in distributive equity of health insurance contribution burden]

[Article in Korean]

Kang HC, Park EC, Lee KS, Park TK, Chung WJ, Kim HJ.

Yonsei University Graduate School of Public Health, National Cancer Center.

OBJECTIVES: We analyzed the changes from 1996 to 2002 in distributive equity of
the contribution burden in the Korean National Health Insurance. METHODS: The
study subjects were a total of 8923 employee households and a total of 7296
self-employed households over the period from 1996 to 2002. Those were the
households meeting the two criteria as completing each annual survey and having
no change in the job of head of the household during that period from the raw
data of the Household Income and Expenditure Survey annually conducted by the
Korean National Statistical Office. The unit of analysis was a household, and
this was the standard for assessing the contribution that is now applied on a
monthly basis. Deciles Distribution Ratio, Contribution Concentration Curve and
Contribution Concentration Index were estimated as the index of inequality.
Multiple regression analysis was conducted to compare the annual ability-to-pay
elasticity of the contribution to the reference year of 1996 for three groups
(all households, the employee households, and the self-employed households).
RESULTS: For the index of inequality, the distributive equity of contribution was
improved in all three groups. In particular, the employee group experienced a
substantial improvement. Using multiple regression analysis, the ability-to-pay
elasticity of the contribution in the employee group significantly increased
(beta = 0.232, p < 0.0001) in the year 2002 as compared to the reference year of 
1996. The elasticity in the self-employed group also significantly increased
(beta = 0.186, p < 0.05), although its change was smaller than that in the
employee group. CONCLUSIONS: The employee group had a greater improvement for the
distributive equity of the contribution burden than the self-employed group.
Within the observation period, there were two important integration reforms: one 
was the integration of 227 self-employed societies in 1998 and the other was the 
integration of 139 employee societies in 2000. We expected that the equity of the
contribution burden would be improved for the self-employed group since the
integration reform of 1998. However, it was not improved for the self-employed
group until the year 2000. This result suggests that capturing exactly the
beneficiaries' ability-to-pay such as income is the precedent for distributive
equity of the contribution burden, although a more sophisticated imposition
standard of contribution is needed.

PMID: 16315375 [PubMed - indexed for MEDLINE]


84. Int J Ment Health Nurs. 2005 Dec;14(4):230-42.

Retaining the mental health nursing workforce: early indicators of retention and 
attrition.

Robinson S, Murrells T, Smith EM.

Nursing Research Unit, King's College, London, London, UK.
sarah.robinson@kcl.ac.uk

In the UK, strategies to improve retention of the mental health workforce feature
prominently in health policy. This paper reports on a longitudinal national study
into the careers of mental health nurses in the UK. The findings reveal little
attrition during the first 6 months after qualification. Investigation of career 
experiences showed that the main sources of job satisfaction were caregiving
opportunities and supportive working relationships. The main sources of
dissatisfaction were pay in relation to responsibility, paperwork, continuing
education opportunities, and career guidance. Participants were asked whether
they predicted being in nursing in the future. Gender and ethnicity were related 
to likelihood to remain in nursing in 5 years time. Age, having children,
educational background, ethnic background, and time in first job were associated 
with likelihood of remaining in nursing at 10 years. Associations between
elements of job satisfaction (quality of clinical supervision, ratio of qualified
to unqualified staff, support from immediate line manager, and paperwork) and
anticipated retention are complex and there are likely to be interaction effects 
because of the complexity of the issues. Sustaining positive experiences,
remedying sources of dissatisfaction, and supporting diplomats from all
backgrounds should be central to the development of retention strategies.

PMID: 16296990 [PubMed - indexed for MEDLINE]


85. Health Qual Life Outcomes. 2005 Nov 8;3:68.

Evaluating change in health-related quality of life in adult rhinitis:
responsiveness of the Rhinosinusitis Disability Index.

Chen H, Katz PP, Shiboski S, Blanc PD.

Department of Medicine, University of California, San Francisco, CA, USA.
hubert.chen@ucsf.edu

BACKGROUND: The Rhinosinusitis Disability Index (RSDI) is a validated measure of 
health-related quality of life (HRQL) in rhinitis. Responsiveness of the RSDI to 
changes in health status over time has not been described. METHODS: We studied
adults with a self-reported physician diagnosis of rhinitis identified through a 
national telephone survey. HRQL was assessed at baseline and at 24 months using
the RSDI. Symptom severity, physical health status (SF-12 PCS), psychological
mood (CES-D), and perceived control of symptoms were also assessed at the time of
each interview. In addition, we ascertained specific health outcomes attributed
to rhinitis, including days of restricted activity, job effectiveness, number of 
physician visits, and medication costs. RESULTS: Of 109 subjects interviewed at
baseline, 69 (63%) were re-interviewed 24 months later. RSDI scores improved by =
0.5 standardized response mean in 13 (19%) subjects and worsened in 17 (25%).
Change in the RSDI over time correlated with changes in symptom severity (r =
0.38, p = 0.001), physical health (r = -0.39, p = 0.001), mood (r = 0.37, p =
0.002) and perceived control of symptoms (r = -0.37, p = 0.01). In multivariate
analyses adjusted for baseline health status, improvement in RSDI was associated 
with less restricted activity (p = 0.01), increased job effectiveness (p = 0.03),
and decreased medication costs (p = 0.05), but was not associated with change in 
the number of physician visits from baseline (p = 0.45). CONCLUSION: The RSDI is 
responsive to changes in health status and predicts rhinitis-specific health
outcomes.

PMCID: PMC1308842
PMID: 16277662 [PubMed - indexed for MEDLINE]


86. Acta Cardiol. 2005 Oct;60(5):521-31.

Forty-year mortality from cardiovascular diseases and their risk factors in men
of the Italian rural areas of the Seven Countries Study.

Menotti A, Lanti M, Maiani G, Kromhout D.

National Institute for Public Health and Environment, Bilthoven, The Netherlands.
menottia@tin.it

OBJECTIVE: Forty-year cardiovascular mortality and its association with entry
risk factor levels are reported for men enrolled in the Italian Rural Areas of
the Seven Countries Study of Cardiovascular Diseases. METHODS AND RESULTS:
Cardiovascular risk factors were measured in 1712 men aged 40-59 years at entry
examination in 1960. Mortality data were collected during 40 years of follow-up. 
Overall death rate was 83.7%. The main causes of death were cardiovascular
diseases, with a preponderance of those of atherosclerotic origin (CVDA, 33.7 %
of all causes) including coronary heart disease, stroke and peripheral arterial
diseases. Using 14 risk factors measured at baseline, multivariate analysis for
CVDA showed that seven of them were strongly and significantly associated with
events. The multivariate hazard ratio for 5 years of age was 1.59 (CI 1.43-1.77);
for heavy job-related physical activity it was 0.96 (CI 0.79-1.18); for 10
cigarettes smoked per day 1.16 (CI 1.05-1.28); for 20 mm Hg of systolic blood
pressure 1.38 (CI 1.25-1.52); for 1 mmol/l of serum cholesterol 1.19 (CI
1.09-1.30); for 0.25 l/m2 of height of vital capacity 0.87 (CI 0.78-0.97); for
the presence of corneal arcus 1.36 (CI 1.03-1.79). Risk factors of which the
coefficient did not reach statistical significance were family history for
cardiovascular diseases, forced expiratory volume, heart rate, mid-arm
circumference, subscapular skinfold, body mass index and diabetes. Similar
findings were obtained for CHD and partially for stroke mortality. CONCLUSIONS:
During a 40-year period classical cardiovascular risk factors were still highly
predictive of cardiovascular diseases of atherosclerotic origin in these Italian 
rural populations.

PMID: 16261784 [PubMed - indexed for MEDLINE]


87. J Occup Environ Med. 2005 Oct;47(10):1015-25.

Psychosocial work characteristics as predictors for burnout: findings from 3-year
follow up of the PUMA Study.

Borritz M, Bültmann U, Rugulies R, Christensen KB, Villadsen E, Kristensen TS.

National Institute of Occupational Health, Copenhagen, Denmark. mb@ami.dk

OBJECTIVE: The objective of this study was to investigate the impact of
psychosocial work characteristics on burnout. METHODS: A total of 1772
participants in different human service sector organizations were eligible for
the cross-sectional analyses (baseline) and 952 for the prospective analyses. We 
measured 14 psychosocial work characteristics and three types of burnout. Linear 
regression models were used for analyzing associations between psychosocial work 
characteristics at baseline and burnout at baseline and at 3 years of follow up. 
RESULTS: Low possibilities for development, high meaning of work, low
predictability, high quality of leadership, low role clarity, and high role
conflicts predicted burnout at 3 years of follow up after the psychosocial work
characteristics were adjusted for each other, potential confounders, and burnout 
level at baseline. CONCLUSION: Psychosocial work characteristics were
prospectively associated with burnout, suggesting that improving the psychosocial
work environment may reduce future burnout in human service work.

PMID: 16217242 [PubMed - indexed for MEDLINE]


88. J Nurs Adm. 2005 Sep;35(9):389-96.

How RNs view the work environment: results of a national survey of registered
nurses.

Ulrich BT, Buerhaus PI, Donelan K, Norman L, Dittus R.

Professional and Editorial Services, Nursing Spectrum/NurseWeek, 2655 Villa Creek
Drive, Ste. 250, Dallas, TX 75234, USA. BUlrich@NursingSpectrum.com

OBJECTIVE: To determine registered nurses' (RNs') views of the workplace
environment. BACKGROUND: Numerous studies have shown relationships between work
environment, RN satisfaction and retention, and patient safety and outcomes. In
2002, NurseWeek Publishing and the American Organization of Nurse Executives
completed a national survey on the views of RNs on the nursing shortage,
workplace environments, and their future career intentions, which revealed areas 
needing improvement. Results from the follow-up survey conducted in 2004 provide 
new information on RNs' views of the work environment and a comparison of results
to the previous survey. METHODS: A nationally representative random sample of
3500 RNs licensed to practice in the United States was surveyed. RESULTS: In the 
views of RNs, there have been improvements in a number of aspects of the work
environment of nurses. While there are no areas of decline, there are areas in
which little or no progress is apparent. CONCLUSIONS/IMPLICATIONS: Some
strategies designed to improve the work environment have resulted in positive
outcomes, but creative solutions must be continuously developed and implemented
to build on recent successes. Results of this survey help identify areas for
continued improvement efforts.

PMID: 16200006 [PubMed - indexed for MEDLINE]


89. Eur J Public Health. 2006 Feb;16(1):89-95. Epub 2005 Aug 26.

Employment loss following HIV infection in the era of highly active
antiretroviral therapies.

Dray-Spira R, Persoz A, Boufassa F, Gueguen A, Lert F, Allegre T, Goujard C,
Meyer L; Primo Cohort Study Group.

INSERM U687-IFR69, Hôpital National de Saint-Maurice, Saint-Maurice, France.
Rosemary.Dray-Spira@st-maurice.inserm.fr

BACKGROUND: Employment is a major factor in maintaining living conditions of
patients with chronic diseases. This study aimed to quantify the frequency and to
identify the determinants of employment loss during the first years of HIV
disease in the era of highly active antiretroviral therapies (HAART). METHODS:
The French PRIMO multicentre prospective cohort of 319 patients enrolled during
primary HIV-1 infection between 1996 and 2002. Employment loss was defined as
moving from employment to inactivity between two visits. Characteristics
associated with employment loss were assessed using generalized estimating
equations. RESULTS: During a median follow-up time of 2.5 years, 56 employment
losses occurred among 51 patients (18.0%). In multivariate analysis, female
gender (adjusted odds ratio 3.1; 95% confidence interval 1.1-8.5), non-permanent 
job (3.8; 1.5-9.3) and poor accommodation (4.2; 1.6-11.2) constituted independent
risk factors for employment loss; subjects with a high occupational position had 
a decreased risk of job loss. Moreover, an updated HIV viral load above 10 000
copies/ml either persistent (2.4; 1.1-5.0) or incident (3.7; 1.0-13.9) and
hospitalization in the preceding 6 months (3.9; 1.6-9.7) constituted independent 
risk factors for employment loss, as tended to be a baseline CD4 cell count
<350/mm(3) (1.9; 0.9-4.3) and chronic comorbidity (1.8; 0.9-3.6). CONCLUSIONS: In
the HAART era, employment loss is frequent from the first months of HIV
infection. Employment loss occurs especially in women and in patients with
adverse socioeconomic conditions, severe HIV infection and/or comorbidity. Social
interventions should seek to prevent HIV-infected patients from leaving their job
from the earliest times of the disease.

PMID: 16126745 [PubMed - indexed for MEDLINE]


90. J Occup Environ Med. 2005 Aug;47(8):769-77.

The association of health risks with on-the-job productivity.

Burton WN, Chen CY, Conti DJ, Schultz AB, Pransky G, Edington DW.

University of Illinois at Chicago, Illinois, USA.

OBJECTIVE: Decreased on-the-job productivity represents a large yet poorly
characterized indirect cost to employers. We studied the impact of employee
health risk factors on self-reported worker productivity (presenteeism). METHODS:
Using a brief version of the Work Limitation Questionnaire incorporated into a
Health Risk Appraisal, 28,375 employees of a national company responded to the
survey. The association between health risks and work limitation and each of the 
four domains was examined. Percentage of lost productivity also was estimated.
RESULTS: Ten of 12 health risk factors studied were significantly associated with
self-reported work limitations. The strength of the associations varied between
risks and the four domains of work limitation. Perception-related risk factors
such as life dissatisfaction, job dissatisfaction, poor health, and stress showed
the greatest association with presenteeism. As the number of self-reported health
risk factors increased, so did the percentage of employees reporting work
limitations. Each additional risk factor was associated with 2.4% excess
productivity reduction. Medium and high-risk individuals were 6.2% and 12.2% less
productive than low-risk individuals, respectively. The annual cost of lost
productivity in this corporation was estimated at between 99Mdollars and
185Mdollars or between 1392dollars and 2592dollars per employee. CONCLUSIONS:
Health risk factors represent additional causes of lost productivity.

PMID: 16093926 [PubMed - indexed for MEDLINE]


91. Prev Med. 2005 Sep-Oct;41(3-4):757-60.

Influence of lifestyle, health, and work environment on smoking cessation among
Danish nurses followed over 6 years.

Sanderson DM, Ekholm O, Hundrup YA, Rasmussen NK.

National Institute of Public Health, Øster Farimagsgade 5, DK-1399 Copenhagen,
Denmark.

BACKGROUND: The purpose of this study was to examine the influence of lifestyle, 
health, and work environment on smoking cessation among Danish nurses age 45-66
years over a 6-year period from 1993-1999. METHODS: Data derive from the Danish
Nurse Cohort Study; a prospective cohort established in 1993 when all Danish
female nurses 45+ years old and members of the Danish Nurses Association were
mailed a questionnaire. The cohort was followed up 6 years later in 1999. In
total, 12,980 responded to questions concerning smoking status in both the 1993
and 1999 surveys. This study deals with the 4713 women (36%) who reported smoking
at baseline. Smoking cessation was based on self-report. RESULTS: At follow-up in
1999, 24% reported that they no longer smoked. Low prior tobacco consumption at
baseline, high fresh fruit consumption, high blood pressure, working day shifts, 
having low physical job strain, perceiving influence on one's own work, and
partner's socio-economic status (as measured by most recent occupation) were
associated with successful smoking cessation. CONCLUSION: The findings from this 
study highlight the importance of various factors, including lifestyle, health
status, and aspects of one's work environment, on successful efforts at smoking
cessation.

PMID: 16081152 [PubMed - indexed for MEDLINE]


92. Sociol Health Illn. 2005 Jul;27(5):602-27.

Do occupation and work conditions really matter? A longitudinal analysis of
psychological distress experiences among Canadian workers.

Marchand A, Demers A, Durand P.

Health and Prevention Social Research Group, University of Montreal, Canada.
amarchan@alcor.concordia.ca

This study analyses the relationship between occupation, work conditions and the 
experience of psychological distress within a model encompassing the stress
promoted by constraints-resources embedded in macrosocial structures
(occupational structure), structures of daily life (workplace, family, social
networks outside the workplace) and agent personality (demography, physical
health, psychological traits, life habits, stressful childhood events).
Longitudinal data were derived from Statistics Canada's National Population
Health Survey and comprised 6,359 workers nested in 471 occupations, followed
four times between 1994-1995 and 2000-2001. Discrete time survival multilevel
regressions were conducted on first and repeated episodes of psychological
distress. Results showed that 42.9 per cent of workers had reported one episode
of psychological distress and 18.7 per cent had done so more than once. Data
supported the model and challenged the results of previous studies. The
individual's position in the occupational structure plays a limited role when the
structures of daily life and agent personality are accounted for. In the
workplace, job insecurity and social support are important determinants, but
greater decision authority increases the risk of psychological distress.
Workplace constraints-resources are not moderated either by the other structures 
of daily life or by agent personality.

PMID: 16078903 [PubMed - indexed for MEDLINE]


93. J Appl Psychol. 2005 Jul;90(4):799-810.

A longitudinal study of the effects of dual-earner couples' utilization of
family-friendly workplace supports on work and family outcomes.

Hammer LB, Neal MB, Newsom JT, Brockwood KJ, Colton CL.

Department of Psychology, Portland State University, Portland, OR 97207-0751,
USA. hammerl@pdx.edu

Little research exists on the effects of the utilization of workplace supports on
work-family conflict and job satisfaction. With family systems theory as a
framework, 2 waves of national survey data were collected from 234 couples (N =
468) caring for children and for aging parents. Data were analyzed with
structural equation modeling techniques. Longitudinal results indicate that
individuals' use of workplace supports was related to work-family conflict in the
direction opposite to expectations and was related to job satisfaction in the
direction consistent with expectations. Differential effects for wives versus
husbands were found. In addition, couples' use of workplace supports was only
minimally related to wives' outcomes. Results are discussed in terms of gender
differences, family systems theory, and methodological and measurement issues
related to the longitudinal study of utilization of workplace supports. Copyright
2005 APA, all rights reserved.

PMID: 16060797 [PubMed - indexed for MEDLINE]


94. Am J Public Health. 2005 Jul;95(7):1226-32.

Occupational injury and absence from work among African American, Hispanic, and
non-Hispanic White workers in the national longitudinal survey of youth.

Strong LL, Zimmerman FJ.

Department of Health Services, School of Public Health and Community Medicine,
University of Washington, Seattle, 98109, USA. lstrong@u.washington.edu

OBJECTIVES: We examined how race and ethnicity influence injury and illness risk 
and number of days of work missed as a result of injury or illness. METHODS: We
fit logistic regression and negative binomial regression models using generalized
estimating equations with data from 1988 to 2000 on currently employed African
American, Hispanic, and non-Hispanic White participants in the National
Longitudinal Survey of Youth. RESULTS: Occupational factors-having a blue-collar 
occupation, working full-time, having longer tenure, working 1 job versus 2, and 
working the late shift-were associated with increased odds of an occupational
injury or illness. Although racial/ethnic minority workers were no more likely
than Whites to report an occupational injury or illness, they reported missing
more days of work. African American and Hispanic men missed significantly more
days of work than non-Hispanic White men, and African American women missed
significantly more days of work than non-Hispanic White women. CONCLUSIONS:
Factors associated with occupational health are multifaceted and complex. Our
findings suggest that race/ethnicity influences the duration of work absence
owing to injury or illness both indirectly (by influencing workers' occupational 
characteristics) and directly (by acting independently of occupational factors).

PMCID: PMC1449344
PMID: 15983275 [PubMed - indexed for MEDLINE]


95. Georgian Med News. 2005 Apr;(121):56-8.

Psychosocial work environment and coronary heart disease.

Danelia M, Trapaidze D.

National Institute of Health; Institute of Clinical and Experimental Cardiology, 
Georgia.

In Georgia, like the other post Soviet republics, CHD morbidity is increasing,
especially among young and middle aged people-- i.e. among those who should have 
the most working ability-- that points at both individual and social significance
of the problem. CHD is becoming more and more common among rural inhabitants,
different professional groups involved not only in mental but also in physical
work. The longstanding observation that rates of coronary heart disease vary
markedly among occupations more than can be accounted for by conventional risk
factors for coronary heart disease has generated a quest for specific components 
of work that might be of etiological importance. Especially when according to
structural changes in society the role of social and psychological factors
increased. Case-control study was carried out based on Karasek model. Our results
indicate that jobs characterized by low decision latitude, high job strain and
low social support at work may be associated with an increased risk of acute
coronary events.

PMID: 15908726 [PubMed - indexed for MEDLINE]


96. Soc Sci Med. 2005 Jul;61(1):27-39. Epub 2005 Jan 23.

Job strain, iso-strain, and the incidence of low back and neck injuries. A
7.5-year prospective study of San Francisco transit operators.

Rugulies R, Krause N.

National Institute of Occupational Health, Lersø Parkallé 105, DK-2100
Copenhagen, Denmark. rer@ami.dk

Work-related musculoskeletal disorders account for the largest single category of
lost-time occupational injury or disease episodes in industrialized countries. In
this study we analyzed the impact of the psychosocial work environment,
conceptualized by the demand-control-support model, on the incidence of low back 
and neck injury in a cohort of 1221 public transit operators followed for 7 years
and 6 months. The two main exposure variables were "job strain" (mismatch of high
psychological demands and low decision latitude) and "iso-strain" (job strain
plus exposure to low social support at work). Analyses controlled for demographic
factors, physical workload, and pain at baseline. For low back injuries,
increased hazard rates were found for job strain and iso-strain based on
tertiles, with hazard ratios (HR) of 1.30 (95% CI=0.96-1.75) and 1.41 (95%
CI=0.98-2.01), respectively. Job strain and iso-strain based on median split or
analyzed as continuous variables were not associated with low back injuries. For 
neck injuries, job strain and iso-strain based on median split showed HRs of 1.27
(95% CI=0.99-1.63) and 1.33 (95% CI=1.01-1.77), respectively. Job strain and
iso-strain based on tertiles had HRs of 1.52 (95% CI=1.13-2.05) and 1.73 (95%
CI=1.21-2.45), respectively. When analyzed as continuous variables, a one-point
increase on the job strain and iso-strain scales led to an 8% (95% CI=0.98-1.19) 
and 14% (95% CI=1.02-1.27) increased hazard of neck injuries, respectively. This 
study shows the importance of the psychosocial work environment in the etiology
of musculoskeletal injuries among transit operators. Since reviews have shown
that psychosocial workplace conditions in this occupational group can be changed,
these findings indicate a potential for prevention at the workplace.

PMID: 15847959 [PubMed - indexed for MEDLINE]


97. Health Soc Work. 2005 Feb;30(1):7-17.

Stability of health care coverage among low-income working women.

Anderson SG, Eamon MK.

School of Social Work, University of Illinois at Urbana-Champaign, 61801, USA.
sandersn@uiuc.edu

This article examines health insurance stability patterns and the factors
associated with stable coverage in a sample of 453 low-income working women.
Using data from the National Longitudinal Survey of Youth (NLSY), the authors
found that only 51 percent of these women had stable coverage during 1995-1997.
Logistic regression results indicate that, controlling for other factors, health 
insurance stability is significantly higher for those who have higher levels of
welfare receipt, have more work hours, have fewer job changes, have higher
education levels, are African American or Hispanic, and who live outside central 
cities. The findings suggest that point-in-time health coverage estimates
substantially underestimate the health coverage problems of low-income working
women. Health policies need to be more sensitive to transitional problems
resulting from job changes, marital disruptions, and other changes in
circumstances. Recommendations for revising health care policies and for
improving existing health care programs are presented.

PMID: 15847233 [PubMed - indexed for MEDLINE]


98. Int J Epidemiol. 2005 Aug;34(4):827-34. Epub 2005 Mar 31.

When aspirations and achievements don't meet. A longitudinal examination of the
differential effect of education and occupational attainment on declines in
self-rated health among Canadian labour force participants.

