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Gender, Depression, and Blue-collar Work: A Retrospective Cohort Study of US Aluminum Manufacturers.

ABSTRACT: BACKGROUND:Industrial blue-collar workers face multiple work-related stressors, but evidence regarding the burden of mental illness among today's blue-collar men and women remains limited. METHODS:In this retrospective cohort study, we examined health and employment records for 37,183 blue- and white-collar workers employed by a single US aluminum manufacturer from 2003 to 2013. Using Cox proportional hazards regression, we modeled time to first episode of treated depression by gender and occupational class. Among cases, we modeled rates of depression-related service utilization with generalized gamma regression. RESULTS:Compared with their white-collar counterparts, blue-collar men were more likely to be treated for depression (hazard ratio [HR] = 1.3; 95% confidence interval [CI] = 1.1, 1.4) as were blue-collar women (HR = 1.4; 1.2, 1.6). Blue-collar women were most likely to be treated for depression as compared with white-collar men (HR = 3.2; 95% CI = 2.1, 5.0). However, blue-collar workers used depression-related services less frequently than their white-collar counterparts among both men (rate ratio = 0.91; 95% CI = 0.84, 0.98) and women (rate ratio = 0.82; 95% CI = 0.77, 0.88). CONCLUSIONS:Blue-collar women were more likely to be treated for depression than white-collar workers, and blue-collar women were most likely to be treated for depression compared with white-collar men. However, blue-collar men and women used depression-related healthcare services less frequently than white-collar workers. These findings underscore that blue-collar women may be uniquely susceptible to depression, and suggest that blue-collar workers may encounter barriers to care-seeking related mental illness other than their insurance status.

SUBMITTER: Elser H

PROVIDER: S-EPMC6461367 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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Project description:Background & aimsImmunoglobulin G4-related disease (IgG4-RD) of the biliary tract and pancreas is a fibroinflammatory disease of unknown origin with striking male predominance. We aimed to investigate whether blue-collar work and occupational contaminant exposure are risk factors for IgG4-RD of the biliary tract and pancreas.MethodWe performed an age-/sex-matched case-control study in the largest academic medical centers of the Netherlands. Occupational history was surveyed by questionnaires. The International Standard Classification of Occupations (ISCO88) was used to classify jobs. Job exposure matrices ALOHA and DOM were utilized to assess the years individuals were exposed to compounds. The disease control cohort consisted of patients from 6 equally sized groups. Conditional logistic regression was used to assess effects of blue-collar work and exposure to occupational contaminants on developing IgG4-RD of the biliary tract and pancreas.ResultsOverall, 101 patients with IgG4-RD of the biliary tract and pancreas were matched 1:3 to 303 controls. Patients with IgG4-RD had a lower level of education (p = 0.001). Individuals who at least once performed blue-collar work (>1 year), had higher odds of developing IgG4-RD than individuals that only performed white-collar work (odds ratio [OR] 3.66; CI 2.18-6.13; p <0.0001). Being ever exposed (>1 year) to industrial ALOHA (e.g. mineral dust; vapors-dust-gases-fumes) and DOM compounds (e.g. asbestos) resulted in higher odds of IgG4-RD (OR 2.14; 95% CI 1.26-3.16; p <0.001 and OR 2.95; 95% CI 1.78-4.90; p <0.001, respectively).ConclusionBlue-collar work is a risk factor for developing IgG4-RD of the biliary tract and pancreas putatively driven by exposure to selected industrial compounds; this may explain the striking male predominance among patients.Lay summaryImmunoglobulin G4-related disease (IgG4-RD) causes tumor-like lesions and typically affects middle-aged to elderly men. The background and cause of this disease remain relatively unknown. In this study, we identified blue-collar work as a risk factor for developing IgG4-RD of the biliary tract and pancreas, which may explain the striking male predominance among patients. Furthermore, these results suggest that toxic exposure to occupational contaminants may drive autoimmunity in IgG4-RD of the biliary tract and pancreas.

Project description:OBJECTIVES:To promote gender diversity and equity in higher education, Athena Scientific Women's Academic Network (SWAN) supports and recognises higher education institutions (HEI) in advancing the careers of women through charter commitment, awards, training and advocacy since 2005. Most evaluation studies, however, are based on qualitative assessments. This study sought to (1) examine the relationship between Athena SWAN accreditation/awards in the UK and gender diversity of leaders and senior academics using quantitative data from 2012/2013 to 2016/2017, and (2) explore the associations between Athena SWAN awards and university performance as measured by overall scores in global ranking systems. DESIGN:Retrospective cohort study based on the UK HEIs. SETTING:Higher education sector in the UK provided by the Higher Education Statistics Agency. PARTICIPANTS:148 HEIs who provided employment data on female-to-male ratios (55% complete data) for each academic year between 2012/2013 and 2016/2017. PRIMARY AND SECONDARY OUTCOME MEASURES:Gender diversity, defined as female representation rates of positions in managerial leadership (eg, heads of institutions, department heads) and professors. The Quacquarelli Symonds (QS) World University Rankings scores, an indicator of research, teaching, employability and internationalisation, were collected to measure university performance. RESULTS:Gender diversity of managerial leaders and non-managerial professors at all levels of Athena SWAN status has improved over the 5 years. Linear mixed effects models identified that Athena SWAN awardees had lower female representation than non-awardees in managerial leadership positions (p<0.05), while the gap was narrowed among Silver awardees over time. Athena SWAN Charter members had increasingly higher female representation than those not in the Charter (p<0.05). Silver-award institutions ranked higher in QS rankings than Bronze-award institutions (?=11.80, p<0.05). CONCLUSIONS:There are overall rising trends in gender diversity from 2012/2013 to 2016/2017. Athena SWAN members showed greater and faster growth in female representations. Silver awardees had greater university performance than Bronze awardees.

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Gender, Depression, and Blue-collar Work: A Retrospective Cohort Study of US Aluminum Manufacturers.

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