Smith P, Frank J.

Institute for Work and Health, 481 University Avenue, Toronto, Ontario M5G 2E9,
Canada. psmith@iwh.on.ca

Comment in:
    Int J Epidemiol. 2005 Aug;34(4):835-6.

BACKGROUND: To examine the association of a mismatch between educational
qualifications and occupational attainment and subsequent declines in self-rated 
health (SRH) in a longitudinal nationally representative Canadian population
sample. METHODS: This study used longitudinal data from 4045 healthy, working
respondents of the Canadian National Population Health Survey. Respondents were
categorized as either qualified, overqualified, or underqualified based on the
match between their education and the skills required for their current
occupation over a 2-year period. Logistic regression analysis estimated the odds 
of decline in SRH over the following 4-year period, using the match between
occupation and education as the main independent variable. Analyses were
controlled for a number of confounding variables including health behaviours,
mental health, self-esteem, job control, and demographic information. RESULTS:
Relative to respondents with university education working in occupations for
which they were qualified, respondents with university education, working in
occupations for which they were overqualified had a significant risk of decline
in SRH between 1996 and 2000, even after adjusting for a number of potential
confounders (OR = 2.08, 95% CI 1.11-3.91). In respondents with secondary
education or less, differences in occupational attainment were not associated
with differences in the odds of decline in SRH. CONCLUSIONS: The effect of
occupational attainment on health is important for individuals who have invested 
the most time in their education. Conversely, differential occupational
attainment is not associated with differences in the odds of decline in health
for participants with lower levels of education.

PMID: 15802380 [PubMed - indexed for MEDLINE]


99. J Nurs Adm. 2005 Mar;35(3):110-20.

Group cohesion and nurse satisfaction: examination of a team-building approach.

DiMeglio K, Padula C, Piatek C, Korber S, Barrett A, Ducharme M, Lucas S,
Piermont N, Joyal E, DeNicola V, Corry K.

The Miriam Hospital, 164 Summit Avenue, Providence, RI 02906, USA.

OBJECTIVES: The purpose of this study was to determine the impact of a
team-building intervention on group cohesion, nurse satisfaction, and turnover
rates. BACKGROUND: Creating an environment that supports and retains nurses
represents a formidable challenge for nursing leaders. Research related to
strategies that positively impact the culture in which nurses practice, thus
potentially improving nurse satisfaction and reducing turnover, is critically
needed. METHODS: Registered nurses (RNs) employed on inpatient units in a
247-bed, private acute care Magnet teaching hospital participated in this quasi
experimental preintervention and postintervention design. The RN-RN interaction
subscale from the National Database of Nursing Quality Indicators Adapted Index
of Work Satisfaction, the National Database of Nursing Quality Indicators Adapted
Index of Job Enjoyment, the Group Cohesion Scale, and a facilitator-developed
measure were completed preimplementation and postimplementation of unit-tailored 
intervention strategies, which took place over a 12-month period. Turnover rates 
were collected 6 month preintervention and postintervention. RESULTS: Improvement
in group cohesion, RN-RN interaction, job enjoyment, and turnover was
demonstrated. CONCLUSION: Targeted, unit-based strategies can be an effective
means of reducing turnover rates and improving group cohesion and nurse
satisfaction.

PMID: 15761307 [PubMed - indexed for MEDLINE]


100. Int J Rehabil Res. 2005 Mar;28(1):33-42.

Disability pension despite vocational rehabilitation? A study from six social
insurance offices of a county.

Ahlgren A, Broman L, Bergroth A, Ekholm J.

Department of Nursing and Health, Mid Sweden University, Ostersund, Sweden.
asa.ahlgren@miun.se

Many long-term sick-listed individuals move from vocational rehabilitation to
pension, rather than reaching the goal of return to work. There is thus reason to
consider whether rehabilitation resources are being used optimally. Individuals
receiving disability pensions are consuming financial and personnel resources at 
the insurance offices and also consume a large amount of health care. The general
objective of the study was to evaluate the proportion of individuals granted
vocational rehabilitation but then obtaining temporary or permanent disability
pensions. All persons receiving any kind of rehabilitation and attending one of
six local national insurance offices in a county in Sweden in 1998 and 1999 were 
studied. A 2-year follow-up was carried out to assess changes in status among
those who had received temporary disability pensions. Of all individuals
receiving rehabilitation, 46.2% ended up with a disability pension allowance. In 
addition, a large portion of the temporary disability pensions was transformed to
permanent disability pensions within 2 years. For clients with a temporary
disability pension, the rate of resuming work was close to nil. Among
rehabilitation measures, investigation showed the lowest figures of work
resumption while job training showed the best outcome in this respect. The study 
concluded that a large portion of the financial and personnel resources allocated
by the national insurance offices to rehabilitation resulted in disability
pensions.

PMID: 15729095 [PubMed - indexed for MEDLINE]




101. Child Dev. 2005 Jan-Feb;76(1):196-211.

Single mothers' employment dynamics and adolescent well-being.

Kalil A, Ziol-Guest KM.

Harris Graduate School of Public Policy Studies, University of Chicago, IL 60637,
USA. a-kalil@uchicago.edu

The links between single mothers' employment patterns and change over time in the
well-being of the mothers' adolescent children were investigated using the
National Longitudinal Survey of Youth. Adolescents were ages 14 to 16 at
baseline, and they and their mothers were followed for 2 years. Relative to being
continuously employed in a good job, findings suggest that adolescents whose
mothers lose a job without regaining employment show declines in mastery and
self-esteem, those whose mothers are continuously employed in a bad job show an
increased likelihood of grade repetition, and those whose mothers are either
persistently unemployed or lose more than one job show an increased likelihood of
school dropout. These effects are not explained by concomitant changes in family 
income.

PMID: 15693767 [PubMed - indexed for MEDLINE]


102. Am J Ind Med. 2005 Feb;47(2):144-52.

Flock workers' exposures and respiratory symptoms in five plants.

Daroowalla F, Wang ML, Piacitelli C, Attfield MD, Kreiss K.

National Institute for Occupational Safety and Health, Division of Respiratory
Disease Studies, Morgantown, West Virginia 26505, USA.

BACKGROUND: Sentinel cases of lymphocytic bronchiolitis in flock production and
coating operations triggered a five-plant study of airborne respirable dust and
fiber exposures and health symptoms. METHODS: Job histories from 219 current
workers were linked to a job-exposure matrix derived from personal exposure
measurements of respirable dust and fibers. Univariate group comparisons and
multivariate modeling tested for relations between indices of cumulative and
current exposure, and respiratory and systemic symptom outcomes. RESULTS:
Respiratory symptoms and repeated flu-like illnesses were associated with use of 
compressed air to clear equipment (blow-downs) and with respirable dust exposure 
(current and cumulative) after controlling for smoking. Blow-downs had an equal
or greater effect than smoking status on most symptoms. CONCLUSIONS: Eliminating 
compressed air cleaning, engineering control of dust exposure, and respirators
are needed to limit exposures to particulates. Longitudinal follow up may provide
guidance for a dust or fiber level without adverse respiratory health effects.

PMID: 15662645 [PubMed - indexed for MEDLINE]


103. J Child Adolesc Psychopharmacol. 2004 Fall;14(3):448-54.

Stimulant drug treatment in childhood-onset schizophrenia with comorbid ADHD: an 
open-label case series.

Tossell JW, Greenstein DK, Davidson AL, Job SB, Gochman P, Lenane M, Nugent Iii
TF, Gogtay N, Sporn AL, Rapoport JL.

Child Psychiatry Branch, National Institute of Mental Health, National Institutes
of Health, Department of Health and Human Services, Building 10, Room 3N202,
Bethesda, MD 20892, USA. tossellj@intra.nimh.nih.gov

The administration of psychostimulants to children with psychotic symptoms is
controversial. This study reports the stimulant drug response of 5 children, aged
8-15 years, with childhood-onset schizophrenia (COS) and comorbid attention
deficit hyperactivity disorder (ADHD). Four COS inpatients were given stimulants 
for comorbid ADHD after stabilization of psychosis on antipsychotic medication. A
fifth COS inpatient received stimulants while still actively psychotic, despite
concurrent neuroleptic treatment. Data from the 10-item Brief Conners Teachers
Ratings Scale (BCTRS) were examined the week before, and the week after,
stimulant addition. A paired t test, conducted using Conners Teachers data from
these 4 subjects, indicated significant improvement in ADHD symptoms (p = 0.02). 
Data obtained from a retrospective chart review indicated no significant
worsening of psychosis. The 2 subjects treated with mixed salts of
dextroamphetamine sulfate and amphetamine sulfate remained on that medication at 
6 months and at the 2-year follow-up. Our results suggest that ADHD comorbid with
COS may be safely treated with a stimulant, once the psychosis is stabilized. A
systematic investigation of this question may be warranted.

PMID: 15650502 [PubMed - indexed for MEDLINE]


104. J Occup Environ Med. 2004 Oct;46(10):1023-32.

The joint effect of noise exposure and job complexity on distress and injury risk
among men and women: the cardiovascular occupational risk factors determination
in Israel study.

Melamed S, Fried Y, Froom P.

Department of Occupational Health Psychology, National Institute of Occupational 
Environmental Health, Raanana, Israel. melameds@ioh.org.il

We sought to explore the possibility that exposure to noise at work might
interact with job complexity and gender to affect the incidence of occupational
injury among industrial employees. In this study, we examined 4084 men and 1643
women from 21 industrial plants while controlling for a number of potent
confounding variables, among them active safety hazards. Logistic regression
results showed that the predictor variables interacted and that the highest
injury risk (odds ratio = 2.72) was observed in women in high noise and high job 
complexity, compared with the referents scoring low on these predictors. The
comparable injury risk in men was only 1.3. Parallel results were observed for
three noise stress indicators: workload, noise annoyance and postwork
irritability. We conclude that the joint exposure to noise and high job
complexity is disruptive, resulting in higher distress and occupational injury
risk, particularly among women.

PMID: 15602176 [PubMed - indexed for MEDLINE]


105. Plast Reconstr Surg. 2004 Dec;114(7):1878-86.

The effect of the Accreditation Council for Graduate Medical Education Duty Hours
Policy on plastic surgery resident education and patient care: an outcomes study.

Basu CB, Chen LM, Hollier LH Jr, Shenaq SM.

Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor
College of Medicine, Houston, Texas 77030, USA.

The Accreditation Council for Graduate Medical Education (ACGME) Work-Hours Duty 
Policy became effective on July 1, 2003, mandating the reduction of resident duty
work hours. The Baylor College of Medicine Multi-Institutional Integrated Plastic
Surgery Program instituted a resident duty work-hours policy on July 1, 2002 (1
year ahead of the national mandate). Outcomes data are needed to facilitate
continuous improvements in plastic surgical residency training while maintaining 
high-quality patient care. To assess the effect of this policy intervention on
plastic surgery resident education as measured through the six core competencies 
and patient/resident safety, the investigators surveyed all categorical plastic
surgery residents 6 months after implementation of the policy. This work
represents the first empiric study investigating the effect of duty hours
reduction on plastic surgery training and education. The categorical plastic
surgery residents at the Baylor College of Medicine Multi-Institutional
Integrated Plastic Surgery Program completed a 68-item survey on a five-point
Likert scale (1 = strongly disagree to 5 = strongly agree). Residents were asked 
to rate multiple parameters based on the ACGME six core competencies, including
statements on patient care and clinical/operative duties, resident education,
resident quality of life, and resident perceptions on this policy. All surveys
were completed anonymously. The sample size was n = 12 (program year 3 through
program year 6), with a 100 percent response rate. Univariate and bivariate
statistical analysis was conducted with SPSS version 10.0 statistical software.
Specifically, interquartile deviations were used to find consensus among resident
responses to each statement. Descriptive statistics indicated higher percentages 
of agreement on a majority of statements in three categories, including patient
care and clinical/operative duties, academic duties, and resident quality of
life. Using interquartile deviation, the highest levels of consensus among the
residents were found in positive statements addressing resident alertness (both
in and out of the operative environment), time to read/prepare for
cases/conferences, efficacy of the didactic curriculum, and overall satisfaction 
with this policy for surgery resident education. Residents also felt that their
patients favored this work hours policy. In addition, there was high consensus
that this policy improved overall patient care. The majority of residents
identified a negative effect of this policy through an increase in cross-coverage
responsibilities, however, and half of the residents perceived that faculty
negatively viewed their unavailability postcall. In addition, no consensus among 
the residents was achieved regarding perceptions on overall weekly operative
experience. Plastic surgery residents perceived that the reduction of resident
work hours through adherence to the ACGME guidelines has beneficial effects on
patient care and clinical/operative duties, academic duties, and resident quality
of life. Residents felt, however, that these benefits may increase cross-coverage
workloads. Furthermore, residents were concerned about faculty perception of
their changes in postcall duties. In contrast to previously published findings in
the general surgery literature, the current results indicate that residents do
not believe that this policy negatively affects continuity of patient care. In
fact, the current findings suggest that adherence to this policy improves patient
care on multiple levels. The effect on the operative experience remains to be
elucidated. Further large-scale and longitudinal research design and analysis is 
warranted to better assess the results of the ACGME resident duty work-hours
policy in plastic surgery resident education.

PMID: 15577363 [PubMed - indexed for MEDLINE]


106. Eur J Epidemiol. 2004;19(8):777-84.

Social class, race/ethnicity and all-cause mortality in the US: longitudinal
results from the 1986-1994 National Health Interview Survey.

Muntaner C, Hadden WC, Kravets N.

Department of Family and Community Health, University of Maryland-Baltimore,
21201-1579, USA. muntaner@son.umaryland.edu

BACKGROUND: Occupational social class has become a leading indicator of social
inequalities in health. In the US, economic sectors are distinct with respect to 
wages, benefits, job security, promotion ladders and working conditions. The
growing economic sector of self-employed workers is characterized by lower wages 
and benefits, and greater job insecurity. Little attention has been given to the 
association between economic sector measures of social class and all-cause
mortality, and there have been no studies of mortality among the self-employed.
METHODS: To determine risk of death associated with economic sector social class,
this study entails a longitudinal analysis of the National Health Interview
Survey (NHIS), an annual household survey representative of the US population for
the period 1986-1994 (n = 377,129). The sample includes 201,566 men and 175,563
women, aged 24-65 years of age, in the civilian labor force. RESULTS: Non-
professionals are at higher risk of death than professionals across all sectors
and self-employed professionals are at higher risk of death than professionals
employed in government and production. Additional social class differences are
accounted for by age, race, gender and marital status. Results are also partially
explained by income. After controlling for income, Black professionals did not
show a lower risk of death than Black non-professionals and self-employed
Hispanic professionals had a higher risk of death than Hispanic professionals
employed in the private sector. CONCLUSIONS: Given the growth of self-employment 
in the US, the noted increased risk of death among self-employed professionals
merits further investigation and monitoring.

PMID: 15469035 [PubMed - indexed for MEDLINE]


107. BMC Public Health. 2004 Sep 30;4:41.

The impact of employee level and work stress on mental health and GP service use:
an analysis of a sample of Australian government employees.

Parslow RA, Jorm AF, Christensen H, Broom DH, Strazdins L, D' Souza RM.

Centre for Mental Health Research, Australian National University ACTON ACT 0200 
Australia. ruth.parslow@anu.edu.au

BACKGROUND: This study sought to identify the extent to which employee level and 
work stressors were associated with mental health problems experienced by
Australian government employees, and with their use of primary care services.
METHODS: 806 government employees aged between 40 and 44 years were surveyed as
part of an epidemiological study conducted in Australia. Data collected from
participants included sociodemographic attributes, physical health, psychological
measures and work stressors relating to job control, job demands, job security
and skills discretion at work. For 88% of these participants, information on
visits made to general practitioners (GPs) for the six months before and after
their survey interview was obtained from health insurance records. RESULTS: When 
work stress and personal factors were taken into account, men at more junior
levels reported better mental health, more positive affect and used fewer GP
services. Women at middle-management levels obtained less GP care than their more
senior counterparts. Both men and women who reported higher levels of work stress
were found to have poorer mental health and well-being. The impact of such
stressors on GP service use, however, differed for men and women. CONCLUSION:
Measures of work stress and not employee level affect the mental health and
well-being of government employees. For governments with responsibility for
funding health care services, reducing work stress experienced by their own
employees offers potential benefits by improving the health of their workforce
and reducing outlays for such services.

PMCID: PMC526193
PMID: 15456518 [PubMed - indexed for MEDLINE]


108. Health Econ. 2004 Sep;13(9):885-99.

The wage effects of obesity: a longitudinal study.

Baum CL 2nd, Ford WF.

Economics and Finance Department, Middle Tennessee State University, USA.
cbaum@mtsu.edu

We use National Longitudinal Survey of Youth (NLSY) data to examine the effects
of obesity on wages by gender. Sample means indicate that both men and women
experience a persistent obesity wage penalty over the first two decades of their 
careers. We then control for a standard set of socioeconomic and familial
variables but find that standard covariates do not explain why obese workers
experience persistent wage penalties. This suggests that other variables --
including job discrimination, health-related factors and/or obese workers'
behavior patterns -- may be the channels through which obesity adversely affects 
wages. The study closes with a discussion of the public policy implications
suggested by these findings.

PMID: 15362180 [PubMed - indexed for MEDLINE]


109. Soc Work. 2004 Jul;49(3):395-405.

Health coverage instability for mothers in working families.

Anderson SG, Eamon MK.

School of Social Work, University of Illinois at Urbana-Champaign, IL 61801, USA.
sandersn@uiuc.edu

Using data from the National Longitudinal Survey of Youth, the authors examined
the health insurance coverage stability of 1,667 women in working families over a
three-year period (1995-1997). Findings revealed that coverage instability is
common. Nearly one-half of low-income women experienced health coverage
instability over the three-year study period, and low-income women with poor
education, single marital status, low work hours, and frequent job changes were
at even greater risk of coverage instability. The findings also imply that women 
affected by recent welfare reforms are likely to experience widespread health
coverage problems. The implications for health care policy development, social
work administration, and social work practice are discussed.

PMID: 15281694 [PubMed - indexed for MEDLINE]


110. J Occup Environ Hyg. 2004 Jun;1(6):371-90.

Historical estimation of exposure to 1,3-butadiene, styrene, and
dimethyldithiocarbamate among synthetic rubber workers.

Macaluso M, Larson R, Lynch J, Lipton S, Delzell E.

Department of Epidemiology, School of Public Health, University of Alabama at
Birmingham, AL, USA. mmacaluso@cdc.gov

Quantitative estimates of exposure to 1,3-butadiene (BD), styrene (STY), and
dimethyldithiocarbamate (DMDTC) were developed for a follow-up study of workers
at six North American synthetic rubber plants. Procedures entailed identifying
tasks and jobs involving exposure, identifying factors influencing historical
changes in exposure potential, and using mathematical models to calculate job-
and time-period-specific exposures. Exposure metrics included 8-hour
time-weighted average (TWA) intensity, the annual number of peak exposures (BD:
>100 ppm, STY: >50 ppm) and TWA intensity below and above the peak threshold. The
5th and 95th percentiles of the approximate probability distribution of each
exposure estimate served as its 90% uncertainty interval. Job- and year-specific 
estimates were linked with subjects' work histories to obtain cumulative exposure
indices. Exposure estimates varied among tasks, jobs, plants, and time periods.
BD TWAs were approximately 10 ppm during the 1940s-1960s and declined during the 
1970s and 1980s. STY TWAs were always <2 ppm. DMDTC exposure began in the 1950s, 
was high through the 1960s, and later declined. BD peak exposure accounted for a 
large proportion of cumulative BD exposure, whereas almost none of the STY
exposure was experienced at levels >50 ppm. Exposure indices were correlated.
Exposures were higher than previously estimated. Multiple correlations among
DMDTC, BD, and STY exposure estimates make it difficult to estimate
agent-specific effects. Limitations of the methodology include the potential
inaccuracy of the estimates, the lack of adequate industrial hygiene data to
validate the estimates, the additional inaccuracy of linkage with poorly
specified job groups, and the potential for differential exposure
misclassification because the jobs and work areas where excess leukemia mortality
occurred were well-known at the time of this study. Nevertheless, the new
exposure estimates were highly correlated with the old, yielding equivalent
exposure ranking of workers and were comparable to limited industrial hygiene
data published by NIOSH.

PMID: 15238328 [PubMed - indexed for MEDLINE]


111. J Occup Environ Hyg. 2004 Aug;1(8):542-50.

Predictors of work-related injuries and illnesses: national survey findings.

Dembe AE, Erickson JB, Delbos R.

University of Massachusetts Medical School, Shrewsbury, Massachusetts, USA.
Allard.Dembe@umassmed.edu

This study used national survey data of working adults (aged 33-41) to identify
factors associated with the occurrence of occupational injuries and illnesses.
Data from the National Longitudinal Survey of Youth were used to compare selected
employment and personal characteristics for respondents who reported experiencing
a work-related injury or illness with those who did not. Multivariate analyses
were performed to calculate nationally representative odds ratios reflecting the 
likelihood for specific individual attributes and job characteristics to be
associated with the reporting of a work-related injury or illness, while
controlling for relevant covariates. In this study the incidence of occupational 
injuries was related to several demographic factors, including low family income 
and rural residence, and several job characteristics, including working in a
high-hazard occupation, job dissatisfaction, and exposure to six specific
hazardous job activities: (1) performing lots of physical effort on the job, (2) 
lifting or carrying more than 10 lbs, (3) using stairs and inclines, (4) kneeling
or crouching, (5) reaching, and (6) hearing special sounds. These results suggest
targeted prevention strategies for decreasing the incidence of work-related
injuries and illnesses, such as worker self-assessment of the total physical
effort demanded by a job and periodic monitoring of workforce job satisfaction.

PMID: 15238307 [PubMed - indexed for MEDLINE]


112. Scand J Psychol. 2004 Jul;45(3):207-14.

Work values among the unemployed: changes over time and some gender differences.

Isaksson K, Johansson G, Bellaagh K, Sjöberg A.

National Institute for Working Life, Stockholm, Sweden. kerstin.isaksson@niwl.se

Work involvement (psychological identification with work in general) has
generally been considered as a stable, dispositional characteristic, although
some studies of unemployment have contradicted this view. Using longitudinal data
from a Swedish representative sample (n= 888), this study examines employment
status change (e.g. from work to unemployment) and work values development in a
15-month time period. Furthermore, the relationship between employment status
change and well-being is explored, with a special focus on the roles played by
work values and gender differences. Results indicated that work values are fairly
stable over 15 months. As expected, the long-term unemployed (mostly active job
seekers) had higher measures of work involvement after 15 months. Further, no
gender difference was found with regard to work involvement but females were more
likely to agree that there is an entitlement to work. Becoming unemployed was
associated with negative health effects, but only among unemployed men.

PMID: 15182238 [PubMed - indexed for MEDLINE]


113. Occup Environ Med. 2004 Apr;61(4):289-94.

The effectiveness of ergonomic interventions on return-to-work after low back
pain; a prospective two year cohort study in six countries on low back pain
patients sicklisted for 3-4 months.

Anema JR, Cuelenaere B, van der Beek AJ, Knol DL, de Vet HC, van Mechelen W.

Body@Work, Research Centre Physical Activity, Work and Health, TNO-VU University 
Medical Centre, Netherlands. h.anema@vumc.nl

Comment in:
    Occup Environ Med. 2004 Apr;61(4):287-8.

AIMS: To study occurrence and effectiveness of ergonomic interventions on
return-to-work applied for workers with low back pain (LBP). METHODS: A
multinational cohort of 1631 workers fully sicklisted 3-4 months due to LBP
(ICD-9 codes 721, 722, 724) was recruited from sickness benefit claimants
databases in Denmark, Germany, Israel, Sweden, the Netherlands, and the United
States. Medical, ergonomic, and other interventions, working status, and
return-to-work were measured using questionnaires and interviews at three months,
one and two years after the start of sickleave. Main outcome measure was time to 
return-to-work. Cox's proportional hazards model was used to calculate hazard
ratios regarding the time to return-to-work, adjusted for prognostic factors.
RESULTS: Ergonomic interventions varied considerably in occurrence between the
national cohorts: 23.4% (mean) of the participants reported adaptation of the
workplace, ranging from 15.0% to 30.5%. Adaptation of job tasks and adaptation of
working hours was applied for 44.8% (range 41.0-59.2%) and 46.0% (range
19.9-62.9%) of the participants, respectively. Adaptation of the workplace was
effective on return-to-work rate with an adjusted hazard ratio (HR) of 1.47 (95% 
CI 1.25 to 1.72; p < 0.0001). Adaptation of job tasks and adaptation of working
hours were effective on return-to-work after a period of more than 200 days of
sickleave with an adjusted HR of 1.78 (95% CI 1.42 to 2.23; p < 0.0001) and 1.41 
(95% CI 1.13 to 1.76; p = 0.002), respectively. CONCLUSIONS: Results suggest that
ergonomic interventions are effective on return-to-work of workers long term
sicklisted due to LBP.

PMCID: PMC1740746
PMID: 15031385 [PubMed - indexed for MEDLINE]


114. J Epidemiol Community Health. 2004 Apr;58(4):321-6.

Sickness absence as a predictor of mortality among male and female employees.

Vahtera J, Pentti J, Kivimäki M.

Finnish Institute of Occupational Health, Turku, Finland.
jussi.vahtera@occuphealth.fi

OBJECTIVE: To determine the extent to which sickness absence is predictive of
mortality. DESIGN: Prospective cohort study. Data on medically certified long
term absences (>3 days), self certified short term absences (1-3 days), and sick 
days were derived from employers' records and data on mortality from the national
mortality register. SETTING: 10 towns in Finland. PARTICIPANTS: 12821 male and
28915 female Finnish municipal employees with a job contract of five consecutive 
years. The mean follow up was 4.5 years. MAIN RESULTS: After adjustment for age, 
occupational status, and type of employment contract, the overall mortality rate 
was 4.3 (95% confidence intervals 2.6 to 7.0) and 3.3 (2.1 to 5.3) times greater 
in men and women with more than one long term absences per year than in those
with no absence. The corresponding hazard ratios for more than 15 annual sick
days were 4.7 (2.3 to 9.6) and 3.7 (1.5 to 9.1). Both these measures of sickness 
absence were also predictive of deaths from cardiovascular disease, cancer,
alcohol related causes, and suicide. Associations between short term sickness
absences and mortality were weaker and changed to non-significant after
adjustment for long term sickness absence. CONCLUSIONS: These findings suggest
that measures of sickness absence, such as long term absence spells and sick
days, are strong predictors of all cause mortality and mortality due to
cardiovascular disease, cancer, alcohol related causes, and suicide.

PMCID: PMC1732735
PMID: 15026447 [PubMed - indexed for MEDLINE]


115. Soc Sci Med. 2004 May;58(10):1889-901.

Tinker, tailor, soldier, patient: work attributes and depression disparities
among young adults.

Zimmerman FJ, Christakis DA, Vander Stoep A.

Department of Health Services, School of Public Health, University of Washington,
USA. fzimmer@u.washington.edu

Prior studies have consistently found the occurrence of depression to be higher
among persons with lower socio-economic status (SES), but causal mechanisms for
this relationship are often not well understood. For example, while depression
has been shown to increase during spells of unemployment, little work has been
done on job attributes that may be related to depression among employed people
early in their careers. This study links the 1992 wave of the National
Longitudinal Survey of Youth 1979 cohort-which included Depression symptom scores
on the Center for Epidemiologic Studies Depression (CES-D) instrument-to the US
Department of Labor's new occupational characteristics O*Net dataset. The
resulting dataset includes information regarding depression, SES, and specific
attributes of jobs held by the young adult respondents. Job attributes included
measures of social status, interpersonal stressors, and physical conditions.
Multivariate analysis revealed that for young men, higher job status is
associated with lower CES-D scores. Higher scores on the opposition scale, which 
measures the extent to which employees are obliged to take a position opposed to 
others, is associated with higher CES-D scores. For young women, physically
uncomfortable or dangerous jobs are associated with more depressive symptoms.
Results are stratified by race/ethnicity. For Black men, unlike for White men or 
Latinos, job security is associated with fewer depressive symptoms; and for
Latino men, but not for Black or White men, physically uncomfortable or dangerous
jobs are associated with more depressive symptoms. For Black women, job status is
associated with fewer depressive symptoms. We conclude that part of the
SES-depression relationship may arise from the psychosocial aspects of jobs,
which we have found to be significantly and meaningfully associated with
depressive symptoms among employed young adults.

PMID: 15020006 [PubMed - indexed for MEDLINE]


116. Oncol Nurs Forum. 2004 Mar-Apr;31(2):E32-8.

Cancer nursing research short course: long-term follow-up of participants,
1984-1998.

Grant M, Mooney K, Rutledge D, Gerard S, Eaton L.

City of Hope National Medical Center, Duarte, CA, USA. mgrant@coh.org.

PURPOSE/OBJECTIVES: To describe research activities of cancer nurses following
participation in the Oncology Nursing Society (ONS)/National Cancer Institute
Cancer Nursing Research Short Course from 1984-1989. DESIGN: Descriptive survey. 
SETTING: National survey of course participants. SAMPLE: 128 cancer nurses who
attended the courses presented from 1984-1998. METHODS: Mailed survey. MAIN
RESEARCH VARIABLES: Demographic characteristics, current job titles,
participation in research since course attendance, sources and amounts of
research support, research roles, and publications. FINDINGS: The course provided
new investigators with a unique research experience not available at their own
institutions and helped them launch their research careers. The participants'
commitment to research is illustrated in their response rate to the survey,
record of studies, funding sources, and research roles. CONCLUSIONS: The short
course is a valuable resource for increasing the number of committed oncology
nursing researchers and assisting in the scientific foundation for the care of
patients with cancer. Findings clearly show the value of the course to
participants' research careers. IMPLICATIONS FOR NURSING: ONS has a commitment to
oncology nursing research as the means to increase the scientific foundation for 
cancer nursing care. The Cancer Nursing Research Short Course provides a valuable
resource for meeting this commitment.

PMID: 15017452 [PubMed - indexed for MEDLINE]


117. J Electromyogr Kinesiol. 2004 Feb;14(1):13-23.

Work-related musculoskeletal disorders: the epidemiologic evidence and the
debate.

Punnett L, Wegman DH.

University of Massachusetts Lowell, One University Avenue, Lowell, MA 01854, USA.
laura_punnett@uml.edu

The debate about work-relatedness of musculoskeletal disorders (MSDs) reflects
both confusion about epidemiologic principles and gaps in the scientific
literature. The physical ergonomic features of work frequently cited as risk
factors for MSDs include rapid work pace and repetitive motion, forceful
exertions, non-neutral body postures, and vibration. However, some still dispute 
the importance of these factors, especially relative to non-occupational causes. 
This paper addresses the controversy with reference to a major report recently
commissioned by the US Congress from the National Research Council (NRC) and
Institute of Medicine (IOM) (2001). The available epidemiologic evidence is
substantial, but will benefit from more longitudinal data to better evaluate gaps
in knowledge concerning latency of effect, natural history, prognosis, and
potential for selection bias in the form of the healthy worker effect. While
objective measures may be especially useful in establishing a more secure
diagnosis, subjective measures better capture patient impact. Examination
techniques still do not exist that can serve as a "gold standard" for many of the
symptoms that are commonly reported in workplace studies. Finally, exposure
assessment has too often been limited to crude indicators, such as job title.
Worker self-report, investigator observation, and direct measurement each add to 
understanding but the lack of standardized exposure metrics limits ability to
compare findings among studies. Despite these challenges, the epidemiologic
literature on work-related MSDs-in combination with extensive laboratory evidence
of pathomechanisms related to work stressors-is convincing to most. The NRC/IOM
report concluded, and other reviewers internationally have concurred, that the
etiologic importance of occupational ergonomic stressors for the occurrence of
MSDs of the low back and upper extremities has been demonstrated.

PMID: 14759746 [PubMed - indexed for MEDLINE]


118. Hautarzt. 2004 Jan;55(1):10-21.

[New dermatologist's procedure. Research plans for improving secondary prevention
of occupational dermatoses]

[Article in German]

Dickel H, John SM, Kuss O, Schwanitz HJ.

Abteilung für Dermatologie, Umweltmedizin und Gesundheitstheorie, Universität
Osnabrück, Osnabrück.

The dermatologist's procedure was introduced in 1972 by employers' liability
insurance funds in the industrial, agricultural, and public sectors of Germany's 
statutory occupational accident insurance as a "procedure for early detection of 
occupational skin diseases." So far, it is still the most relevant tool for
secondary prevention in occupational dermatology in Germany. According to the
intention of this procedure, insured persons with a skin disease in which an
occupational etiology is suspected must be offered preventive measures and, if
necessary, given appropriate treatment to avoid job-loss. To improve the
efficiency of the "classic" dermatologist's procedure, in 1999, on the initiative
of the Central Federation of Industrial Professional Associations, a study group 
was founded in cooperation with the Task Force on Occupational and Environmental 
Dermatology of the German Dermatological Society and the Professional
Organisation of German Dermatologists. In October 2002, a controlled intervention
study started in North-western Germany to scientifically evaluate the "optimised"
dermatologist's procedure, which was proposed by the study group and compare it
to the standard ("classic") procedure. The study results should allow detailed
suggestions for an improved dermatologist's procedure before it is introduced
nationwide.

PMID: 14749856 [PubMed - indexed for MEDLINE]


119. J Child Health Care. 2003 Dec;7(4):258-76.

Planning a career as a children's nurse: the availability of career guidance
during the nurse diploma course.

Cox SJ, Robinson S, Murrells T.

Nursing Research Unit, King's College, University of London, London, UK.
susanne.cox@kcl.ac.uk

The recruitment and retention of registered children's nurses is paramount to the
implementation of the national service framework for children's services. In
recent years there have been increased career opportunities for children's nurses
and a diversity of career pathways. Career guidance has a potential contribution 
to make to the effective management of nurses' careers. This article presents
findings on child health diplomates' experiences of career guidance during the
nurse diploma course. Findings indicate a substantial unmet demand for career
guidance. The implications of the findings for child health nurses' careers are
discussed and considered in relation to two key questions: should efforts be
directed towards ensuring greater provision of career guidance, and if so, by
whom?

PMID: 14636431 [PubMed - indexed for MEDLINE]


120. Arthritis Care Res. 2000 Jun;13(3):168-76.

The prevalence and impact of accommodations on the employment of persons 51-61
years of age with musculoskeletal conditions.

Yelin E, Sonneborn D, Trupin L.

Department of Medicine, Institute for Health Policy Studies, University of
California, San Francisco, USA.

OBJECTIVE: To provide estimates of the frequency with which persons 51 to 61
years of age with musculoskeletal conditions receive workplace accommodations
from their employers and to determine if the receipt of such accommodations is
associated with higher rates of employment two years later. METHODS: The
estimates derive from the Health and Retirement Survey, a national probability
sample of 8,781 respondents who were interviewed both in 1992 and 1994 and who
were between the ages of 51 and 61 years, of whom 5,495 reported one or more
musculoskeletal conditions. We tabulated the frequency of accommodations provided
in 1992 and then estimated the impact of accommodations and demographic and
medical characteristics on 1994 employment status, using logistic regression.
RESULTS: In 1992, about 14.40 million persons aged 51-61 years reported a
musculoskeletal condition. Of these, 1.32 million (9.2%) reported a disability
and were employed, the target population for accommodations. Overall, fewer than 
1 in 5 persons with musculoskeletal conditions who had a disability and were
employed indicated that they had received any form of accommodation on their
current jobs. Although no form of accommodation was reported with great
frequency, the most commonly used ones included getting someone to help do one's 
job (12.1%), scheduling more breaks during the work day (9.5%), changing the time
that the work day started and stopped (6.3%), having a shorter work day (5.6%),
getting special equipment (5.3%), and changing the work tasks (5.3%). Persons
with one or more accommodations in 1992, however, were no more likely to be
working in 1994 than those with none. Only one specific accommodation--getting
someone to help do one's job--was associated with a higher rate of employment in 
1994. CONCLUSIONS: Receipt of employment accommodations occurred infrequently,
and was not generally associated with an improvement in the employment rate of
persons with musculoskeletal conditions and disabilities.

PMID: 14635290 [PubMed - indexed for MEDLINE]


121. J Clin Anesth. 2003 Jun;15(4):289-94.

Recruitment of house staff into anesthesiology: a re-evaluation of factors
responsible for house staff selecting anesthesiology as a career and individual
training program.

Wass CT, Long TR, Randle DW, Rose SH, Faust RJ, Decker PA.

Department of Anesthesiology and Section of Biostatistics, Mayo Clinic and Mayo
Medical School, Rochester, MN 55905, USA. wass.thomas@mayo.edu

STUDY OBJECTIVE: To reexamine, in a follow-up to our first study, those factors
responsible for house staff (i.e., residents and clinical fellows) selecting
anesthesiology as a career and a specific training program, as well as house
staff satisfaction with various educational aspects of our training program, and 
their perceptions of the future for graduating anesthesiology trainees. DESIGN:
Survey questionnaire of 77 house staff at the Mayo Clinic during the 2000 to 2001
academic year. SETTING: Academic medical center. MEASUREMENTS: A cross-sectional 
analysis was conducted using a questionnaire to survey 77 house staff enrolled in
the anesthesiology training program at Mayo Clinic, Rochester, MN during the 2000
to 01 academic year. All responses were anonymous. Data were compared between
time epochs using an f-exact test. A p-value 7 days within the last year of follow-up among the nonsymptomatic
respondents at baseline. RESULTS: Men's and women's previous symptoms, women's
low influence at work and high-placed computer screen, and men's short time in
the same job and good computer skills were associated with neck symptoms.
Hand-wrist symptoms were predicted by previous symptoms and low influence at work
for both the men and women and sensorial demands for the women only. The duration
of computer use predicted hand-wrist symptoms [eg, odds ratio (OR) of 2.3, 95%
confidence interval (95% CI) 1.2-4.3, for almost continual computer use], but not
neck symptoms. For those with almost continual computer use, hand-wrist symptoms 
were associated with mouse use for at least half of the worktime (OR 4.0, 95% CI 
1.0-15.5) and not using the mouse at all (OR 4.0, 95% CI 1.1-14.4), as compared
with mouse use for one-fourth of the worktime. CONCLUSIONS: Limiting computer use
to less than three-fourths of the worktime would help to prevent hand-wrist
symptoms. Furthermore, low influence at work predicts both neck and hand-wrist
symptoms.

PMID: 12828389 [PubMed - indexed for MEDLINE]


124. Ann Epidemiol. 2003 May;13(5):385-92.

Assessing exposure to crystalline silica from farm work: a population-based study
in the Southeastern United States.

Parks CG, Cooper GS, Nylander-French LA, Storm JF, Archer JD.

Epidemiology Branch, National Institute of Environmental Health Sciences,
Research Triangle Park, NC 27709, USA. parks@niehs.nih.gov

PURPOSE: Farm workers are exposed to crystalline silica, but there are no
established questionnaires to assess silica dust exposure from farm work in
epidemiologic studies. This study examines aspects of farm work that were used to
estimate potential silica dust exposure in a population-based study conducted in 
the southeastern United States. METHODS: We collected work and farming histories 
through in-person interviews with 620 participants in a population-based
case-control study of systemic lupus erythematosus. A dust-exposure matrix was
used to develop a telephone interview for 69 participants with potential medium- 
or high-level exposure, including questions on tasks, frequency, and farm
location. Soil systems maps were used to infer soil type (sandy/other). Exposure 
indices were constructed based on tasks, frequency, and soil type. RESULTS:
Thirty-six percent of study participants worked on a farm, but only 52 (8%) were 
classified in the high (n=16) or medium (n=36) exposure groups based on responses
to follow-up interview questions. Exposure indices based on open-ended job
descriptions in initial interviews correctly categorized 52% of participants who 
answered prompted questions on relevant dusty tasks in follow-up interviews.
CONCLUSIONS: Specific questions on dusty tasks and frequency are needed to
accurately assess silica exposure from farm work.

PMID: 12821278 [PubMed - indexed for MEDLINE]


125. Rheumatology (Oxford). 2003 Oct;42(10):1216-25. Epub 2003 Jun 16.

Prognostic factors in lateral epicondylitis: a randomized trial with one-year
follow-up in 266 new cases treated with minimal occupational intervention or the 
usual approach in general practice.

Haahr JP, Andersen JH.

Department of Occupational Medicine, Herning Hospital, Denmark. hecjph@ringamt.dk

OBJECTIVES: To determine whether minimal intervention by occupational specialists
involving information about the disorder, encouragement to stay active and
instruction in graded self-performed exercises could enhance the prognosis of
lateral epicondylitis compared with the treatment usually given in general
practice, to quantify workplace factors associated with the prognosis, and to
consider treatments given in general practice. METHODS: A randomized controlled
trial was performed in a cohort of 266 consecutive new cases of lateral
epicondylitis diagnosed in general practice. Workplace factors were assessed with
questionnaires at the time of inclusion, and patients completed follow-ups at 3, 
6 and 12 months. Status at 1 yr was assessed as overall improvement and pain
reduction compared with the time of diagnosis. General practitioners (GPs)
registered the treatments given for both cases and controls during follow-up.
Numbers of contacts with GPs and physiotherapists were obtained from the National
Health Insurance registry. Prognostic factors were analysed by multiple logistic 
regression analysis. RESULTS: After 1 yr, 83% of cases showed improvement in the 
condition, but the intervention was found to have had no advantage. Poor overall 
improvement was associated with employment in manual jobs [odds ratio (OR) 3.0,
95% confidence interval (CI) 1.0-8.7], a high level of physical strain at work
(OR 8.5, CI 1.0-74.7) and a high level of pain at baseline (OR 2.3, CI 1.0-5.3). 
Pain reduction less than 50% was associated with manual jobs (OR 2.3, CI
1.1-5.1), high physical strain at work (OR 3.6, CI 1.0-12.9), high baseline
distress (OR 1.9, CI 1.0-4.0) and tennis elbow on the dominant side (OR 3.1, CI
1.4-6.8). The intervention group received less treatment and fewer treatment
modalities, but the intervention was not followed by a reduction in the number of
visits to GPs and physiotherapist clinics during 12 months of follow-up.
CONCLUSIONS: Poor prognosis at 1 yr of follow-up for lateral epicondylitis was
related to manual work and high baseline pain, whilst no relation was found
between the type of medical treatment given/chosen and prognosis. This may have
implications for the future management of lateral epicondylitis in terms of a
greater focus on interaction with the workplace regarding job modification to
reduce physical demands during recovery.

PMID: 12810936 [PubMed - indexed for MEDLINE]


126. AIHA J (Fairfax, Va). 2003 May-Jun;64(3):346-51.

Construction work practices and conditions improved after 2-years' participation 
in the HomeSafe pilot program.

Gilkey DP, Hautaluoma JE, Ahmed TP, Keefe TJ, Herron RE, Bigelow PL.

Department of Environmental Health, Occupational Safety and Health Section,
Colorado State University, 104 Environmental Health Building, Ft. Collins, CO
80523-1676, USA.

This study reevaluated changes in job-site safety audit scores for a cohort of
residential construction workers that had protracted exposure to the HomeSafe
pilot program for 2(1/2) years. The investigation was a repeated measure of a
cohort study underway in the six-county metro area of Denver, Colo. The larger
study was a longitudinal, quasi-experimental design with a cohort of residential 
construction workers within the HomeSafe strategic partnership between
Occupational Safety and Health Administration Region VIII and the Home Builders
Association of Metropolitan Denver (HBA). Audits were conducted on residential
construction sites. Study subjects were construction workers employed by partner 
or control companies within the study. Repeated measures of 41 companies showed
significant improvement (p=.01) in audit scores, increasing from 71.8 to 76.8
after 2(1/2) years in the program. HomeSafe companies out-performed controls
(p=.01) for both the retest group and previously unaudited HomeSafe companies.
Prolonged exposure in the HomeSafe pilot program resulted in improved audit
scores for companies within the program for at least 2 years.

PMID: 12809540 [PubMed - indexed for MEDLINE]


127. Emerg Infect Dis. 2003 Jun;9(6):708-12.

Community reaction to bioterrorism: prospective study of simulated outbreak.

DiGiovanni C Jr, Reynolds B, Harwell R, Stonecipher EB, Burkle FM Jr.

National Naval Medical Center, Bethesda, Maryland, USA. cdig@july.dgsys.com

To assess community needs for public information during a bioterrorism-related
crisis, we simulated an intentional Rift Valley fever outbreak in a community in 
the southern part of the United States. We videotaped a series of simulated print
and television "news reports" over a fictional 9-day crisis period and invited
various groups (e.g., first-responders and their spouses or partners,
journalists) within the selected community to view the videotape and respond to
questions about their reactions. All responses were given anonymously.
First-responders and their spouses or partners varied in their reactions about
how the crisis affected family harmony and job performance. Local journalists
exhibited considerable personal fear and confusion. All groups demanded, and put 
more trust in, information from local sources. These findings may have
implications for risk communication during bioterrorism-related outbreaks.

PMID: 12781011 [PubMed - indexed for MEDLINE]


128. J Health Soc Behav. 2003 Mar;44(1):18-33.

Does perceived discrimination affect health? Longitudinal relationships between
work discrimination and women's physical and emotional health.

Pavalko EK, Mossakowski KN, Hamilton VJ.

Department of Sociology, 744 Ballantine Hall, 1020 E. Kirkwood Ave., Indiana
University, Bloomington, IN 47405, USA. epavalko@indiana.edu

This study uses longitudinal data to examine the causal relationships between
perceived work discrimination and women's physical and emotional health. Using
data on 1,778 employed women in the National Longitudinal Survey of Mature Women,
we investigate the structural and individual characteristics that predict later
perceptions of discrimination and the effects of those perceptions on subsequent 
health. We find that perceptions of discrimination are influenced by job
attitudes, prior experiences of discrimination, and work contexts, but prior
health is not related to later perceptions. However, perceptions of
discrimination do impact subsequent health, and these effects remain significant 
after controlling for prior emotional health, physical health limitations,
discrimination, and job characteristics. Overall, the results provide even
stronger support for the health impact of workplace discrimination and suggest a 
need for further longitudinal analyses of causes and consequences of perceived
discrimination.

PMID: 12751308 [PubMed - indexed for MEDLINE]


129. Ann Allergy Asthma Immunol. 2003 Mar;90(3):308-15.

The impact of a large-scale population-based asthma management program on
pediatric asthma patients and their caregivers.

Georgiou A, Buchner DA, Ershoff DH, Blasko KM, Goodman LV, Feigin J.

UnitedHealth Group, Minnetonka, Minnesota, USA.

Comment in:
    Ann Allergy Asthma Immunol. 2003 Mar;90(3):282-3.

BACKGROUND: The consequences of pediatric asthma include missed school
attendance, limitations in physical activity, and increased health care
utilization and costs. Caregivers of asthmatic children are affected through
missed work days and decreased job productivity. In response to these issues, a
disease management program encompassing asthmatic children and their caregivers
was developed as part of the core services offered to members of a large,
national health care plan. OBJECTIVE: To determine the impact of the asthma
management program on pediatric asthma patients and their caregivers over a
12-month period. METHODS: In this longitudinal study, 401 randomly selected
member households with asthmatic children from 17 regional markets completed
surveys before and after 12 months of participation in the asthma management
program. Program interventions, which were tailored according to risk and need
status, included various staggered educational mailings, reminder aids, videos, a
peak expiratory flow rate meter, and telephonic case management. The Asthma
Quality Assessment System survey, a battery of self-reported quality indicators, 
was used to solicit information from parents or caregivers of asthmatic children 
on issues pertaining to quality of life, asthma management skills and knowledge, 
and lost work/school days related to asthma. RESULTS: Statistically significant
postprogram outcomes were observed in various domains, including a reduction in
adverse utilization, symptomatology, and restricted activity days for children
and lost work days for adult caretakers. CONCLUSIONS: These findings demonstrate 
that a large-scale population-based intervention program can produce measurable
clinical and economic benefits, thereby lessening the burden of asthma on the
family unit.

PMID: 12669894 [PubMed - indexed for MEDLINE]


130. Int J Epidemiol. 2002 Dec;31(6):1155-61.

Serious health events following involuntary job loss in New Zealand meat
processing workers.

Keefe V, Reid P, Ormsby C, Robson B, Purdie G, Baxter J; Ngäti Kahungunu Iwi
Incorporated.

Röpü Rangahau Hauora a Eru Pömare (Eru Pömare Mäori Health Research Centre),
Wellington School of Medicine and Health Sciences, University of Otago,
Wellington, New Zealand. tmhvko@wnmeds.ac.nz

Comment in:
    Int J Epidemiol. 2002 Dec;31(6):1094-7.

BACKGROUND: The association between unemployment and poor health outcomes is well
documented. Significant debate exists as to whether unemployment causes ill
health or whether those with poor health find it harder to obtain and maintain
employment. Factory closure studies are well placed to comment on causation. The 
objective of this study was to investigate associations between involuntary job
loss, mortality and serious illness. METHODS: An 8-year follow-up of workers from
two meat-processing plants in the Hawkes Bay region of New Zealand. A cohort (n =
1945) made redundant in 1986 was compared with a cohort (n = 1767) from the
neighbouring plant that remained open until 1994. Incidence rates for mortality, 
cancer registrations and admissions to public hospitals were derived from record 
linkage with routinely collected national data. RESULTS: Follow-up for the period
1986-1994 was 96% complete for both plants. Among the cohort made redundant in
1986, there was an increased risk of serious self-harm which led to
hospitalization or death (adjusted for age, sex and ethnicity relative risk [RR] 
= 2.47; 95% CI: 1.04-5.89) compared to the employed cohort. The RR of admission
to hospital with a mental health diagnosis was 1.17 (95% CI: 0.68-2.01). There
were no other statistically significant findings. CONCLUSIONS: This study has
most of the features of an 'ideal' factory closure study, in that it achieved
near-complete follow-up of a large workforce made redundant and a similar
employed workforce for 8 years. We found that exposure to involuntary job loss
increased the risk of mental distress leading to serious self-harm. No other
association was found.

PMID: 12540716 [PubMed - indexed for MEDLINE]


131. J Intern Med. 2002 Dec;252(6):542-50.

Obesity and myocardial infarction--vulnerability related to occupational level
and marital status. A 23-year follow-up of an urban male Swedish population.

Hedblad B, Jonsson S, Nilsson P, Engström G, Berglund G, Janzon L.

Department of Community Medicine, Lund University, Malmö University Hospital,
Malmö, Sweden. bo.hedblad@smi.mas.lu.se

BACKGROUND: People, who are single, have a blue-collar job or low income have an 
increased cardiovascular risk. This study on myocardial infarction sought to
explore whether the socio-economic pattern of disease has any relationship with
obesity. METHODS: In the cohort are 20,099 middle-aged men of whom 9,150 were
manual and 9,190 nonmanual workers and 1,759 were self-employed. A total of 4,081
were single, 16,018 cohabiting. The body mass index (BMI) cut-off values for
overweight and obesity were 25-30 and >/=30 kg m-2, respectively. Local and
national registers were used to monitor incidence of events over 18 years.
RESULTS: Obesity was associated with an increased incidence of coronary events
and deaths in each occupational group. Being single significantly increased the
risk associated with obesity. After stratification for civil status the risk
associated with obesity was limited to those who were single and who either had a
blue-collar job or were self-employed. The multivariate-adjusted relative risk
(RR) of coronary events and deaths in obese manual workers who were single was
1.91 (95% confidence interval: 1.21-3.02) and 2.54 (1.74-3.69), respectively,
times higher than it was amongst those who were cohabiting. Amongst those who
were self-employed, the corresponding age-adjusted RRs were 4.79 (1.69-13.57) and
3.80 (1.62-8.93). CONCLUSIONS: Adjusted for lifestyle and biological risk
factors, the increased risk of coronary events and death for obese men with
manual jobs was applicable only to those who were single. It is concluded that
being single significantly increases the cardiovascular risk associated with
obesity.

PMID: 12472916 [PubMed - indexed for MEDLINE]


132. Work. 2002;18(1):75-87.

Early employment careers of people with disabilities in the National Child
Development Study.

Pilling DS.

Rehabilitation Resource Centre, City University, Northampton Square, London EC1V 
0HB, UK. D.S. Pilling@city.ac.uk

OBJECTIVES: To compare the early employment careers of people with disabilities
and their non-disabled contemporaries. STUDY DESIGN: The employment of 436 people
with disabilities was investigated between the ages of 23 and 33. The sample were
part of a continuing longitudinal study, the National Child Development Study
(NCDS), of some 17,000 people born during one week in 1958 and living in England,
Wales and Scotland. Cross-tabulations were carried out comparing the employment
of people with disabilities and that of their non-disabled counterparts using
SPSS for Windows. RESULTS: Despite the majority of the sample not having
difficulties with everyday activities people with disabilities were disadvantaged
in terms of educational and vocational qualifications, employment rates and
earnings. Those with physical disabilities fared better than the other disability
groups in terms of employment and earnings, among this group men with 'below
average' educational and vocational qualifications differing most from their
non-disabled counterparts and women with 'above average' qualifications differing
least. CONCLUSIONS: Findings indicate the importance of educational and
vocational qualifications for those with disabilities, for more emphasis on job
retention, for measures against wage discrimination, and for job placement
assistance for some groups of those with a disability.

PMID: 12441593 [PubMed - indexed for MEDLINE]


133. BMJ. 2002 Oct 19;325(7369):857.

Work stress and risk of cardiovascular mortality: prospective cohort study of
industrial employees.

Kivimäki M, Leino-Arjas P, Luukkonen R, Riihimäki H, Vahtera J, Kirjonen J.

Department of Psychology, University of Helsinki, PO Box 13, FIN-00014, Finland. 
mika.kivimaki@occuphealth.fi

Erratum in:
    BMJ 2002 Dec 14;325(7377):1386.

OBJECTIVE: To examine the association between work stress, according to the job
strain model and the effort-reward imbalance model, and the risk of death from
cardiovascular disease. DESIGN: Prospective cohort study. Baseline examination in
1973 determined cases of cardiovascular disease, behavioural and biological
risks, and stressful characteristics of work. Biological risks were measured at 5
year and 10 year follow up. SETTING: Staff of a company in the metal industry in 
Finland. PARTICIPANTS: 812 employees (545 men, 267 women) who were free from
cardiovascular diseases at baseline. MAIN OUTCOME MEASURE: Cardiovascular
mortality 1973-2001 from the national mortality register. RESULTS: Mean length of
follow up was 25.6 years. After adjustment for age and sex, employees with high
job strain, a combination of high demands at work and low job control, had a
2.2-fold (95% confidence interval 1.2 to 4.2) cardiovascular mortality risk
compared with their colleagues with low job strain. The corresponding risk ratio 
for employees with effort-reward imbalance (low salary, lack of social approval, 
and few career opportunities relative to efforts required at work) was 2.4 (1.3
to 4.4). These ratios remained significant after additional adjustment for
occupational group and biological and behavioural risks at baseline. High job
strain was associated with increased serum total cholesterol at the 5 year follow
up. Effort-reward imbalance predicted increased body mass index at the 10 year
follow up. CONCLUSIONS: High job strain and effort-reward imbalance seem to
increase the risk of cardiovascular mortality. The evidence from industrial
employees suggests that attention should be paid to the prevention of work
stress.

PMCID: PMC129630
PMID: 12386034 [PubMed - indexed for MEDLINE]


134. Prehosp Emerg Care. 2002 Oct-Dec;6(4):433-9.

Longitudinal Emergency Medical Technician Attribute and Demographic Study
(LEADS): an interim report.

Brown WE Jr, Dickison PD, Misselbeck WJ, Levine R.

National Registry of Emergency Medical Technicians, Columbus, Ohio 43229, USA.

OBJECTIVES: This ten-year longitudinal study examines various attributes and
demographic characteristics of emergency medical technicians (EMTs) and
paramedics to identify factors that influence their careers, to identify trends
in emergency medical services (EMS), and to provide data on why individuals
report leaving the EMS career field. METHODS: A 46-item core survey and a 16-item
cross-sectional survey were administered to EMT-basics and EMT-paramedics who
were randomly selected and placed in cohort groups stratified by duration of
continuous registration at each level and by race. The core survey focused on
five broad areas of attributes and demographics, including general, professional,
educational, personal, and financial. Case weights were calculated for
respondents in each stratum, reflecting the individual's probability of
selection. These case weights were adjusted, within strata, for nonresponse. The 
survey will be administered annually. The cross-sectional survey focused on EMS
education. RESULTS: This interim report is descriptive of the overall responses
of EMT-basics and EMT-paramedics to core survey items. The demographic
characteristics of EMT-basics and EMT-paramedics are described as well as a
description of their work activities, working conditions, and job satisfaction
CONCLUSIONS: The initial EMT and paramedic attribute and demographic data have
been collected, analyzed, and reported. The longitudinal nature of this study
requires further data collection and analysis to accurately present trends in
EMS, as well as correlations and associations between identified attributes and
other factors that influence the careers of EMTs and paramedics. Further reports 
of the findings will be necessary.

PMID: 12385612 [PubMed - indexed for MEDLINE]


135. Am J Community Psychol. 2002 Dec;30(6):787-813.

Mental health and welfare transitions: depression and alcohol abuse in AFDC
women.

Dooley D, Prause J.

Department of Psychology and Social Behavior, School of Social Ecology,
University of California, Irvine 92697, USA. cddooley@uci.edu

From a selection perspective, does prior dysfunction select women into welfare or
serve as a barrier to leaving welfare? From a social causation perspective, does 
entering or exiting welfare lead to changes in well being? These questions were
analyzed in panel data for over 3,600 women drawn from the National Longitudinal 
Survey of Youth for the period 1992-94. Welfare is associated with both
depression and alcohol consumption cross-sectionally. This link appears to derive
in small part from selection into welfare by depression (in interaction with
marital status), butdepression and alcohol abuse did not operate as barriers to
leaving welfare. Entering welfare was clearly associated with increased
depression and alcohol consumption, but confidence in an apparent beneficial
effect on alcohol symptoms of leaving welfare for employment was limited by small
sample sizes. These findings are located in the context of the 1996-welfare
reform and the recent economic expansion. One implication is that community
psychology should consider welfare entry as a risk factor similar to adverse
employment changes such as job loss.

PMID: 12385483 [PubMed - indexed for MEDLINE]


136. Br J Psychiatry. 2002 Aug;181:111-7.

Psychosocial factors at work, personality traits and depressive symptoms.
Longitudinal results from the GAZEL Study.

Paterniti S, Niedhammer I, Lang T, Consoli SM.

INSERM Unité 360, Paris, France. paternit@chups.jussieu.fr

BACKGROUND: An association between stressful job conditions and depressive
symptoms has been reported. This association could be explained by personality
traits. AIMS: To examine the relationship between psychosocial factors at work
and changes in depressive symptoms, taking into account personality traits.
METHOD: The role of occupational characteristics, psychosocial stress and
personality traits in predicting an increase of depressive symptoms was evaluated
in 7729 men and 2790 women working at the French National Electricity and Gas
Company, with a 3-year follow-up. RESULTS: In men, high decision latitude was
predictive of a decrease in the Centre for Epidemiologic Studies - Depression
scale (CES-D) scores. In both genders, high job demands and low social support at
work were predictive of increased scores, irrespective of personality traits and 
covariates. CONCLUSIONS: Adverse psychosocial work conditions are predictors of
depressive symptom worsening, independent of personality traits.

PMID: 12151280 [PubMed - indexed for MEDLINE]


137. Occup Environ Med. 2002 Jul;59(7):473-80.

Cancer mortality among man-made graphite electrode manufacturing workers: results
of a 38 year follow up.

Mori I.

Department of Work Stress Control, National Institute of Industrial Health,
Japan. mouri@niih.go.jp

BACKGROUND AND AIMS: To examine the risk for cancer mortality among workers
exposed to coal tar and coal tar pitch volatiles in a man-made graphite electrode
factory. The risk for cancer mortality in this type of factory is still
inconclusive, although coal tar and coal tar pitch are recognised as human
carcinogens. METHODS: The study cohort consisted of 332 male employees who served
more than five years in the period 1951-74. The cohort was traced until 1988.
Analyses used standardised mortality ratios (SMRs) to compare cause specific
mortality with that in the general and local population. Effect of smoking was
estimated based on the information collected from the subgroup of the cohort.
SMRs for leading causes of death were compared among different job titles,
duration of employment, time since first employment, and observation subperiods. 
Exposure level for tar and benzo[a]pyrene (BaP) in the factory was also
discussed, based on measurements done by other researchers in the past. RESULTS: 
During the study period, 52 deaths were identified (SMR 0.68), including 22
cancer deaths (SMR 1.01). The SMR for lung cancer was significantly increased in 
comparison with the general population (SMR 2.62). It was slightly decreased in
comparison with the local population, but remained significant (SMR 2.35). Excess
deaths were also observed for lymphatic and haematopoietic cancers (SMR 3.46).
Smoking habits in the subgroup were similar to those in the general population;
thus the increased SMR for lung cancer was unlikely to be explained by smoking.
CONCLUSION: Previous environmental measurements suggested that considerable
exposure to tar and BaP had existed in the factory. The results suggest a
possible risk for lung cancer among the cohort, but the limitations of the study,
such as the small study population and insufficient information on exposure,
indicate that further study is required.

PMCID: PMC1740330
PMID: 12107297 [PubMed - indexed for MEDLINE]


138. Schizophr Res. 2002 Jul 1;56(1-2):105-19.

Symptom patterns and subgrouping of schizophrenic patients: significance of
negative symptoms assessed on admission.

Hwu HG, Chen CH, Hwang TJ, Liu CM, Cheng JJ, Lin SK, Liu SK, Chen CH, Chi YY,
Ou-Young CW, Lin HN, Chen WJ.

Department of Psychiatry, National Taiwan University Hospital and College of
Medicine, National Taiwan University, Taipei, Taiwan. haigohgwu@ha.mc.ntu.edu.tw

This study subgroups schizophrenic patients based on symptoms assessed on
admission and examines the validity of the subgrouping using follow-up data and
other clinical outcome variables. Schizophrenic patients (n=163) from consecutive
admission received ratings on the positive and negative syndrome scale (PANSS) on
admission and during a 1-year follow-up course. An exploratory graphic analysis
on the admission PANSS derived four symptom dimensions: negative symptoms,
disorganized thought, hostility/excitement and delusions/hallucinations. This
yielded two subgroups of patients on admission, a group with marked negative
(GWNEG) and a group without marked negative (GONEG) symptoms. Compared with the
GONEG, the GWNEG had a poorer recovery rate, more impairment in attention, a
slower response of the delusion/hallucination symptoms to neuroleptic treatment
and a longer duration of index hospitalization. At a one-year follow-up, the
GWNEG assessed on admission had persistently higher scores on the negative
symptom and disorganized thought syndromes, less relapse rate, a shorter duration
on job, as well as worse social functioning than the GONEG. Thus, the GONEG might
comprise patients having a pure paranoid syndrome with quick and better treatment
response, while the GWNEG comprises patients with the blunt-disorganization
syndrome having a poorer outcome.

PMID: 12084425 [PubMed - indexed for MEDLINE]


139. Sleep. 2002 May 1;25(3):315-22.

Excessive daytime sleepiness and risk of occupational injuries in non-shift
daytime workers.

Melamed S, Oksenberg A.

Occupational Health Psychology Department, National Institute of Occupational &
Environmental Health , Raanana, Israel. melameds@ioh.org.il

STUDY OBJECTIVES: Only a few studies have examined the possible association
between excessive daytime sleepiness (EDS) and risk of occupational injuries, and
most of them were based on self-reports. This study tested this association in
daytime workers using injury data taken from organizational archives. DESIGN: A
retrospective and prospective study. It covered injury occurrence during two
years prior to a sleep disorder assessment/education procedure and injury
occurrence in the following year. The workers were given the assessment results
and, when applicable, a letter to the treating physician. SETTING: Eight
industrial plants. Lectures and discussions on sleep disorders, treatment, and
implications to safety and quality of life were conducted with small groups who
completed the sleep assessment questionnaire beforehand. The workers completed
the sleep assessment questionnaire prior to the lecture/discussion. PARTICIPANTS:
532 non-shift daytime workers. INTERVENTIONS: N/A. MEASURES AND RESULTS: A
battery of questionnaires to assess EDS (by the Epworth Sleepiness Scale),
suspected sleep disorders, sleep habits, and job and environmental conditions. Of
the workers studied 22.6% had EDS. Most of those (96.3%) indicated that they had 
experienced this propensity for the past two years or more and 56% of them had
experienced it for 10 years or more. Logistic regression analysis indicated that 
during the two-year period prior to the procedure, EDS was associated with an
increased risk of sustaining a work injury (OR=2.23, 95% CI 1.30-3.81), even
after controlling for possible confounders, including factory category, job and
environmental conditions. In the year after the procedure, the injury rate
decreased by one-third in the workers with EDS but remained unchanged in the
workers without EDS. Consequently, the association between EDS and injury was no 
longer significant (OR=1.42, 95% CI 0.71-2.85). CONCLUSION: EDS is a prevalent
phenomenon in non-shift daytime workers. Workers with EDS had over two-fold
higher risk of sustaining an occupational injury. Providing workers with the
assessment results and of the implications of EDS for safety may explain the
decrease in occupational injuries upon follow-up. This decrease might have
occurred either because of workers taking steps to reduce EDS and/or adopting
safety behaviors.

PMID: 12003162 [PubMed - indexed for MEDLINE]


140. Nurs Stand. 2000 Oct 11-17;15(4):40-6.

From reforms to modernisation.

Kesby S.

Personal Social Services Research Unit, University of Kent at Canterbury.

This article investigates how the 1991 and 1993 reforms have affected service
delivery. It uses district nursing as a case study to demonstrate how a
profession can be changed by the implementation of national health and social
policy.

PMID: 11971494 [PubMed - indexed for MEDLINE]


141. J Am Med Womens Assoc. 2002 Winter;57(1):5-10.

What causes job loss among former welfare recipients: the role of family health
problems.

Earle A, Heymann SJ.

Department of Health and Social Behavior, Harvard School of Public Health, USA.

OBJECTIVE: to test whether women's or children's health status influences the
likelihood that low-income single mothers experience job loss. METHODS: Using a
nationally representative probability sample from the National Longitudinal
Survey of Youth, we estimated whether having a health limitation or having a
child with a health limitation was associated with job loss for a sample of 783
women who had previously been on welfare. RESULTS: Both having a health
limitation (odds ratio [OR]=1.53; 95% confidence interval [CI], 1.19-1.97) and
having a child with a health limitation (OR=1.36; 95% CI, 1.18-1.56) were
associated with significantly increased risk of job loss among women previously
on welfare. The effects remained significant after adjustment for age, education,
marital status, race, age and number of children, and economic conditions.
CONCLUSIONS: Dramatic changes in welfare policy in the United States have made
many single mothers living in poverty dependent on work as their sole source of
income. Although studies have shown that families on welfare are more likely to
have health limitations, little is known about how family health affects the
ability of poor single mothers to remain employed. These results demonstrate that
women with health limitations and mothers of children with health limitations are
at particularly high risk of losing their jobs. Public and private policies that 
can help reduce job loss as a consequence of family health problems are
discussed.

PMID: 11905494 [PubMed - indexed for MEDLINE]


142. Am J Respir Crit Care Med. 2001 Dec 1;164(11):2031-5.

Role of snoring and daytime sleepiness in occupational accidents.

Lindberg E, Carter N, Gislason T, Janson C.

Department of Medical Sciences, Respiratory Medicine and Allergology, Akademiska 
sjukhuset, Uppsala, Sweden. eva.lindberg@medsci.uu.se

To establish whether snoring and excessive daytime sleepiness (EDS), the main
symptoms of obstructive sleep apnea syndrome, influence the risk of occupational 
accidents a population-based, prospective study was performed. In 1984, 2,874 men
aged 30-64 answered questions on snoring and EDS. Ten years later 2,009 (73.8% of
the survivors) responded to a follow-up questionnaire including work-related
questions and potential confounders. Information on occupational accidents during
1985-1994 was obtained from national register data. A total of 345 occupational
accidents were reported by 247 of the men (12.3%). Multivariate analysis revealed
that men who reported both snoring and EDS at baseline were at an increased risk 
of occupational accidents during the following 10 yr, with an adjusted odds ratio
of 2.2 (95% CI 1.3-3.8) after adjusting for age, body mass index, smoking,
alcohol dependence, years at work, blue-collar job, shift work, and exposure to
noise, organic solvents, exhaust fumes, and whole-body vibrations. However, no
significant increased risk was found for snorers without EDS or nonsnorers with
EDS. We conclude that sleepy, male snorers have an increased risk of occupational
accidents. The results indicate that early identification and treatment of
sleep-disordered breathing may reduce the number of injuries at work.

PMID: 11739131 [PubMed - indexed for MEDLINE]


143. Cancer Causes Control. 2001 Nov;12(9):773-84.

Pooled exposure-response analyses and risk assessment for lung cancer in 10
cohorts of silica-exposed workers: an IARC multicentre study.

Steenland K, Mannetje A, Boffetta P, Stayner L, Attfield M, Chen J, Dosemeci M,
DeKlerk N, Hnizdo E, Koskela R, Checkoway H; International Agency for Research on
Cancer.

National Institute for Occupational Safety and Health, Cincinnati, USA.
nsteenland@cdc.gov

Erratum in:
    Cancer Causes Control 2002 Oct;13(8):777.

Comment in:
    Cancer Causes Control. 2001 Nov;12(9):785-7.
    Cancer Causes Control. 2002 Oct;13(8):779-80; author reply 781-2.
    Cancer Causes Control. 2002 Oct;13(8):783-4; author reply 785.

OBJECTIVES: Silica is one of the most common occupational exposures worldwide. In
1997 the International Agency for Research on Cancer (IARC) classified inhaled
crystalline silica as a human carcinogen (group 1), but acknowledged limitations 
in the epidemiologic data, including inconsistencies across studies and the lack 
of extensive exposure-response data. We have conducted a pooled exposure-response
analysis of 10 silica-exposed cohorts to investigate lung cancer. METHODS: The
pooled cohort included 65,980 workers (44,160 miners, 21,820 nominees), and 1,072
lung cancer deaths (663 miners, 409 nonminers). Follow-up has been extended for
five of these cohorts beyond published data. Quantitative exposure estimates by
job and calendar time were adopted, modified, or developed to permit common
analyses by respirable silica (mg/m3) across cohorts. RESULTS: The log of
cumulative exposure, with a 15-year lag, was a strong predictor of lung cancer (p
= 0.0001), with consistency across studies (test for heterogeneity, p = 0.34).
Results for the log of cumulative exposure were consistent between underground
mines and other facilities. Categorical analyses by quintile of cumulative
exposure resulted in a monotonic trend with odds ratios of 1.0. 1.0, 1.3, 1.5,
1.6. Analyses using a spline curve also showed a monotonic increase in risk with 
increasing exposure. The estimated excess lifetime risk (through age 75) of lung 
cancer for a worker exposed from age 20 to 65 at 0.1 mg/m3 respirable crystalline
silica (the permissible level in many countries) was 1.1-1.7%, above background
risks of 3-6%. CONCLUSIONS: Our results support the decision by the IARC to
classify inhaled silica in occupational settings as a carcinogen, and suggest
that the current exposure limits in many countries may be inadequate. These data 
represent the first quantitative exposure-response analysis and risk assessment
for silica using data from multiple studies.

PMID: 11714104 [PubMed - indexed for MEDLINE]


144. Am J Ind Med. 2001 Oct;40(4):363-70.

A historical cohort mortality study among shipyard workers in Genoa, Italy.

Puntoni R, Merlo F, Borsa L, Reggiardo G, Garrone E, Ceppi M.

Environmental Epidemiology and Biostatistics, National Cancer Institute, Largo
Rosanna Benzi 19, 16132 Genoa, Italy. puntonir@hp380.ist.unige.it

BACKGROUND: A historical cohort mortality study was conducted among 3984 shipyard
workers assigned to ship repair, refitting, and construction in the harbor of
Genoa, Italy, between 1960 and 1981. These workers were exposed to asbestos
fibers, welding fumes and gases, silica dust, polycyclic aromatic hydrocarbons,
and solvents. METHODS: Workers were classified in 20 different job-titles
depending upon the type of activity. Standardized mortality ratios (SMRs) were
computed using male residents of the Province of Genoa as the referent
population. RESULTS AND CONCLUSIONS: For the whole cohort significantly increased
SMRs were detected for all causes, all cancers, liver, larynx, lung, pleural and 
bladder cancers, respiratory tract diseases, and cirrhosis of the liver. The
analysis by job-title showed increased SMRs not only for pleural cancer, but also
for lung, laryngeal cancers and respiratory tract diseases in occupations
entailing heavy asbestos exposure. Bladder and liver cancers and liver cirrhosis 
mortality also appeared to be related to occupational exposure. Copyright 2001
Wiley-Liss, Inc.

PMID: 11598985 [PubMed - indexed for MEDLINE]


145. Am J Med Genet. 2001 Sep 1;102(4):309-13.

Neuropsychological and functional cognitive skills of 35 unselected adults with
sex chromosome abnormalities.

Bender BG, Linden MG, Harmon RJ.

Department of Pediatrics, National Jewish Medical and Research Center, 1400
Jackson Street, Denver, CO 80206, USA. benderb@njc.org

This report presents data defining the neuropsychological and cognitive
phenotypes of a group of adults with sex chromosome abnormalities identified at
birth through the chromosome screening of 40,000 consecutive newborns between
1964 and 1974. In all three nonmosaic groups, reading skills were impaired and
intelligence quotients were on average reduced more than 20 points relative to
controls. The 47,XXX women demonstrated greatest overall impairment, including
reduced scores on tests of conceptualization and problem solving. 45,X women
demonstrated impairment in spatial thinking skills, and 47,XXY men in verbal
processing skills. No reduced scores were found in the female mosaic group.
Marked variability in scores was seen in all groups; some propositi have been
unable to hold any job, whereas others have completed college and are
professionally employed. Copyright 2001 Wiley-Liss, Inc.

PMID: 11503155 [PubMed - indexed for MEDLINE]


146. J Occup Health Psychol. 2001 Jul;6(3):182-95.

The interactive effect of chronic exposure to noise and job complexity on changes
in blood pressure and job satisfaction: a longitudinal study of industrial
employees.

Melamed S, Fried Y, Froom P.

Department of Occupational Health Psychology, National Institute of Occupational 
and Environmental Health, Ra'anana, Israel. melameds@ioh.org.il

The hypothesis of this study was that noise exposure level and job complexity
interact to affect changes in blood pressure (BP) levels and job satisfaction
over 2-4 years of follow-up. Results showed that among workers exposed to high
noise, those with complex jobs showed increases in BP that were more than double 
shown by those with simple jobs. Under low noise exposure, there was a small
increase in BP for workers with complex jobs but about a 3-fold increase in
workers with simple jobs. The prevalence of elevated BP showed a similar trend.
Job satisfaction increased among workers with complex jobs but was much less in
those exposed to high noise. It was concluded that exposure to occupational noise
has a greater negative impact on changes in BP and job satisfaction over time
among those performing complex jobs. In contrast, job complexity had a clear
beneficial effect for workers exposed to low noise.

PMID: 11482631 [PubMed - indexed for MEDLINE]


147. J Am Diet Assoc. 2001 Jul;101(7):820-4.

Dietetics professionals have a positive perception of professional development.

Keim KS, Gates GE, Johnson CA.

Nutritional Sciences Department, Oklahoma State University, Stillwater, USA.

This study summarizes the perceptions towards the Professional Development
Portfolio method of recertification and attitude towards professional development
of dietetic professionals as measured in the national pilot study of the
Portfolio. Portfolio compared to control respondents had greater awareness, and
better understanding and knowledge of the Portfolio process after using the
Portfolio guide. The perception that the Portfolio process will aid in
maintaining competence did not differ between groups. The perception that
self-reflection aided in determining career goals and confidence to conduct a
learning needs assessment differed slightly between groups. Both groups had a
positive attitude towards professional development and that continuing
professional education (CPE) improved competence. All perceptions and attitudes
were positive. The focus of CPE in foods, business, management, education, and
research did affect the ability of dietetics professionals to find appropriate
CPE. Rural and unemployed respondents had more difficulty finding appropriate
CPE. The findings indicate that the Portfolio guide aides the dietetics
professional using the Portfolio process and that the perception towards the
Portfolio process is positive. Some dietetics professionals with different CPE
focus had difficulty finding appropriate CPE, and this did not differ by control 
and Portfolio group. More innovative methods of CPE delivery may need to be
considered for these practitioners.

PMID: 11478483 [PubMed - indexed for MEDLINE]


148. Infect Control Hosp Epidemiol. 2001 Apr;22(4):206-10.

Risk of exposure to bloodborne infection for Italian healthcare workers, by job
category and work area. Studio Italiano Rischio Occupazionale da HIV Group.

Puro V, De Carli G, Petrosillo N, Ippolito G.

Centro di Riferimento AIDS, National Institute for Infectious Diseases--IRCCS
Lazzaro Spallanzani, Rome, Italy.

OBJECTIVE: To analyze the rate of occupational exposure to blood and body fluids 
from all sources and specifically from human immunodeficiency virus
(HIV)-infected sources among hospital workers, by job category and work area.
DESIGN: Multicenter prospective study. Occupational exposure data (numerator) and
full-time equivalents ([FTEs] denominator) were collected over a 5-year period
(1994-1998) and analyzed. SETTING: 18 Italian urban acute-care hospitals with
infectious disease units. RESULTS: A total of 10,988 percutaneous and 3,361
mucocutaneous exposures were reported. The highest rate of percutaneous exposure 
per 100 FTEs was observed among general surgery (11%) and general medicine
(10.6%) nurses, the lowest among infectious diseases (1.1%) and laboratory (1%)
physicians. The highest rates of mucocutaneous exposure were observed among
midwives (5.3%) and dialysis nurses (4.7%), the lowest among pathologists (0%).
Inadequate sharps disposal and the prevalence of sharps in the working unit
influence the risk to housekeepers. The highest combined HIV exposure rates were 
observed among nurses (7.8%) and physicians (1.9%) working in infectious disease 
units. The highest rates of high-risk percutaneous exposures per 100 FTE were
again observed in nurses regardless of work area, but this risk was higher in
medical areas than in surgery (odds ratio, 2.1; 95% confidence interval, 1.9-2.5;
P<.0001). CONCLUSION: Exposure risk is related to job tasks, as well as to the
type and complexity of care provided in different areas, whereas HIV exposure
risk mainly relates to the prevalence of HIV-infected patients in a specific
area. The number of accident-prone procedures, especially those involving the use
of hollow-bore needles, performed by job category influence the rate of exposure 
with high risk of infection. Job- and area-specific exposure rates permit
monitoring of the effectiveness of targeted interventions and control measures
over time.

PMID: 11379710 [PubMed - indexed for MEDLINE]


149. Soc Sci Med. 2001 Feb;52(3):405-15.

Psychophysiological effects of temporary alternative employment.

Westerlund H, Theorell T, Bergström A.

National Institute for Psychosocial Factors and Health, Stockholm, Sweden.
Hugo.Westerlund@ipm.ki.se

Twenty-one participants in a mobilising labour market project offering temporary,
alternative employment in Sweden were followed longitudinally for one year,
including a six month post-participation follow-up period. Earlier analyses of
self-rated psychosocial data have indicated consistent improvements in mental
health and quality of life. In the present study, however, a significant rise in 
serum prolactin, plus decreased dehydro-epiandro-sterone sulphate levels and
tendencies towards increased alanine aminotransferase, gamma-glutamyl transferase
and diastolic blood pressure, seem to disconfirm the hypothesis that biological
markers of psychosocial health would improve in a similar fashion. It is
speculated that this apparent inconsistency could be part of a protective
adaptation to long-term unemployment similar to the cocooning tendencies in
maternal behaviour. Specifically, we argue that this could protect against the
stress of being in an uncontrollable and 'helpless' situation by facilitating a
re-focusing on more private matters as opposed to 'hopeless' job seeking. While
being potentially detrimental for people with fair chances on the labour market, 
it is possible that such an adaptation may be helpful for more vulnerable groups.

PMID: 11330775 [PubMed - indexed for MEDLINE]


150. J Health Soc Behav. 2000 Dec;41(4):421-36.

Underemployment and depression: longitudinal relationships.

Dooley D, Prause J, Ham-Rowbottom KA.

Department of Psychology and Social Behavior, School of Social Ecology,
University of California, Irvine, CA 92697, USA.

We conceptualize employment status not as a dichotomy of working versus not
working but as a continuum ranging from adequate employment to inadequate
employment (involuntary part-time or low wage) to unemployment. Will shifts from 
adequate to inadequate employment increase depression as do shifts from
employment to unemployment, and to what extent does prior depression select
workers into such adverse employment change? We analyze panel data from the
National Longitudinal Survey of Youth for the years 1992-1994 for the 5,113
respondents who were adequately employed in 1992. Controlling for prior
depression, both types of adverse employment change resulted in similar,
significant increases in depression. These direct effects persisted despite
inclusion of such potential mediators as changes in income, job satisfaction, and
marital status. Marital status buffered the depressive effect of both types of
adverse change, but education and job dissatisfaction amplified the effect of
unemployment on depression. Prior depression did not predict higher risk of
becoming inadequately employed but did predict increased risk of unemployment,
particularly for those with less education. These results confirm that both
unemployment and inadequate employment affect mental health, and they invite
greater efforts to monitor the extent and impact of underemployment.

PMID: 11198566 [PubMed - indexed for MEDLINE]


151. Assessment. 2000 Dec;7(4):365-78.

Personality at midlife: stability, intrinsic maturation, and response to life
events.

Costa PT Jr, Herbst JH, McCrae RR, Siegler IC.

Laboratory of Personality and Cognition, Intramural Research Program, National
Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA.
ptc@nih.gov

Although developmental theories and popular accounts suggest that midlife is a
time of turmoil and change, longitudinal studies of personality traits have
generally found stability of rank order and little or no change in mean levels.
Using data from 2,274 men and women in their 40s retested after 6 to 9 years, the
present study examined two hypotheses: (a) that retest correlations should be no 
higher than about .60 and (b) that there should be small decreases in
Neuroticism, Extraversion, and Openness, and small increases in Agreeableness and
Conscientiousness. The study also explored the effects of recalled life events on
subsequent personality scores. Results did not support the first hypothesis;
uncorrected retest correlations uniformly exceeded .60. This was true for all
personality traits, including facets of Agreeableness and Conscientiousness not
previously included in longitudinal studies. The hypothesized decreases in
Neuroticism, Extraversion, and Openness were found, but Conscientiousness showed 
a small decrease instead of the predicted increase. Life events in general showed
very little influence on the levels of personality traits, although some effects 
were seen for changes in job and marital status that warrant further research.

PMID: 11151962 [PubMed - indexed for MEDLINE]


152. Alcohol Clin Exp Res. 2000 Dec;24(12):1820-9.

US low-risk drinking guidelines: an examination of four alternatives.

Dawson DA.

Division of Biometry and Epidemiology, National Institute on Alcohol Abuse and
Alcoholism, National Institutes of Health, Bethesda, Maryland 20892-7003, USA.
ddawson@sillco.niaaa.nih.gov

BACKGROUND: This study compared four sets of US low-risk drinking guidelines (two
interpretations of the US Dietary Guidelines and two variations of the NIAAA
physicians' guidelines) in terms of adherence and how well they predicted five
different alcohol-related outcomes. METHODS: Using data from a nationally
representative sample of 17,542 US adults 21 years of age and over who drank 12
or more drinks in the past year, this study assessed the sensitivity,
specificity, overall accuracy, positive and negative predictive values, and odds 
ratios of the various drinking guidelines (specifically, of having exceeded them 
with different degrees of frequency) as predictors of alcohol dependence,
impaired driving, liver disease, peptic ulcer, and hypertension. RESULTS: The
proportions of past-year regular drinkers exceeding the four sets of guidelines
varied from 20.9%, whose average intake exceeded the weekly limits, to between
21.0% and 42.7% who exceeded the daily guidelines at least once a week, and to
between 69.2% and 94.2% who ever exceeded the daily limits in the year preceding 
the interview. Sensitivity and odds ratios were highest for the ever exceeding
the Dietary Guidelines daily limits, intermediate for ever exceeding the two
variations based on the NIAAA physicians' guidelines, and lowest for exceeding
the Dietary Guidelines interpreted as weekly limits. The opposite pattern was
observed for specificity and overall predictive accuracy. When frequently
exceeding the daily limits was considered, their sensitivity declined but their
specificity and positive predictive value increased. CONCLUSIONS: If sensitivity 
and specificity are deemed equally important, the NIAAA physicians' guidelines
incorporating both daily and weekly limits seem to do the best job of balancing
these dimensions in the prediction of a variety of alcohol-related outcomes.

PMID: 11141041 [PubMed - indexed for MEDLINE]


153. Int J Health Serv. 2000;30(3):453-76.

Job insecurity and health.

McDonough P.

Department of Sociology, Faculty of Arts, York University, Toronto, Ontario,
Canada.

As employers respond to new competitive pressures of global capitalism through
layoffs and the casualization of labor, job insecurity affects a growing number
of workers. It appears to harm mental health, but less is known about its effects
on physical health and health behaviors and the mechanisms through which it may
act. The prevailing individual-centered conceptualization of job insecurity as
the perception of a threat to job continuity precludes systematic investigation
of the social patterning of its health effects. Analysis of data from a 1994
Canadian national probability sample of adults determined that high levels of job
insecurity lowered self-rated health and increased distress and the use of
medications, but had no impact on heavy drinking. The findings support one
possible mechanism of action whereby job insecurity reduces feelings of control
over one's environment and opportunities for positive self-evaluation; these
psychological experiences, in turn, have deleterious health consequences. There
is little evidence of social patterning of this relationship by gender,
education, household income, age, marital status, and social support at work.

PMID: 11109176 [PubMed - indexed for MEDLINE]


154. Am J Public Health. 2000 Nov;90(11):1765-70.

Psychosocial work environment and depression: epidemiologic assessment of the
demand-control model.

Mausner-Dorsch H, Eaton WW.

Department of Health Policy and Management, Johns Hopkins University School of
Public Health, Baltimore, MD 21205, USA. hmausner@jhsph.edu

Erratum in:
    Am J Public Health 2001 May;91(5):828.

OBJECTIVES: This study examined the relation between occupational variables and 3
forms of depression (major depressive episode, depressive syndrome, and
dysphoria). It was hypothesized that individuals working in occupations with high
psychologic strain (high psychologic demands and low decision authority) would
have a higher prevalence of depression relative to those working in occupations
with the other 3 possible conditions. METHODS: The analysis was based on data for
905 respondents who were employed full-time in the year before the follow-up
interview for the Epidemiologic Catchment Area Program in Baltimore, Md, between 
1993 and 1996. Psychosocial work environment, sociodemographic variables, and
psychopathology were assessed in a household interview that included the National
Institute of Mental Health Diagnostic Interview Schedule. Subscales for the
demand-control model for psychosocial work environment were modified slightly
after factor analysis. RESULTS: High job strain was associated with greater
prevalence of all 3 forms of depression, especially major depressive episode. The
results were stronger for women; for men, being unmarried was the strongest
prevalence correlate. CONCLUSIONS: Major depressive episode, depressive syndrome,
and dysphoria are strongly associated with the psychosocial dimensions of the
demand-control model.

PMCID: PMC1446399
PMID: 11076247 [PubMed - indexed for MEDLINE]


155. Prehosp Emerg Care. 2000 Oct-Dec;4(4):345-51.

A statewide study of EMS oversight: medical director characteristics and
involvement compared with national guidelines.

Stone RM, Seaman KG, Bissell RA.

Division of Emergency Medicine, University of Maryland Medical System, Baltimore,
USA. emsrog@x-press.net

INTRODUCTION: From their inception, advanced life support (ALS) programs have had
oversight by emergency medical services (EMS) medical directors. Position
statements about medical direction have been published in the medical literature,
initially by the American College of Emergency Physicians (ACEP). Most recently, 
the National Association of EMS Physicians (NAEMSP) published a position paper to
serve as a guideline for the medical directors' tasks, describing qualifications 
and areas of involvement. OBJECTIVE: To study the baseline status of EMS
oversight in Maryland as the position paper was disseminated, to view how local
directors meet the published guidelines. METHODS: Twenty-two of the 23 (96%)
jurisdictional EMS medical directors (JMDs) in Maryland were interviewed in
face-to-face meetings. Information was collected about their qualifications and
their regular involvement in activities within various EMS subsystems. RESULTS:
Sixteen (73%) JMDs are members of ACEP and four (18%) are members of NAEMSP. Six 
(27%) received EMS medical director training. Three (14%) went through a formal
application process for their positions. Activities of relatively high
involvement were investigations of variance from protocols (100% of JMDs
involved), runsheet review (15 [68%]), liaison duties (20 [91%]), and disaster
drills (15 [68%]). Most other subsystems, including dispatch, public health,
administration, system evaluation, and quality programs, showed relatively low
regular involvement (0-59%). CONCLUSION: In Maryland, significant increases in
active physician involvement in EMS are necessary to meet the national job
description. These data provide supportive evidence of the need for further
commitment by state and local agencies, as well as trained EMS physicians in
national societies, to enable all JMDs to reach the goals set forth for their
important roles in EMS systems.

PMID: 11045415 [PubMed - indexed for MEDLINE]


156. Int J Epidemiol. 2000 Oct;29(5):785-92.

Lifestyle risk factors for cancer: the relationship with psychosocial work
environment.

van Loon AJ, Tijhuis M, Surtees PG, Ormel J.

National Institute of Public Health and the Environment, Bilthoven, The
Netherlands. jeanne.van.loon@rivm.nl

BACKGROUND: Psychosocial work characteristics (job demands, control, support, job
strain and iso-strain [high job strain combined with social isolation at work])
may be linked to cancer risk, by affecting cancer-related lifestyles like
smoking, high alcohol consumption, low intake of fruits and vegetables and lack
of physical activity. METHODS: Cross-sectional data obtained from 3309
respondents participating in an ongoing prospective cohort study in the
Netherlands on psychosocial factors and cancer risk were used to study the
association between psychosocial job characteristics and lifestyle. Information
on job characteristics and risk factor prevalence was collected from
20-65-year-old men and women, through self-administered questionnaires. Multiple 
logistic and linear regression analyses were undertaken by gender, with
adjustment for age and education. RESULTS: No differences in the prevalence of
lifestyle risk factors for cancer were found amongst the psychosocial work
characteristics studied. Moreover, little evidence was found for a relation
between job (or iso-) strain and cancer-related lifestyles in multivariate
analyses. CONCLUSIONS: The present study found no support for the hypothesis that
job strain or iso-strain are associated with a cancer-related lifestyle. Further 
research on the role of other psychosocial factors-like personality or social
support outside work-in mediating associations between job characteristics and
lifestyle, is warranted.

PMID: 11034957 [PubMed - indexed for MEDLINE]


157. J Adv Nurs. 2000 Sep;32(3):580-6.

Who cares? Offering emotion work as a 'gift' in the nursing labour process.

Bolton SC.

Simon Marks Research Fellow, Department of Sociology, The University of
Manchester, Manchester, England. scbolton@aol.com

Who cares? Offering emotion work as a 'gift' in the nursing labour process The
emotional elements of the nursing labour process are being recognized
increasingly. Many commentators stress that nurses' 'emotional labour' is hard
and productive work and should be valued in the same way as physical or technical
labour. However, the term 'emotional labour' fails to conceptualize the many
occasions when nurses not only work hard on their emotions in order to present
the detached face of a professional carer, but also to offer authentic caring
behaviour to patients in their care. Using qualitative data collected from a
group of gynaecology nurses in an English National Health Service (NHS) Trust
hospital, this paper argues that nursing work is emotionally complex and may be
better understood by utilizing a combination of Hochschild's concepts: emotion
work as a 'gift' in addition to 'emotional labour'. The gynaecology nurses in
this study describe their work as 'emotionful' and therefore it could be said
that this particular group of nurses represent a distinct example. Nevertheless, 
though it is impossible to generalize from limited data, the research presented
in this paper does highlight the emotional complexity of the nursing labour
process, expands the current conceptual analysis, and offers a path for future
research. The examination further emphasizes the need to understand and value the
motivations behind nurses' emotion work and their wish to maintain caring as a
central value in professional nursing.

PMID: 11012799 [PubMed - indexed for MEDLINE]


158. Soc Sci Med. 2000 Oct;51(7):1019-30.

Social class and self-rated health: can the gradient be explained by differences 
in life style or work environment?

Borg V, Kristensen TS.

Department of Psychology and Sociology, National Institute of Occupational
Health, Copenhagen O, Denmark. vb@ami.dk

The purpose of the present paper is to describe differences in work environment
and life style factors between social classes in Denmark and to investigate to
what extent these factors can explain social class differences with regard to
changes in self-rated health (SRH) over a 5 year period. We used data from a
prospective study of a random sample of 5001 Danish employees, 18-59 years of
age, interviewed at baseline in 1990 and again in 1995. At baseline we found
higher prevalence in the lower classes of repetitive work, low skill discretion, 
low influence at work, high job insecurity, and ergonomic, physical, chemical,
and climatic exposures. High psychological demands and conflicts at work were
more prevalent in the higher classes. With regard to life style factors, we found
more obese people and more smokers among the lower classes. The proportion with
poor SRH increased with decreasing social class at baseline. The follow-up
analyses showed a clear association between social class and worsening of SRH:
The lower the social class, the higher the proportion with deterioration of SRH. 
There was no social gradient with regard to improved SRH over time. Approximately
two thirds of the social gradient with regard to worsening of SRH could be
explained by the work environment and life style factors. The largest
contribution came from the work environment factors.

PMID: 11005390 [PubMed - indexed for MEDLINE]


159. J Adv Nurs. 2000 Aug;32(2):343-51.

British nurses in behavioural psychotherapy: a 25-year follow-up.

Gournay K, Denford L, Parr AM, Newell R.

Department of Health Services Research, Institute of Psychiatry and Maudsley
Hospital, Denmark Hill, London, England. spjukjg@iop.kcl.ac.uk

BACKGROUND: The National Service Framework for Mental Health has emphasized the
need to prioritize the provision of cognitive behaviour therapy as the central
evidence-based non-pharmacological intervention for mental health problems. For
25 years one programme (English National Board Course No. 650--Diploma in
Behavioural Cognitive Therapy, formerly called Nursing in Behavioural
Psychotherapy) has trained nurses in such methods. This is the only programme in 
nursing which qualifies graduates to be fully certified as a cognitive behaviour 
therapist by the British Association of Behavioural Psychotherapy and by the
United Kingdom Council for Psychotherapy. The practice of these nurse therapists 
(most commonly known as nurse behaviour therapists, NBTs) is the most rigorously 
evaluated in mental health nursing, with several randomized controlled trials to 
testify to clinical and economic efficacy. AIM: The aim of this study is to
continue the systematic follow-up of all NBT graduates previously undertaken in
two earlier surveys published in 1986 and 1994. These previous surveys examined
clinical practice, organizational context and career and professional development
issues. This up-to-date picture of NBTs will provide useful baselines for the
implementation of the National Service Framework, and may be used by the
Department of Health, education providers and services. METHOD: A postal survey
(using the same template for categories of information as the two earlier
surveys) was used and questionnaires were sent to 237 of the 274 trained NBTs
whose name appears on the Central NBT Register, maintained at the Institute of
Psychiatry/Maudsley Training Centre. RESULTS: One hundred and five of 230
eligible respondents (45.6%) returned questionnaires and additional data were
obtained from 27 NBTs who provided information to the Register in the year before
the survey. Thus, some data were available for 57% of the sample. As in earlier
surveys, it was found that the majority of therapists remain in clinical
practice, undertake substantial further education and training and are involved
in research and teaching as part of their overall role. The two central
developments are an increasing move towards working in primary care and an
increased emphasis on cognitive interventions. NBTs complete a substantial number
of treatments per year and increasingly treat clients with difficulties not
encountered during their basic training. NBTs now receive much more supervision
than in previous surveys and continue to use valid and reliable measures of
change in practice. However, the number of NBTs remains small and the impact on
potential populations who would benefit from effective psychological
interventions is minimal. This paper discusses the implications for service
delivery.

PMID: 10964181 [PubMed - indexed for MEDLINE]


160. Int J Occup Environ Health. 2000 Jul-Sep;6(3):194-202.

Cancer mortality among males in relation to exposures assessed through a
job-exposure matrix.

Weston TL, Aronson KJ, Siemiatycki J, Howe GR, Nadon L.

Bureau of Biostatistics and Computer Applications, Health Protection Branch,
Health Canada, Banting Building PL:2203B, Tunney's Pasture, Ottawa, Ontario K1A
0L2, Canada. anya_weston@hc-sc.gc.ca>

To identify potential associations between workplace exposures and cancer
mortality risks, job titles collected from 1965 to 1971 for 58,678 men (a subset 
of a large representative sample of the Canadian workforce) were transformed into
probable chemical exposures using a job-exposure matrix developed in Montreal.
Mortality follow-up was determined through computerized record linkage with the
National Mortality Database in Canada for 1965-1991. Cancer mortality risk was
evaluated at two levels of exposure, any and substantial, using Poisson
regression controlling for age, calendar period, and social class. Among the
58,678 men, 3,160 died of cancer. Using a liberal reporting criterion, relative
risk (RR) >1.0, five or more exposed cancer deaths, p < or = 0.100, several
potential associations were identified, including: lung cancer and any exposure
to abrasives dust (RR = 2.84), prostate cancer and any exposure to calcium
carbonate (RR = 2.46), and prostate cancer and substantial exposure to metallic
dust (RR = 2.13).

PMID: 10926723 [PubMed - indexed for MEDLINE]


161. Lakartidningen. 2000 May 17;97(20):2489-93.

[Troubled times in care of the elderly. Increasing number of the "oldest old" and
demented, shortage of general practitioners and lack of clarity with regards to
locating resources]

[Article in Swedish]

Wimo A.

Institutionen för folkhälsa, Karolinska institutet, Stockholm.

The media image of general breakdown in care of the elderly, replete with
portrayals of malpractice and maltreatment, is analyzed in the light of changes
in demographics, care resources and care delivery systems during the past
decades. A substantial increase in the number of people aged 80 years or more,
increasing numbers of elderly persons with dementia, deinstitutionalization of
health care, together with the present economic crisis, place a considerable
burden on the care system, as illustrated by an increased nursing load, a
decrease in the number of elderly persons receiving home services, and a
concentration of support to the most impaired. The author calls attention to the 
need for refined methods for describing care delivery systems, longitudinal
population based studies, and a national hospital plan. Primary health care,
already pushed to the limit by dwindling resources and job vacancies, is hard put
to shoulder the burden of responsibility for the elderly.

PMID: 10909226 [PubMed - indexed for MEDLINE]


162. AACN Clin Issues. 1999 Nov;10(4):515-20.

Longitudinal survey of acute care nurse practitioner practice: year 1.

Kleinpell-Nowell R.

Rush University College of Nursing, Chicago, Illinois 60657, USA.

This article reports on the results of an ongoing survey among acute care nurse
practitioners (ACNPs) as part of a 5-year longitudinal study in progress
exploring role aspects and issues in practice of this new practitioner in
advanced practice nursing. The role of the ACNP is progressing, and responses
from 619 ACNPs 1 year after they sought national certification reveal continued
role development and role challenges, along with increased independence,
autonomy, and confidence in practice. Implications for ACNP educational programs 
and suggestions for those contemplating pursuing an ACNP position as reported by 
study participants are also discussed.

PMID: 10865536 [PubMed - indexed for MEDLINE]


163. Am J Epidemiol. 2000 May 15;151(10):982-90.

Characterization of dust exposure for the study of chronic occupational lung
disease: a comparison of different exposure assessment strategies.

Heederik D, Attfield M.

Environmental and Occupational Health Group, University of Utrecht, The
Netherlands. Dick.Heederik@Staff.eoh.wau.nl

Various exposure assessment strategies were compared in the study of the relation
between dust exposure and 11-year lung function change in 1,172 miners with
36,824 concurrently measured personal dust samples available from the 1969-1981
US National Study of Coal Workers' Pneumoconiosis. A miner's average exposure was
assessed by calculating average exposures based on dust samples taken from each
individual and by using different job exposure matrices (JEMs) with different
underlying exposure categorizations, based on occupational categories, job title,
mine, and time, to obtain average exposure estimates. For each grouping
procedure, intragroup and intergroup variances and the pooled standard error of
the mean were calculated to assess relative efficiency. The results show that
considerable variation in slopes of exposure-response relations was found using
different exposure assessment strategies. Standard errors of the slopes of the
exposure-response relations with exposure on an individual basis compared with
JEMs. Exposure assessment on an individual basis was extremely sensitive to the
number of exposure measurements per individual. The study demonstrates the
advantages and disadvantages of different exposure assessment strategies and
shows the need for explicit publication of exposure assessment strategies for
epidemiologic studies. Careful assessment of the influence of misclassification
error in the exposure assessment on exposure-response modeling is warranted.

PMID: 10853637 [PubMed - indexed for MEDLINE]


164. Am J Ind Med. 2000 Apr;37(4):390-9.

Analysis of construction injury burden by type of work.

Lowery JT, Glazner J, Borgerding JA, Bondy J, Lezotte DC, Kreiss K.

Department of Preventive Medicine and Biometrics, University of Colorado Health
Sciences Center, Denver, Colorado 80262, USA.

BACKGROUND: To lay groundwork for identifying patterns of injury etiology, we
sought to describe injury experience associated with types of work performed at
construction sites by examining workers' compensation (WC) claims for the 32,081 
construction workers who built Denver International Airport (DIA). METHODS:
Injury rates and WC payment rates were calculated for 25 types of work based on
claims and payroll data reported to DIA's owner-controlled insurance program
according to National Council on Compensation Insurance job classifications. By
linking DIA claims with corresponding lost-work-time (LWT) claims filed with
Colorado's Workers' Compensation Division, we were also able to obtain and
examine both total and median lost days for each type of work. RESULTS: Injury
experience varied widely among the types of construction work. Workers building
elevators and conduits and installing glass, metal, or steel were at particularly
high risk of both LWT and non-LWT injury. Median days lost by injured workers was
highest (202 days) for driving/trucking. Median days lost for most types of work 
was much greater than previously reported for construction: 40 days or more for
18 of the 25 types of work analyzed. WC payment rates reflect both number and
severity of injuries and were generally not significantly different from expected
losses. They were, however, significantly higher than expected for
driving/trucking, metal/steel installation, inspection/analysis, and elevator
construction. CONCLUSIONS: Analysis of injury data by type of work allows
targeting of safety resources to high risk construction work and would be useful 
in prospective surveillance at large construction sites with centrally
administered workers' compensation plans. Copyright 2000 Wiley-Liss, Inc.

PMID: 10706751 [PubMed - indexed for MEDLINE]


165. Aust N Z J Ment Health Nurs. 1999 Sep;8(3):86-92.

The 4th quinquennial national community mental health nursing census of England
and Wales.

White E.

Keele University, Staffordshire, United Kingdom. e.g.white@keele.ac.uk

Since 1980, a survey of community mental health nursing has been conducted in the
United Kingdom, at five-yearly intervals. These three data sets have been
uniquely useful in plotting trends in Community Mental Health Nursing (CMHN)
activity over time. Substantial administrative changes to the National Health
Service have taken place in England and Wales since 1990, however, and these have
impacted on the nature of mental health service provision. These changes have
implications for all mental health service personnel and, in particular, the work
of community mental health nurses. This article presents selected findings from
the national census, conducted between 1996 and 1997. It sets these findings
within the context of data derived from the three previous national studies in
the series and within the contemporary national policy context and discusses the 
substantive implications which flow from the changes detected over time in the
practice, organisation and management, and education of community mental health
nurses in England and Wales.

PMID: 10661076 [PubMed - indexed for MEDLINE]


166. Nippon Koshu Eisei Zasshi. 1999 Dec;46(12):1048-59.

[Analysis of items missing in responses to a series of follow-up surveys in
Japanese elderly]

[Article in Japanese]

Sugisawa H, Kishino H, Sugihara Y, Shibata H.

Department of Health Sociology, Tokyo Metropolitan Institute of Gerontology.

PURPOSES: We examined whether the percentage of items missing and the factors
related to item missing differ across follow-up surveys, Variables targeted to
examine missing items included health indicators (activities of daily living,
cognitive function, self-rated health, Center for Epidemiologic
Studies--Depression, and PGC Morale Scale), health habits (cigarette smoking,
alcohol consumption, physical exercise, and relative weight), and socioeconomic
indicators (educational attainment, income, and social networks). METHODS:
Longitudinal data were collected at intervals of three years since 1987 through a
national survey of Japanese adults aged 60 and over, At the baseline survey, a
total of 2,200 interviews were completed from the list of 3,288 names. At the
following three follow-up surveys, 1,671, 1,369, and 1,068 persons were
reinterviewed respectively. Possible factors related to appearance of a missing
item consisted of five aspects; 1) demographic variables (age and sex), 2) social
status (educational attainment, existence of a spouse, and job status), 3) health
status (activities of daily living and cognitive function), 4) cooperative
attitude toward a survey, and 5) whether an item had been missing at the previous
survey (s). Those factors were analyzed for each variable respectively. If a
group with scaled or collective items had one or more missing items, we
classified that group as a missing item group. RESULTS: 1. The percentage of
cases with items missing was 5 percent or more for four variables; CES-D, PGC
Morale Scale, income, and health habits. Those percentages were almost constant
over the four surveys. 2. Factors related to appearance of items missing differed
by psychological variables such as, CES-D and PGC Morale Scale, income, or health
habits. Those factors had constant impact on appearance of items missing over
follow-up surveys. 3. Regarding CES-D, PGC Morale Scale, income, or health
habits, persons with an item missing at a previous survey, or who did not have a 
cooperative attitude toward the survey had a significant impact on an increase in
the percentage of missing items. CONCLUSION: Characteristics of persons with
items missing differs among the variables, and those characteristics may
contribute to the incidence of items missing in subsequent surveys.

PMID: 10658469 [PubMed - indexed for MEDLINE]


167. Stroke. 1999 Dec;30(12):2568-73.

Stroke location is not associated with return to work after first ischemic
stroke.

Wozniak MA, Kittner SJ, Price TR, Hebel JR, Sloan MA, Gardner JF.

Departments of Neurology, University of Maryland School of Medicine, Baltimore
21201, USA. mwozniak@som.umaryland.edu

BACKGROUND AND PURPOSE: In prior studies, age, race, job category, disability,
and cortical functions such as praxis, language, and memory have been associated 
with vocational outcome, but the influence of stroke location on return to work
has never been critically examined. METHODS: We examined the influence of stroke 
location on vocational outcome in patients with clinically confirmed acute
ischemic stroke from the National Institute of Neurological Disorders and Stroke 
Stroke Data Bank. RESULTS: Of 143 patients working full time at the time of first
ischemic stroke, 23 patients were dead and 120 were alive at 1 year. Employment
status was known in 109 (mean age, 55 years; 51 [47%] were white, and 82 [75%]
were male). Fifty-eight (53%) had returned to work; most (85%) worked full time. 
Younger age was positively associated with return to work (P<0.05). In an
age-adjusted analysis, stroke severity as measured by the Barthel Index 7 to 10
days after stroke was negatively associated with return to work (P<0.001). Higher
household income and absence of cortical neurological dysfunction 7 to 10 days
after stroke were positively but less strongly associated with return to work
(P<0.08). Stroke location, sex, and depression at time of stroke were not
associated with vocational outcome. CONCLUSIONS: Our data suggest that stroke
location may be less important than other more easily measured factors in
predicting vocational outcome.

PMID: 10582979 [PubMed - indexed for MEDLINE]


168. Nippon Koshu Eisei Zasshi. 1999 Jul;46(7):551-62.

[Comparison of characteristics between respondents and nonrespondents in a
national survey of Japanese elderly using six year follow-up study]

[Article in Japanese]

Sugisawa H, Kishino H, Sugihara Y, Okabayashi H, Shibata H.

Department of Health Sociology, Tokyo Metropolitan Institute of Gerontology.

PURPOSES: The purpose of this study were twofold: 1) to examine differences
between respondents and nonrespondents in sociodemographic or health
characteristics, 2) to study nonresponse effects on relationships between
variables, using a 6 year follow-up study for both respondents and nonrespondents
at the initial survey. METHODS: The data were collected in 1987 through a
national survey of Japanese adults aged 60 and over. A total of 2,200 interviews 
were completed from the list of 3,288 names. In 1993, 1,010 nonrespondents
excluding persons who had died, moved, or whose addresses were unknown in the
prior interview, were recontacted through a mail questionnaire. A total of 559
persons completed the mail questionnaire. Of the original 2,200 baseline
interviewees, some by proxy interviews, 2,260 persons were reinterviewed, at the 
same time as the mail survey. Sociodemographic and health variables (age and
sex), social indicators (educational attainment, marital status, and job status),
health status (mortality, existence of diseases, and activities of daily living),
subjective well-being (life satisfaction, self-rated health, and economic
satisfaction) were compared between respondents and nonrespondents. Relationships
between self-rated health and sociodemographic or health variables were examined 
by multiple regression analysis. RESULTS: 1. Compared to people who participated 
in the survey, norespondents were likely to be male, in the lower age categories,
and with higher educational attainment at the follow-up survey. Also, life
satisfaction and self-rated health were lower in nonrespondents than in
respondents. Reasons for nonresponse varied but appeared to be somewhat related
to characteristics of nonrespondents. 2. No significant relationships between
self-rated health and sociodemographic or health variables appeared for the
respondent group and also when including the nonrespondent group. CONCLUSION:
While differences between respondents and nonrespondents on certain variables
were significant, relationships between self-rated health and sociodemographic
variables were not observed.

PMID: 10550979 [PubMed - indexed for MEDLINE]


169. Am J Epidemiol. 1999 Oct 15;150(8):825-33.

Risk factors for back injury in 31,076 retail merchandise store workers.

Gardner LI, Landsittel DP, Nelson NA.

Division of Safety Research, National Institute for Occupational Safety and
Health, Morgantown, WV, USA.

Risk factors for work-associated strain or sprain back injuries were investigated
in a cohort of 31,076 material handlers from 260 retail merchandise stores in the
United States. The workers studied were those with significant material-handling 
responsibilities--daily lifting and movement of merchandise. Workers in jobs with
the greatest physical work requirements had an injury rate of 3.64 per 100
person-years versus 1.82 in workers with lesser work requirements. The unadjusted
injury rate for males was 3.67 per 100 person-years compared with 2.34 per 100
person-years for females, but the excess for males was confounded by higher
physical work requirements for men in the stocker/receiver job category. The
injury rate ratio for short versus long duration of employment was 3.53 (95%
confidence interval: 2.90, 4.30); for medium versus long duration of employment, 
it was 1.38 (95% confidence interval: 1.18, 1.62). The elevated rate ratios were 
maintained when the data were stratified by subsets with different rates of
turnover. The results suggest that workers with the greatest physical work
requirements and those with the shortest duration of employment are at the
highest risk of back injuries. However, selection forces causing worker turnover 
within this cohort of active workers are not well characterized and have the
potential to bias the measures for time-related factors such as duration of
employment.

PMID: 10522653 [PubMed - indexed for MEDLINE]


170. Spine (Phila Pa 1976). 1999 Jul 15;24(14):1455-62.

One-year predictive factors for various aspects of neck disorders.

Leclerc A, Niedhammer I, Landre MF, Ozguler A, Etore P, Pietri-Taleb F.

INSERM U88, Hôpital National de Saint-Maurice, Saint-Maurice, France.
a.leclerc@st-maurice.inserm.fr

STUDY DESIGN: A longitudinal epidemiologic study conducted over 12 months among
active workers in different occupations. The study was primarily designed to
evaluate intervention for prevention of low back and other spinal disorders.
OBJECTIVE: To determine factors that predict incidence, recurrence, and
persistence of neck disorders (ND), taking into account various dimensions of ND.
SUMMARY OF BACKGROUND DATA: Neck pain is often supposed to have essentially the
same risk factors as back pain; however, there is comparatively little data
relevant to this issue. Moreover, there is a lack of prospective studies that
take into account a diversity of predictive factors. METHODS: The Nordic
questionnaire for the analysis of musculoskeletal symptoms was completed twice at
a 12-month interval by 568 workers. Predictive factors were studied with logistic
models for four dimensions of ND from the second questionnaire: 1) any ND in the 
past 6 months; 2) ND for more than 30 days; 3) treatment for ND; and 4) visit to 
a health care professional for ND. The predictive factors were obtained from the 
first questionnaire and included gender, age, occupational group, level of
psychological distress and psychosomatic problems, and ND at baseline. RESULTS:
Female gender and older age were predictors of ND. Headaches or pain in the head,
psychological distress, and psychosomatic problems were predictors for all
dimensions of ND. These effects were observed for both incidence and persistence 
of ND. CONCLUSIONS: The results emphasize the role of psychosomatic and
psychological factors in the occurrence and course of ND for various dimensions
of the disorder.

PMID: 10423791 [PubMed - indexed for MEDLINE]


171. Child Dev. 1999 May-Jun;70(3):779-801.

Welfare dynamics, support services, mothers' earnings, and child cognitive
development: implications for contemporary welfare reform.

Yoshikawa H.

Department of Psychology, New York University, NY 10003, USA. hiro@psych.nyu.edu

This prospective longitudinal study, using data from the National Longitudinal
Survey of Youth (NLSY; N = 614), addresses the gap in the research literature
regarding the effects of welfare reform on children. Key questions addressed
include whether welfare dynamics and support services relevant to welfare reform,
both measured across the first 5 years of life, are associated with mothers'
earnings in the 6th year and three child cognitive outcomes in the 7th and 8th
years: Peabody Individual Achievement Test (PIAT) math and reading scores, and
the Peabody Picture Vocabulary Test (PPVT). Welfare dynamics are represented by
total time on welfare, degree of cycling on and off welfare, and degree to which 
welfare and work are combined. Support services measured include three forms of
child care (relative, babysitter, and center-based), as well as three forms of
human capital supports (child support, job training, and education). Controlling 
for a range of background factors and for different patterns of welfare use
across the first 5 years, small positive associations with mother's earnings were
found for child support, education, and job training. Small positive associations
also were found between child support and both math and reading scores. Finally
positive associations of medium effect size were found between center care and
both mothers' earnings and child PPVT scores. Although effect sizes are generally
small, the results suggest the potential value of welfare reform approaches that 
emphasize long-term human capital development. Interactions between welfare
dynamics and support services suggest subgroup differences. Specifically,
positive effects of support services on earnings are strongest among mothers with
higher levels of human capital (higher levels of work while on welfare, lower
total time on welfare). Babysitter care appears to have negative effects on both 
reading and math scores of children whose mothers report low levels of work while
on welfare. Implications for welfare reform policy are discussed.

PMID: 10368922 [PubMed - indexed for MEDLINE]


172. Am J Ind Med. 1999 Jul;36(1):83-9.

Ovarian cancer and occupational exposures in Finland.

Vasama-Neuvonen K, Pukkala E, Paakkulainen H, Mutanen P, Weiderpass E, Boffetta
P, Shen N, Kauppinen T, Vainio H, Partanen T.

Department of Epidemiology and Biostatistics, Finnish Institute of Occupational
Health, Helsinki. kvas@occuphealth.fi

BACKGROUND: No single occupational or environmental agent has been established as
causing ovarian cancer, existing studies often being based on ecologic or
proportional mortality data in which potential confounders related to
reproductive history have not been taken into account. METHODS: This study linked
324 job titles of occupationally active Finnish women (n = 892,591) at 1970
census with incidence of ovarian cancer (Finnish Cancer Registry, 5,072 cases)
during 1971-1995 (over 15 million person-years). The job titles were converted
into indicators of exposure to 33 agents, using a national job-exposure matrix
based on measurements and surveys (FINJEM). Poisson regression analyses were
performed with stratification by birth cohort, follow-up period, and
socioeconomic status, and adjusted for mean number of children, mean age at first
delivery, and turnover rate for each job title. RESULTS: We found indications of 
elevated risks for aromatic hydrocarbon solvents (standardized incidence ratio
1.3 (95% CI 1.0-1.7), leather dust (1.4; 0.7-2.7), man-made vitreous fibers (1.3;
0.9-1.8), and high levels of asbestos (1.3; 0.9-1.8), and diesel (1.7; 0.7-4.1), 
and gasoline (1.5; 1.0-2.0) engine exhausts). Previously reported findings for
hairdressers and women in the printing industry were supported in our data, but
not for women in dry cleaning jobs. CONCLUSIONS: Given the various drawbacks in
linkage studies and job-exposure matrices, the excesses found in this study need 
confirmation in individual-level studies.

PMID: 10361591 [PubMed - indexed for MEDLINE]


173. J Affect Disord. 1999 Jan-Mar;52(1-3):145-52.

Characteristics and psychosocial problems of patients with bipolar disorder at
high risk for suicide attempt.

Tsai SY, Lee JC, Chen CC.

Department of Psychiatry, Taipei Medical College and Hospital, Taiwan.
tmcpsyts@mail.tmc.edu.tw

BACKGROUND: Bipolar disorder with a history of substance abuse or suicide attempt
is a strong predictor of suicide. A high comorbidity of substance use disorders
may obscure the specificity of findings about suicide behaviors in Western
patients with bipolar disorder. METHODS: The clinical data of Chinese bipolar
patients (DSM-III-R) in Taiwan who had been naturalistically followed up for at
least 15 years were obtained by a combination of chart reviews and interviews
with patients and family members. The national identity numbers were used to
search for deceased subjects. RESULTS: There were 158 patients originally
included for chart review; 4 of them died from suicide. A 9.9% lifetime
prevalence of alcohol use disorders was found in 101 final subjects who accepting
interview. Multiple logistic regression showed that subjects with a history of
suicide attempt (n = 53, 52.5%) were more likely to have interpersonal problems
with spouse or romantic partner (adjusted odds ratio = 2.85, 95% C.I. =
0.69-11.51), occupational problems mainly maladjustment and frequently changing
job (adjusted odds ratio = 3.08, 95% C.I. = 1.12-10.49), and an earlier age (< or
= 22 years) of onset (adjusted odds ratio = 0.96, 95% C.I. = 0.90-1.02).
LIMITATION: To use an interview schedule for assessing the psychosocial problems 
of clinical population limits the interpretation and generalisability of the
data. CONCLUSION: Despite low comorbidity of alcohol/drug use disorders in
Chinese bipolar patients, a consistently high rate of suicide attempts reinforces
that bipolar disorder is a high-risk group of suicide. An earlier age of onset,
interpersonal problems with spouse or romantic partner, and occupational
maladjustment rather than demographic characteristics may collectively identify
those at high risk of suicide attempt in bipolar disorder.

PMID: 10357027 [PubMed - indexed for MEDLINE]


174. Am J Epidemiol. 1999 Apr 1;149(7):671-9.

Tuberculin skin testing among economically disadvantaged youth in a federally
funded job training program.

Lifson AR, Halcón LL, Johnston AM, Hayman CR, Hannan P, Miller CA, Valway SE.

Division of Epidemiology, School of Public Health, University of Minnesota,
Minneapolis 55454, USA.

Erratum in:
    Am J Epidemiol 1999 Jun 1;149(11):1075.

Low income, medically underserved communities are at increased risk for
tuberculosis. Limited population-based national data are available about
tuberculous infection in young people from such backgrounds. To determine the
prevalence of a positive tuberculin skin test among economically disadvantaged
youth in a federally funded job training program during 1995 and 1996, the
authors evaluated data from medical records of 22,565 randomly selected students 
from over 100 job training centers throughout the United States. An estimated
5.6% of students had a documented positive skin test or history of active
tuberculosis. Rates were highest among those who were racial/ethnic minorities,
foreign born, and (among foreign-born students) older in age (p < 0.001).
Weighted rates (adjusting for sampling) were 1.3% for white, 2.2% for Native
American, 4.0% for black, 9.6% for Hispanic, and 40.7% for Asian/Pacific Islander
students; rates were 2.4% for US-born and 32.7% for foreign-born students.
Differences by geographic region of residence were not significant after
adjusting for other demographic factors. Tuberculin screening of
socioeconomically disadvantaged youth such as evaluated in this study provides
important sentinel surveillance data concerning groups at risk for tuberculous
infection and allows recommended public health interventions to be offered.

PMID: 10192315 [PubMed - indexed for MEDLINE]


175. Int J Radiat Oncol Biol Phys. 1999 Mar 1;43(4):833-7.

The situation of radiation oncology training programs and their graduates in
1997.

Crewson PE, Sunshine JH, Schepps B.

Research Department, American College of Radiology, Reston, VA 20191, USA.

PURPOSE: In light of concerns about the job market, the American College of
Radiology (ACR) studied the employment situation of 1997 radiation oncology
graduates, and the status and plans of radiation oncology training programs.
METHODS AND MATERIALS: In April-May 1997, and in a December follow-up, the ACR
surveyed all radiation oncology residency directors about the employment
situation of their 1997 residency and fellowship graduates and about their
programs. Ninety-four percent of those surveyed responded. We compared findings
with surveys from 1995 and 1996. Differences were assessed with p < or = 0.05 as 
the test of statistical significance. RESULTS: By six months after graduation,
98% of residency graduates and all fellowship graduates were employed. Program
directors reported approximately 95% of graduates had positions that reasonably
matched their training and personal employment goals. Programs have reduced
beginning residency slots by 22% over the past three years, and further
reductions are planned. Many observers were disappointed with fill rates in the
1997 National Match, but by the December follow-up, 96% of beginning-year
residency slots were filled. CONCLUSION: Unemployment continues to be low, and
one "softer" indicator, the job market perceptions of residency program
directors, showed improvement.

PMID: 10098439 [PubMed - indexed for MEDLINE]


176. Eur J Contracept Reprod Health Care. 1998 Dec;3(4):201-6.

On-the-job training through follow-up visits to improve the quality of family
planning services.

Ozek B, Saat Z, Temiz AT, Kinzie B.

Johns Hopkins Program for International Education for Reproductive Health
Corporation, Turkey Office, Ankara, Turkey.

As part of a broader set of activities to strengthen family planning training and
improve the quality of family planning services in Turkey, follow-up visits were 
performed at different family planning sites across the country in order to
conduct on-the-job training. The objective of on-the-job training was to refresh 
and improve family planning counselling skills for all methods as well as to
refresh and improve intrauterine device insertion/removal skills and also some
determinants of quality care. It was also aimed at transferring up-to-date
information to family planning practitioners, identifying frequently encountered 
problems and helping with solution approaches for problems both at the individual
and programmatic levels. The results of the follow-up visits reflect issues about
both the staff and the clinical facility itself in terms of conforming with the
standards of the 'National Family Planning Guidelines' set forth by the Ministry 
of Health. The follow-up team consisted of nine members who were specially
trained. They represented different sectors such as a non-governmental
organization, a medical school and the Ministry of Health. The follow-up team
performed 90 visits to 16 clinics in 11 provinces between 1995 and 1998. Methods 
used were structured observations via standard checklists, meetings with the
clinic staff, self-assessment, role plays, demonstration, coaching and the
provision of feedback. During this period, a total of 130 health professionals
working in 16 clinics were trained on-the-job. A significant improvement was
observed in the performance of the family planning practitioners and the quality 
of care provided in clinics. While none of the service providers were found to
have a standard skill level in general counselling during the first visit, at the
end of the fifth visit all were capable of providing counselling services
according to the national standards. Intrauterine device insertion skills were
high at the beginning of the visits, and 16 of the 17 observed service providers 
(94%) were assessed as conforming to the standards. At the fifth visit, all of
the 42 service providers (100%) were found to be adequate. At the facility level,
all 16 clinics established separate counselling rooms in the follow-up period.
Additionally, the number of clinics conforming to infection prevention standards 
increased from two clinics in 15 at the first visit to all 16 clinics at the
fifth visit. This study showed that the ultimate success of family planning
programs depend on structured and well-supervised on-the-job training through
follow-up visits to the sites.

PMID: 10036603 [PubMed - indexed for MEDLINE]


177. J Stud Alcohol. 1998 Nov;59(6):669-80.

Underemployment and alcohol misuse in the National Longitudinal Survey of Youth.

Dooley D, Prause J.

Department of Psychology and Social Behavior, University of California, Irvine
92697, USA.

OBJECTIVE: This study measured the impact of unemployment and underemployment on 
alcohol misuse. METHOD: A panel of respondents from the National Longitudinal
Survey of Youth was studied in 1984-85 and 1988-89. In each pair of years, the
effect of employment change (e.g., becoming underemployed) on alcohol misuse was 
assessed controlling for misuse in the first year. Alcohol misuse was
operationalized in two ways: elevated symptoms and heavy drinking. Three samples 
were analyzed: a core sample of 2,441 who were available in both pairs of years
(approximately 65% male) and two extended samples that included everyone
available in one pair of years but not the other (n = 4,183 in 1984-85 and n =
3,926 in 1988-89). RESULTS: The 1984-85 analyses revealed a significant
association of adverse change in employment with both elevated alcohol symptoms
and heavy drinking (the latter moderated by prior heavy drinking). The 1988-89
analyses found no relationship between adverse change in employment and heavy
drinking in the core sample and no main effect of adverse change in employment on
symptoms, but they did reveal interactions involving prior symptoms (core sample)
and marital status (extended sample). CONCLUSIONS: Several explanations for these
decreasing effects over time were considered including changes in measurement
reliability, statistical power, economic environment and respondents' maturity.
These results confirm previous findings that job loss can increase the risk of
alcohol misuse, provide new evidence that two types of underemployment
(involuntary part-time and poverty-level wage) can also increase this risk and
suggest that these effects vary over time.

PMID: 9811088 [PubMed - indexed for MEDLINE]


178. BMJ. 1998 Nov 7;317(7168):1283-6.

Suicide, deprivation, and unemployment: record linkage study.

Lewis G, Sloggett A.

Division of Psychological Medicine, University of Wales College of Medicine,
Cardiff CF4 4XN. wpcghl@cardiff.ac.uk

Comment in:
    BMJ. 1999 Apr 3;318(7188):941-2.

OBJECTIVES: To investigate the association between suicide and socioeconomic
status, unemployment, and chronic illness. DESIGN: Longitudinal study. SETTING:
England and Wales. SUBJECTS: Individuals from the Office for National Statistics 
longitudinal study for whom 1981 census data were available. The longitudinal
study is a representative 1% sample of the population of England and Wales in
which census variables are linked to mortality data. MAIN OUTCOME MEASURES:
Suicide and undetermined deaths occurring between 1983 and 1992. Odds ratios
estimated with logistic regression adjusted for attrition of cohort members.
RESULTS: There was a strong independent association between suicide and
individuals who were unemployed (odds ratio 2.6; 95% confidence interval 2.0 to
3.4) and permanently sick (2.5; 1.6 to 4.0). Those without access to a car had an
increased risk (1.3; 1.0 to 1.5), but other measures of socioeconomic status were
not associated with suicide. CONCLUSIONS: The association between suicide and
unemployment is more important than the association with other socioeconomic
measures. Although some potentially important confounders were not adjusted for, 
the findings support the idea that unemployment or lack of job security increases
the risk of suicide and that social and economic policies that reduce
unemployment will also reduce the rate of suicide.

PMCID: PMC28707
PMID: 9804714 [PubMed - indexed for MEDLINE]


179. Scand J Work Environ Health. 1998 Aug;24(4):276-84.

Immunologic and renal markers among photogravure printers exposed to toluene.

Stengel B, Cénée S, Limasset JC, Diebold F, Michard D, Druet P, Hémon D.

INSERM U 170 (National Research Institute on Health and Medicine, Unit 170),
Villejuif, France. stengel@vjf.inserm.fr

OBJECTIVES: This study assessed immunologic and early renal effects of chronic
toluene exposure. METHODS: In a longitudinal study of 92 printers and 74
referents, 145 subjects had pre- and poststudy samples of blood and urine taken
for the following measurements: immunoglobulin E (IgE), antiglomerular basement
membrane (anti-GBM) and antilaminin (anti-LAM) antibodies in blood; creatinine
and beta2-microglobulin in blood and urine; and microalbumin,
N-acetyl-b-D-glucosaminidase (NAG) and alanine-aminopeptidase in urine.
Creatinine clearance was calculated according to the Cockroft-Gault formula.
Eight-hour personal air samples were collected twice to assess present exposure
to toluene. A job-exposure matrix was developed to estimate past cumulative
exposure. Information about potential confounders was recorded by questionnaire. 
Multiple regression analysis was performed to study dose-effect relations
adjusted for age and smoking. RESULTS: No subject was positive for anti-GBM
antibodies, and only 12 were positive for anti-LAM. No relation was observed
between the markers studied and present exposure to toluene except that
creatinine clearance was higher among the exposed subjects than among the
referents. A dose-response relation was observed between cumulative toluene
exposure and both IgE and NAG excretion. No interaction was observed between
hypertension and exposure, but the relationship with NAG did not persist when
subjects with hypertension were excluded. Past or present exposure did not alter 
the 2-year trend of any marker studied. CONCLUSIONS: According to the results of 
this study, toluene at 50 ppm is not related to detectable renal dysfunction. The
increased IgE levels associated with present and past exposure require further
investigation.

PMID: 9754859 [PubMed - indexed for MEDLINE]


180. Scand J Work Environ Health. 1998 Jun;24(3):197-205.

Psychosocial factors at work and subsequent depressive symptoms in the Gazel
cohort.

Niedhammer I, Goldberg M, Leclerc A, Bugel I, David S.

INSERM (National Research Institute on Health and Medicine), Unit 88, Hôpital
National de Saint-Maurice, France. i.niedhammer@st-maurice.inserm.fr

OBJECTIVE: This study attempted to establish whether psychosocial factors at work
are predictors of depressive symptoms in a prospective cohort of men and women
employed in a wide variety of occupations by the French national company
Electricité De France - Gaz De France (EDF-GDF). METHODS: This prospective cohort
study followed the Gazel cohort by means of annual self-administered
questionnaires and independent data obtained from the medical and personnel
departments of the company. The self-administered questionnaire, in 1995,
provided information about the psychosocial work environment characteristics,
psychological job demands, decision latitude, and social support at work.
Depressive symptoms were assessed by the Center for Epidemiologic Studies
Depression (CES-D) Scale in the 1996 questionnaire. Potential confounding
variables were age, marital status, and number of children, assessed in the 1995 
questionnaire, stressful personal and occupational events during the previous 12 
months, assessed in the 1996 questionnaire, and educational level, occupation and
previous absenteeism for mental disorders, assessed from the independent data
provided by EDF-GDF. The subjects were 11 552 workers (8422 men aged 46-56 years 
in 1995 and 3130 women aged 41-56 years) who answered the 1995 and 1996
questionnaires and were working during this period. RESULTS: High levels of
psychological demands, low levels of decision latitude, and low levels of social 
support at work were significant predictors of subsequent depressive symptoms in 
both the men and the women. These results were unchanged after adjustment for
potential confounding variables. CONCLUSIONS: The results strongly support the
possibility that psychosocial factors at work are predictive of depressive
symptoms.

PMID: 9710372 [PubMed - indexed for MEDLINE]


181. Psychother Psychosom. 1998 Jul-Oct;67(4-5):226-40.

What prevents professional drivers from following physicians' cardiologic advice?

Emdad R, Belkic K, Theorell T, Cizinsky S.

Division for Psychosocial Factors and Health, Department of Public Health
Sciences, Karolinska Institute, and the National Institute for Psychosocial
Factors and Health, Stockholm, Sweden.

BACKGROUND: There is a scarcity of published studies of the effects of cardiac
counselling among professional drivers (PD). Aims of the study were: (1) to
examine explanatory variables for two classical 'driver' risk factors - body mass
index (BMI), and smoking - and to analyse the interrelations among smoking
cessation, losing weight and work-related life changes; (2) to assess the
effectiveness of risk factor counselling after 6 months, and (3) to gain insight 
into possible discrepancies between PD perception of needed changes and
compliance with the physician's advice. METHODS: There were 4 groups of male PD: 
13 with ischemic heart disease, 12 hypertensives, 10 borderline hypertensives and
34 normotensives. Baseline cardiovascular risk factors as well as occupational
and behavioral data were assessed via questionnaire. The counselling was aimed at
smoking cessation, weight loss and promoting leisure-time physical activity.
Qualitative methods were used to assess PD perceptions about the work environment
and health promotion. RESULTS: Baseline smoking intensity was best predicted by
the total burden of occupational stress and number of smoking years. Baseline BMI
was best predicted by long work hours behind the wheel, low availability of
attachment outside work and low self-reported job strain. Self-initiated smoking 
cessation was best predicted by few smoking years, low coffee intake and
admitting fear during driving. Physical activity was significantly increased
after 6 months. Losing weight was associated with: quitting or diminishing
smoking and making other, work-related, life changes. None of the heavy smokers
decreased their daily number of cigarettes after 6 months, although expressing
the need to do so in self-generated statements. CONCLUSIONS: Exposure to
occupational stressors, mainly, long work hours and the concomitant denial of job
strain, in combination with low availability of social attachment outside work,
could contribute to maintenance of maladaptive behavior in PD. These findings
could serve as a basis for designing standardized intervention trials and suggest
that modification of the work environment, with participation of the drivers, is 
a needed component of such trials. Particular attention should be paid to the
length and scheduling of work shifts.

PMID: 9693350 [PubMed - indexed for MEDLINE]


182. Am J Epidemiol. 1998 Aug 1;148(3):241-8.

Lung cancer risk in hard-metal workers.

Moulin JJ, Wild P, Romazini S, Lasfargues G, Peltier A, Bozec C, Deguerry P,
Pellet F, Perdrix A.

Service Epidémiologie, Institut National de Recherche et de Sécurité (INRS),
Vandoeuvre, France.

An industry-wide mortality study on the association between lung cancer and
occupational exposure to cobalt and tungsten carbide was carried out in the
French hard-metal industry. This case-control study was nested in the historical 
cohort of workers ever employed in this industry's 10 facilities, most of which
are located in eastern France. Workers were followed up from 1968 to 1991.
Occupational exposure was assessed using a job-exposure matrix that provided
semiquantitative scores for 320 job periods. These scores were significantly
correlated with the levels of cobalt measured in 744 historical air samples. In
this cohort, which comprised 5,777 males and 1,682 females, the death rate from
lung cancer was significant (63 deaths, standardized mortality ratio=1.30, 95%
confidence interval (CI) 1.00-1.66) when compared with national death rates.
Sixty-one cases and 180 controls were included in the study. When the exposures
during the last 10 years were ignored, a twofold lung cancer risk was observed
among workers simultaneously exposed to cobalt and tungsten carbide (odds ratio
(OR)=1.93, 95% CI 1.03-3.62) adjusted for other cobalt exposure (OR=2.21, 95% CI 
0.99-4.90). The odds ratios increased with cumulative exposure (first quartile,
OR=1.00; second quartile, OR=2.64; third quartile, OR=2.59; fourth quartile,
OR=4.13) and, to a lesser degree, with duration of exposure (one decade, OR=1.00;
two decades, OR=1.61; three decades, OR=2.77; four decades, OR=2.03). Adjustments
for smoking and for exposures to known or suspected carcinogens did not change
the results, yet the odds ratio for smoking (3.38) was lower than expected,
suggesting the possibility of some misclassification. Occupational risk was
highest among smokers. This study supports the hypothesis that workers who
manufacture hard metals have an increased mortality from lung cancer due to
simultaneous exposure to cobalt and tungsten carbide.

PMID: 9690360 [PubMed - indexed for MEDLINE]


183. J Nurs Manag. 1998 May;6(3):137-46.

Getting started: choice and constraint in obtaining a post after qualifying as a 
registered mental nurse.

Robinson S, Murrells T.

Nursing Research Unit, King's College London, UK.

AIMS: To explore the extent to which obtaining a post after qualifying as a
registered mental nurse (RMN) is a matter of exercising choice or experiencing
constraints. BACKGROUND: The paper is drawn from the first phase of a
longitudinal study of the careers of RMNs, commissioned in response to concerns
about attrition from the mental health nursing workforce. METHODS: Questionnaires
were sent to all RMNs (n = 550) qualifying from 3-year and post-registration
courses in four regional health authorities; 80% (447) responded. FINDINGS: Some 
73% had obtained a National Health Service (NHS) psychiatric nursing post shortly
after qualifying; 95% had hoped to do so. Of those with a post, 71% had obtained 
their first choice of client group. A wide range of professional and personal
constraints emerged as affecting job choice; lack of NHS posts in preferred
location and/or speciality was cited most often. CONCLUSIONS: Support and
guidance may be helpful for nurses experiencing delays in obtaining a post, or
who are starting careers in a post which is not their first choice.

PMID: 9661396 [PubMed - indexed for MEDLINE]


184. Rev Epidemiol Sante Publique. 1998 Mar;46(2):85-92.

[Mortality in the French paper and pulp industry]

[Article in French]

Wild P, Bergeret A, Moulin JJ, Lahmar A, Hours M.

Institut National de Recherche et de Sécurité, Service épidémiologie, Vandoeuvre.

BACKGROUND: The objective was to describe a possible cancer mortality risk in
relation with the occupational exposure within an International study
co-ordinated by the International Agency for Research on Cancer. METHODS: An
epidemiological cohort study was set up to assess the mortality in four French
pulp and paper companies. The four cohorts were followed up from January 1st 1968
to December 31st 1992. The causes of death were ascertained by matching with the 
national file of causes of death. RESULTS: The full cohort consisted in 5,529 men
and 876 women. The total numbers of subjects deceased between 1968 and 1992 were 
respectively 708 and 34. Causes of death could be traced for 98%. The observed
mortality was significantly lower than the expected for all causes of deaths (SMR
= 0.86) as well for all deaths by cancer (SMR = 0.87). The analysis by
departments showed an excess mortality by cancer of the pancreas in the wood
preparation department (SMR = 3.14) as well as in the paper production department
(SMR = 2.04). CONCLUSIONS: In absence of any prior hypothesis, it is difficult to
assign an occupational origin to these observed excesses. The future results of
the international study will enable us to interpret these results more precisely.

PMID: 9592850 [PubMed - indexed for MEDLINE]


185. Am J Community Psychol. 1997 Dec;25(6):787-807.

Effect of favorable employment change on alcohol abuse: one- and five-year
follow-ups in the National Longitudinal Survey of Youth.

Dooley D, Prause J.

Department of Psychology, University of California, Irvine 92697, USA.

Job loss has been linked to adverse outcomes such as alcohol abuse, but improved 
employment, usually assumed to be beneficial, has seldom been evaluated and may
not help with addictive disorders. Using the National Longitudinal Survey of
Youth, young adults who were unemployed or underemployed (low income or
involuntary part-time) in 1984 were followed up in 1985 and 1989. Controlling for
1984 alcohol abuse, there were no effects of positive employment change on 1985
symptoms, but there were significant restorative effects on 1985 binge drinking
among those who were heavy drinkers in 1984. There also appeared to be an
indirect link of favorable 1984-1985 employment change to heavy drinking in 1989 
via 1989 employment status. Because the effects of underemployment partially
resembled those of unemployment, the discussion cautions against the conventional
wisdom of promoting any work, including underemployment, as curative for the ills
of unemployment.

PMID: 9534219 [PubMed - indexed for MEDLINE]


186. Ann N Y Acad Sci. 1997 Dec 26;837:114-21.

Validation of benzene exposure assessment.

Dosemeci M, Rothman N, Yin SN, Li GL, Linet M, Wacholder S, Chow WH, Hayes RB.

Division of Cancer Epidemiology and Genetics, National Cancer Institute,
Bethesda, Maryland 20892, USA. DosemecM@EPNDCE.NCI.NIH.GOV

We conducted a methodologic study to validate a quantitative retrospective
exposure assessment method used in a follow-up study of workers exposed to
benzene. Assessment of exposure to benzene was carried out in 672 factories in 12
cities in China. Historical exposure data were collected for 3179 unique job
titles. The basic unit for exposure assessment was a factory/work-unit/job-title 
combination over seven periods between 1949 and 1987. A total of 18,435 exposure 
estimates was developed, using all available historical information, including
8477 monitoring data. Overall, 38% of the estimates were based on benzene
monitoring data. The highest time-weighted average exposures occurred in the
rubber industry (30.7 ppm), particularly for rubber glue applicators (52.6 ppm). 
Because of its recognized link with benzene exposure, the association between a
clinical diagnosis of benzene poisoning (hematotoxicity) and benzene exposure was
evaluated (412 cases and 614,509 person-years) to validate the
exposure-assessment method. Relative risks of benzene hematotoxicity increased
very sharply with increasing estimated intensity of benzene exposure. Odds ratios
were 2.2 (95% CI: 1.7-2.9), 4.7 (95% CI: 3.4-6.5), and 7.2 (95% CI: 5.3-9.8) for 
the intensity levels of less than 5 ppm, 5-19 ppm, 20-39 ppm, and 40 and more
ppm, respectively. This sharp trend between benzene hematotoxicity and estimated 
exposure to benzene indicated that the exposure-estimation method used in this
cancer epidemiology study is reliable.

PMID: 9472334 [PubMed - indexed for MEDLINE]


187. Am J Public Health. 1997 Dec;87(12):2012-4.

Incidence of tuberculosis infection among New York State prison employees.

Steenland K, Levine AJ, Sieber K, Schulte P, Aziz D.

National Institute for Occupational Safety and Health, Cincinnati, Ohio 45226,
USA.

OBJECTIVES: This study examined tuberculosis skin test conversions among 24,487
New York State prison employees in 1992. METHODS: Conversions were analyzed by
prison and by job category. RESULTS: The conversion rate was 1.9%. Employees in
prisons with low and high numbers of prisoner cases had odds ratios for
conversion of 1.67 (95% confidence interval [CI] = 1.27, 2.19) and 2.20 (95% CI =
1.69, 2.87), respectively, relative to employees in prisons with no prisoner
cases. In prisons with cases, guards and medical personnel had odds ratios of
1.64 (95% CI = 1.11, 2.43) and 2.39 (95% CI = 1.40, 4.08), respectively, relative
to employees with little prisoner contact. CONCLUSIONS: In 1992, approximately
one third of new infections among New York State prison employees were due to
occupational exposure.

PMCID: PMC1381246
PMID: 9431293 [PubMed - indexed for MEDLINE]


188. Occup Environ Med. 1997 Sep;54(9):671-5.

Allergy risk in an enzyme producing plant: a retrospective follow up study.

Johnsen CR, Sorensen TB, Ingemann Larsen A, Bertelsen Secher A, Andreasen E,
Kofoed GS, Fredslund Nielsen L, Gyntelberg F.

Clinic of Occupational Medicine, National University Hospital, Copenhagen,
Denmark.

OBJECTIVE: To investigate the risk of enzyme sensitisation and clinical allergy
in workers exposed to enzymes at Novo Nordisk A/S. METHODS: The study was a
retrospective follow up study based on medical history and test data originally
collected at routine screenings for enzyme allergy by the Occupational Health
Service (OHS) of Novo Nordisk A/S during the period 1970-92. Workers were exposed
to proteases, lipases, cellulases, and carboxyhydrases. Medical records of 3815
subjects were registered in the OHS database. According to criteria including
possible enzyme exposure, allergy tests at the time of engagement, and
participation in the allergy screening programme 1064 were selected for the
present study. Outcomes were allergy symptoms, specific IgE test
(radioallergosorbent test (RAST)) to enzymes, skin test reactions to common
allergens and enzymes, forced expiratory volume in one second (FEV1), and forced 
vital capacity (FVC). Potential risk factors were smoking habits, workplace, type
of job, age, and sex. RESULTS: Sensitisation occurred to all types of enzymes
handled in the plant, most often in production areas and laboratories; 8.8%
developed clinical enzyme allergy during the first three years of employment. The
risk declined during the period. The frequency of enzyme sensitisation, expressed
as RAST values > 0.5 SU, was 36%, and the frequency of significant RAST values > 
or = 2 SU was 8%. Ranking diagnoses of enzyme allergy by severity, the frequency 
of asthma was 5.3%, rhinitis 3.0%, and urticaria 0.6%. Half of the cases occurred
within the first 15 months of exposure. Smoking was an independent risk factor
for clinical enzyme allergy (odds ratio (OR) = 2.3 (95% exact confidence interval
(95% CI) 1.4 to 3.9), measurable RAST > or = 0.5 SU (OR = 1.5 (95% CI 1.1 to
2.1)), and RAST > or = 2 SU (OR = 4.5 (95% CI 2.2 to 8.4)). Atopic predisposition
at the time of engagement was not a significant risk factor for enzyme allergy.
This could be due to various selection mechanisms.

PMCID: PMC1128842
PMID: 9423581 [PubMed - indexed for MEDLINE]


189. Ann Clin Psychiatry. 1997 Sep;9(3):127-37.

Lifetime diagnosis of major depression as a multivariate predictor of treatment
outcome for inpatients with substance use disorders from abstinence-based
programs.

Miller NS, Hoffmann NG, Ninonuevo F, Astrachan BM.

Department of Psychiatry, The University of Illinois at Chicago, 60612-7327, USA.

A multisite, longitudinal study of patients undergoing inpatient alcohol and drug
dependence treatment was conducted in private inpatient facilities, consisting of
4339 subjects from 38 independent programs enrolled in a national addiction
treatment outcomes registry. Structured interviews were conducted upon admission,
including documentation of current alcohol/drug disorder (DSM-III-R) and lifetime
diagnosis of major depressive syndrome; structured interviews were conducted
prospectively at 6- and 12-month follow-up periods. The prevalence rate of
lifetime diagnosis of major depression in the sample was 39%. Comorbidity varied 
according to gender and substance of choice. Lifetime depressive symptoms did not
correlate with differential length-of-stay, treatment completion, or follow-up
consent and, at best, were very weakly associated with follow-up contact.
Patients diagnosed with lifetime depression showed the same frequency of
participation in posttreatment continuing care: they also showed statistically
significant reductions in job absenteeism, inpatient hospitalizations, and arrest
rates pre- vs. posttreatment comparable to those of patients without lifetime
depression diagnosis. Lifetime major depressive syndrome was not a predictor of
outcome in response to abstinence-based treatment. Involvement in posttreatment
continuing care accounted for far greater outcome variance. Posttreatment vs.
pretreatment factors may be more decisive in influencing risk for relapse.

PMID: 9339877 [PubMed - indexed for MEDLINE]


190. J Psychoactive Drugs. 1997 Jul-Sep;29(3):239-48.

Integration of treatment and posttreatment variables in predicting results of
abstinence-based outpatient treatment after one year.

Miller NS, Ninonuevo FG, Klamen DL, Hoffmann NG, Smith DE.

Department of Psychiatry, The University of Illinois at Chicago, 60612-7327, USA.

A multi-site, longitudinal study of patients undergoing outpatient alcohol and
drug dependence treatment was conducted in private outpatient facilities,
consisting of 2,029 subjects from 33 independent programs enrolled in a national 
addiction treatment outcomes registry. Pretreatment demographic and substance
variables, treatment utilization variables, and post-treatment continuum of care 
variables were examined simultaneously in a multivariate prediction context for
association with outcome. Upon admission patients provided history information to
treatment staff trained in the collection of data for the evaluation efforts.
Trained interviewers conducted consecutive structured interviews prospectively
for treatment outcome at six- and 12-month follow-up periods. Multivariate
analysis with stepwise multiple regression indicated that, relatively speaking,
the most powerful predictors of treatment outcome were posttreatment variables:
namely, support group attendance and involvement in a continuing care program.
Pretreatment and treatment variables contributed proportionately little to the
prediction of outcome. Additional sequential-stage analysis showed that the
incremental contribution to prediction by posttreatment attendance at Alcoholics 
Anonymous and involvement in a treatment program following discharge far exceeded
the initial predictive validity of the 14 pretreatment and treatment variables
examined. Participation in posttreatment continuing care correlated with
statistically significant reductions in job absenteeism, inpatient
hospitalizations, and arrest rates. Posttreatment more than pretreatment factors 
may be decisive in influencing risk for relapse.

PMID: 9339855 [PubMed - indexed for MEDLINE]


191. Addict Behav. 1997 Jul-Aug;22(4):479-89.

A test of socioeconomic status as a predictor of initial marijuana use.

Miller DS, Miller TQ.

University of Texas Medical Branch, Department of Preventive Medicine and
Community Health, Galveston 77555-1153, USA.

The current study examined the effects of socioeconomic status (SES) on
adolescent marijuana use using data from a national longitudinal survey of
subjects aged 11 to 17 (N = 1,725). Both direct and indirect measures of SES
(e.g., Hollingshead's measure of SES, predicts marijuana use among adolescents.
For males, our study found a nonlinear relationship between the Hollingshead
measure and marijuana use that had not been identified in previous research. For 
females, the Hollingshead measure was nonsignificant when alcohol use and having 
friends who use marijuana were added to the model. This finding suggests that the
effects of SES on marijuana use may be mediated by alcohol use and friends' use
of marijuana. Weekly alcohol users were much more likely than nonusers to
initiate marijuana use for both males (Odds ratio [OR] = 18.28, Confidence
interval [CI] = 4.93-67.81) and females (OR = 11.75, CI = 3.22-42.86). Other
significant variables for both sexes included having a job, having friends who
use marijuana, and having used some alcohol in the past year. For males, grade
point average (GPA), commitment to friends, urbanicity, time spent with friends, 
and peer strain were also significant predictors of initial marijuana use. For
females, prior victimization and low school aspirations were significant. In sum,
our findings suggest that psychosocial risk factors for marijuana use are
substantially different for males than for females and that future researchers
need to test for nonlinear relationships between SES and adolescent substance
use.

PMID: 9290858 [PubMed - indexed for MEDLINE]


192. Am J Epidemiol. 1997 Jun 15;145(12):1061-75.

Cancer mortality in workers exposed to phenoxy herbicides, chlorophenols, and
dioxins. An expanded and updated international cohort study.

Kogevinas M, Becher H, Benn T, Bertazzi PA, Boffetta P, Bueno-de-Mesquita HB,
Coggon D, Colin D, Flesch-Janys D, Fingerhut M, Green L, Kauppinen T, Littorin M,
Lynge E, Mathews JD, Neuberger M, Pearce N, Saracci R.

Unit of Environmental Cancer Epidemiology, International Agency for Research on
Cancer, Lyon, France.

Comment in:
    Am J Epidemiol. 1998 Jun 1;147(11):1094-5.

The authors examined cancer mortality in a historical cohort study of 21,863 male
and female workers in 36 cohorts exposed to phenoxy herbicides, chlorophenols,
and dioxins in 12 countries. Subjects in this updated and expanded multinational 
study coordinated by the International Agency for Research on Cancer were
followed from 1939 to 1992. Exposure was reconstructed using job records, company
exposure questionnaires, and serum and adipose tissue dioxin levels. Among
workers exposed to phenoxy herbicides contaminated with
2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) or higher chlorinated dioxins,
mortality from soft-tissue sarcoma (6 deaths; standardized mortality ratio (SMR) 
= 2.03, 95% confidence interval (CI) 0.75-4.43) was higher than expected from
national mortality rates. Mortality from all malignant neoplasms (710 deaths; SMR
= 1.12, 95% CI 1.04-1.21), non-Hodgkin's lymphoma (24 deaths; SMR = 1.39, 95% CI 
0.89-2.06), and lung cancer (225 deaths; SMR = 1.12, 95% CI 0.98-1.28) was
slightly elevated. Risks for all neoplasms, for sarcomas, and for lymphomas
increased with time since first exposure. In workers exposed to phenoxy
herbicides with minimal or no contamination by TCDD and higher chlorinated
dioxins, mortality from all neoplasms (398 deaths; SMR = 0.96, 95% CI 0.87-1.06),
non-Hodgkin's lymphoma (9 deaths; SMR = 1.00), and lung cancer (148 deaths; SMR =
1.03) was similar to that expected, and mortality from soft-tissue sarcoma was
slightly elevated (2 deaths; SMR = 1.35). In a Poisson regression analysis,
workers exposed to TCDD or higher chlorinated dioxins had an increased risk for
all neoplasms (rate ratio = 1.29, 95% CI 0.94-1.76) compared with workers from
the same cohort exposed to phenoxy herbicides and chlorophenols but with minimal 
or no exposure to TCDD and higher chlorinated dioxins. These findings indicate
that exposure to herbicides contaminated with TCDD and higher chlorinated dioxins
may be associated with a small increase in overall cancer risk and in risk for
specific cancers.

PMID: 9199536 [PubMed - indexed for MEDLINE]


193. Br J Nutr. 1997 Jun;77(6):833-51.

Characteristics of the low-energy reporters in a longitudinal national dietary
survey.

Price GM, Paul AA, Cole TJ, Wadsworth ME.

MRC Dunn Nutrition Unit, Combridge.

The aim of the present study was to establish whether the characteristics of
members of a large national birth cohort study who submitted diet diaries with
implausibly low-energy intake differed from those whose recorded energy intake
was more plausible. Survey members (n 1898) recorded their diets in a 7 d diary
in household measures. Those whose reported energy intake (EI) as a fraction of
their estimated BMR was less than 1.10, here termed low-energy reporters (LER)
but often called under-reporters, constituted 20.6% of the study population. None
of the variables describing dietary, smoking or exercise behaviour bore a
significant relationship with low EI/BMR (< 1.10), neither did those describing
region of residence, subjective adequacy of income, current social class, social 
relations or the social environment of the subjects. Results of logistic
regression analysis showed that the only independently significant characteristic
for men was higher BMI. In women, in addition to higher BMI, having been
overweight or obese as an adult independently, but less significantly, predicted 
low EI/BMR, while membership as a child of social class III (non-manual), having 
more children in the household and having a paid job marginally but independently
decreased the probability of reporting low EI/BMR. Submission of a diary with
EI/BMR < 1.10 7 years earlier in the same survey was an even more powerful
predictor of current low EI/BMR than higher BMI in both sexes. The average
reported diet-composition of LER was more micronutrient- and protein-rich than
that of the others, indicating different dietary, or diet-recording, behaviour in
this group of subjects. LER are not a random sample of the survey population, and
their characteristics, definable to some extent, put them at risk for lower
health status. Although EI/BMR cut-off points can be used to identify LER, the
problem of how to use their data is still unresolved.

PMID: 9227182 [PubMed - indexed for MEDLINE]


194. J Epidemiol Community Health. 1997 Feb;51(1):24-9.

Socioeconomic status and lung cancer incidence in men in The Netherlands: is
there a role for occupational exposure?

van Loon AJ, Goldbohm RA, Kant IJ, Swaen GM, Kremer AM, van den Brandt PA.

University of Limburg, Department of Epidemiology, Maastricht, The Netherlands.

STUDY OBJECTIVE: To evaluate the influence of occupational exposure to
carcinogens in explaining the association between socioeconomic status and lung
cancer. DESIGN: A prospective cohort study. Data on diet, other lifestyle
factors, sociodemographic characteristics and job history were collected by means
of a self administered questionnaire. Follow up for incident cancer was
established by record linkage with a national pathology register and with
regional cancer registries. SETTING: Population originating from 204
municipalities in The Netherlands. PARTICIPANTS: These comprised 58 279 men aged 
55-69 years in September 1986. After 4.3 years of follow up there were 470
microscopically confirmed incident lung cancer cases with complete data on
dietary habits and job history. MEASUREMENTS AND MAIN RESULTS: Estimation of
occupational exposure to asbestos, paint dust, polycyclic aromatic hydrocarbons, 
and welding fumes was carried out by two experts, using information on job
history from the baseline questionnaire. Socioeconomic status was measured by
means of highest attained level of education and two indicators based on
occupation. In the initial multivariate analyses of socioeconomic status and lung
cancer, adjustment was made for age, smoking habits, intake of vitamin C,
beta-carotene and retinol, and history of chronic obstructive pulmonary disease
or asthma. Additional adjustment for occupational exposure to the four
carcinogens mentioned above did not change the inverse association between the
level of education and lung cancer risk (initial model: RR highest/lowest level
of education = 0.53; 95% CI 0.34, 0.82; additional model: RR highest/lowest level
of education = 0.53; 95% CI 0.34, 0.84). Nor was the association between the two 
occupation based indicators of socioeconomic status and lung cancer risk
influenced by occupational exposure to carcinogens. The effect of occupational
exposure on the association between the level of education and lung cancer risk
did not differ between ex-smokers and current smokers. CONCLUSIONS: Occupational 
exposure to asbestos, paint dust, polycyclic aromatic hydrocarbons, and welding
fumes could not explain the inverse association between socioeconomic status and 
lung cancer risk. More research which explicitly addresses possible explanations 
for the association between socioeconomic status and lung cancer risk is needed.

PMCID: PMC1060405
PMID: 9135784 [PubMed - indexed for MEDLINE]


195. Am J Ind Med. 1997 Feb;31(2):256-60.

A follow-up study of job strain and heart disease among males in the NHANES1
population.

Steenland K, Johnson J, Nowlin S.

National Institute for Occupational Safety and Health (NIOSH), Cincinnati, Ohio
45226, USA. kns1@nioshe1.em.cdc.gov

Several studies have associated heart disease with job strain, defined as low job
control and high job demands. We have studied incident heart disease (519 cases) 
and job strain among 3,575 males in NHANES1 survey who were currently employed at
baseline in the early 1970s, and followed through 1987. Scores for job control
and job demands were assigned to each subject based on current occupation at
baseline. Controlling for conventional risk factors, we found no excess risk for 
those with the highest strain (lowest control and highest demands, rate ratio
1.08). Those with highest job control did have significantly decreased risk (rate
ratio 0.71, 95% CI 0.54-0.93). In blue-collar workers (58% of subjects) there was
a significant inverse trend in risk with increasing job demands. Control for
level of physical activity did not change this finding. A combination of high
control and demand was protective among blue-collar workers (odds ratio 0.69,
0.48-0.99). Our findings suggest that class-specific analyses are needed in
studying job stress, and that "active" blue-collar workers with high control and 
high demand are protected against heart disease. The "job demand" variable may
measure whether work is challenging rather than fast-paced. Our findings are
limited by the use of assigned job scores based on job title.

PMID: 9028443 [PubMed - indexed for MEDLINE]


196. Scand J Work Environ Health. 1997;23 Suppl 3:97-103.

Technological stress: psychophysiological aspects of working with modern
information technology.

Arnetz BB.

National institute for Psychosocial Factors and Health, Stockholm, Sweden.
bengt.arnetz@medhs.ki.se

There is rapid technological transformation occurring in both work and social
life. The results of information technology, such as mobile telephones,
computers, and electronic networks, have been looked upon as the key to solving
several of the most pressing problems of the Western world. At the same time,
numerous studies have shown that the great majority of computerization projects
fail to meet their deadlines with the originally specified functionality mainly
because human factors are not sufficiently taken into account during the planning
and implementation phase of the project. In a study of the bodily, mental, and
psychophysiological reactions of employees involved in the design of advanced
telecommunications systems and of office employees using regular video display
technology, several stress-related psychosomatic disorders have been identified. 
They include sleep disturbances, psychophysiological stress and somatic
complaints. Controlled intervention programs aimed at enhancing organizational
structures and individual coping strategies have been proved effective in
counteracting the negative effects of working with information technology. The
two-way interaction between the external information technology environment and
bodily and mental reactions needs to be taken more into account in the design and
use of modern information technology. There appears to be an increased awareness 
of human aspects when the risks and benefits of the rapid spread of information
technologies are discussed.

PMID: 9456075 [PubMed - indexed for MEDLINE]


197. Environ Health Perspect. 1996 Dec;104 Suppl 6:1431-6.

Leukemia risk associated with benzene exposure in the Pliofilm cohort.

Paxton MB.

American Petroleum Institute, Washington, DC 20005, USA. paxton@.api.org

A reanalysis of the Pliofilm cohort was conducted incorporating six additional
years of follow-up information gathered by the National Institute of Occupational
Safety and Health (NIOSH) and a new set of exposure estimates developed recently.
The distribution of individual worker exposures calculated with the Paustenbach
exposure estimates was compared to those derived using two earlier sets of job-, 
plant-, and year-specific exposure estimates. A traditional standardized
mortality ratio analysis and the Cox proportional hazards model were used to
investigate the impact of these exposure estimates and the NIOSH updated
information on evaluation of benzene's leukemogenicity. There were no additional 
cases of multiple myeloma or any indication of increased incidences of solid
tumors. The data added in the update did not greatly modify the estimated
relative risk of all leukemias associated with benzene exposure but confirmed
previous findings that occupational exposure only to very high concentrations had
leukemogenic potential. Leukemia has not been observed in anyone who began
employment in Pliofilm production after 1950. Neither the Paustenbach nor the
Crump exposures gave dose-response estimates as steep as that resulting from the 
Rinsky exposures.

PMCID: PMC1469754
PMID: 9118929 [PubMed - indexed for MEDLINE]


198. Spine (Phila Pa 1976). 1996 Dec 1;21(23):2781-5.

Self-reported physical exertion in geriatric care. A risk indicator for low back 
symptoms?

Josephson M, Hagberg M, Hjelm EW.

National Institute for Working Life, Division of Ergonomics, Solna, Sweden.

STUDY DESIGN: The study group consisted of 131 female nursing aides who took part
in an intervention program with physical training or education. Assessments were 
performed before the intervention program and after 6 months. At follow-up
evaluation, 91 nursing aides remained in the study. OBJECTIVES: To examine if
perceived physical exertion was a risk indicator for low back symptoms, and to
examine the relationship between perceived physical exertion, aerobic capacity,
back endurance, psychological demands, and job control. SUMMARY OF BACKGROUND
DATA: Perceived physical exertion frequently is assessed in epidemiologic studies
concerning low back symptoms. More information about the relationship between
perceived exertion, other potential risk indicators, and symptoms may provide
opportunities for effective prevention of symptoms. METHODS: Assessments were
obtained by questionnaires and physical capacity tests. RESULTS: The nursing
aides who reported high physical exertion and were 45 years of age or older were 
at greater risk in the follow-up period for reporting new symptoms, continued
symptoms with the same intensity, or more intense symptoms from the low back
(rate ratio, 3.01; 95% confidence interval, 1.1-8.2). The exposure variable
correlated most strongly (r = 0.4) with perceived physical exertion was
psychological demands. CONCLUSIONS: The results indicated being aged 45 years or 
older, combined with high perceived physical exertion, was a risk indicator for
low back symptoms. A relationship between perceived physical exertion and
psychological demands was observed, but there was no influence of physical
capacity on perceived physical exertion.

PMID: 8979326 [PubMed - indexed for MEDLINE]


199. Demography. 1996 Nov;33(4):511-21.

The effect of the sex composition of jobs on starting wages in an organization:
findings from the NLSY.

England P, Reid LL, Kilbourne BS.

Department of Sociology, University of Arizona, Tucson 85721, USA.
ENGLAND@U.ARIZONA.EDU

We show that individuals in a job with a higher percentage of females earn lower 
starting wages with an employing organization. This holds true with controls for 
individuals' human capital, job demands for skill or difficult working
conditions, and detailed industry. We use a measure of sex composition that
applies to detailed jobs: cells in a three-digit census occupation by three-digit
census industry matrix. We use pooled panel data from the 1979-1987 waves of the 
National Longitudinal Survey of Youth. The unit of analysis is the spell-the time
in which a person worked for one organization. The dependent variable is the
first wage in the spell. We use models with fixed-effects to control for
unmeasured, unchanging individual characteristics; we also show results from OLS 
and weighted models for comparison. The negative effect on wages of the
percentage female in one's job is robust across procedures for black women, white
women, and white men. For black men the sign is always negative but the
coefficient is often nonsignificant.

PMID: 8939422 [PubMed - indexed for MEDLINE]


200. Soc Sci Med. 1996 Aug;43(4):517-24.

Stress, satisfaction and militancy among Canadian physicians: a longitudinal
investigation.

Burke RJ.

York University, Faculty of Administrative Studies, Ontario, Canada.

The introduction of a national health care system in Canada has resulted in
regular and increasing conflict between the medical profession, government and
other political actors. The present longitudinal study utilizes a stressor-strain
framework to understand physician militancy in Canada. Data were collected from
1298 men and women physicians at two points in time separated by 4-5 years using 
questionnaires completed anonymously. Four groups of predictor variables
identified in previous research were considered: individual demographic
characteristics, practice characteristics, work stressors and work and
professional satisfactions. Empirical support for the model was found. Each panel
of predictor variables had significant and unique relationships with most
measures of physician militancy measured 4-5 years later.

PMID: 8844952 [PubMed - indexed for MEDLINE]