Pain in Multiple Sites and Clusters of Cause-Specific Work Disability Development among Midlife Municipal Employees.
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ABSTRACT:
SUBMITTER: Hiilamo A
PROVIDER: S-EPMC8037270 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundPrecarious employment is a potent occupational health risk, but little is known about its association with work-related disability and its causes. This study analyzes whether employment precariousness is associated with receiving disability pension (DP) due to depression and whether this differs according to gender.MethodsStatistics Finland's Quality of Work Life Surveys (1997, 2003, 2008 and 2013) were merged with register-based DP data obtained from the Finnish Centre for Pensions. The survey material was used to measure employment precariousness using five variables: fear of job loss, poor employability prospects, previous unemployment, low earnings and temporary contracts. We followed 20-60-year-old employees until 2016 and studied Cox proportional hazard ratios (HRs) for receiving DP among women and men, adjusting for sociodemographic covariates, working conditions and health at baseline.ResultsThe overall risk of receiving DP tended to increase as precarious job features accumulated. Among men, a higher risk of receiving DP due to depression was associated with previous unemployment [HR 2.2, 95% confidence interval (CI) 1.1-4.2] and poor employability (HR 2.4, 95% CI 1.3-4.7), whereas no corresponding association was found among women.ConclusionsEmployment precariousness may reflect a psychological stress mechanism that predisposes the individual to mental health problems, predicting future disability. Work disability risk shows gendered differences depending on the cause of DP. Promoting employability at workplace and policy levels could offset the health risks associated with precariousness.
| S-EPMC8643409 | biostudies-literature
Project description:OBJECTIVE:Childhood disadvantage is associated with a higher risk of adult obesity, but little is known about its associations with body mass index (BMI) trajectories during adulthood. This study aimed first to identify adulthood BMI trajectories, and second to investigate how childhood disadvantage is associated with trajectory group membership. METHODS:Data from the Helsinki Health Study, a longitudinal cohort study of initially 40- to 60-year-old employees of the City of Helsinki in Finland, were used. The baseline survey was conducted in 2000-2002, and similar follow-up surveys in 2007, 2012, and 2017. Based on self-reported BMI, participants' (n =5,266; 83% women) BMI trajectories, including their retrospectively reported BMI at the age of 25 years, were examined. Data on childhood disadvantage, including parental education and 7 types of childhood adversity (their own serious illness; parental divorce, death, mental disorder, or alcohol problems; economic difficulties at home; and peer group bullying) before the age of 16 years, were obtained from the baseline survey. Group-based trajectory modeling was used to identify BMI trajectories, and multinomial logistic regression to analyze the odds for trajectory group membership for the disadvantage variables. RESULTS:Four ascending BMI trajectories in women and men were found: persistent normal weight (trajectory 1; women 35% and men 25%), normal weight to overweight (trajectory 2; women 41% and men 48%), normal weight to class I obesity (trajectory 3; women 19% and men 23%) and overweight to class II obesity (trajectory 4; women 5% and men 4%). Compared to trajectory 1, women with multiple adversities and repetitive peer bullying in childhood had greater odds of belonging to trajectories 3 and 4, whereas men with parental alcohol problems had greater odds of belonging to trajectory 4. For women and men, a low level of parental education was associated with a higher-level BMI trajectory. CONCLUSIONS:Low parental education for both genders, multiple adversities and repetitive peer bullying in childhood among women, and parental alcohol problems among men increased the odds of developing obesity during adulthood. Further studies are needed to clarify how gender differences modify the effects of childhood disadvantage on adult BMI trajectories.
| S-EPMC6876612 | biostudies-literature
Project description:ObjectivesQuality of life (QoL) and work ability are elementary parts in defining the well-being of an employed person. The aim of this study was to demonstrate factors associated with QoL and self-reported work ability among public sector employees, while taking into account several confounding factors, including sleep quality, occupational stress and psychological symptoms.MethodsA cross-sectional study was conducted in Finland among 710 employees (89% women, mean age 49 (SD=10) years) from 10 municipal work units in 2015. Information about the participants was collected by physical examination, self-administered questionnaire and from medical history. QoL was assessed with the EUROHIS-Quality of Life 8-item index and work ability with the Work Ability Score (WAS).ResultsThe EUROHIS-QOL mean score among all participants was 4.07 (95% CI 4.03 to 4.11). QoL was positively associated with good sleep quality, cohabiting, university-level education and lower body mass index (BMI), and negatively associated with occupational stress, depression and/or anxiety and disease burden. Work ability was reported good or excellent by 80% of the participants and the WAS mean score among all participants was 8.31 (95% CI 8.21 to 8.41). Work ability was positively associated with good sleep quality, younger age, lower BMI and university-level education, and negatively associated with occupational stress and disease burden.ConclusionsOccupational stress and self-reported sleep quality were strongly associated with both QoL and work ability among Finnish public sector employees. These findings highlight the need for screening and handling of work stress and sleep problems in occupational and primary healthcare.
| S-EPMC7513561 | biostudies-literature
Project description:PurposeWe examined the associations between recurrent single- and multisite pain and incident sickness absence (SA) of different lengths and the risk of disability pension (DP).MethodsThe data were derived from the Finnish Helsinki Health Study. Pain measures were recorded for panel 1 in 2000/2 and 2007, and for panel 2 in 2007 and 2012 (altogether 3191 employees). SA data were obtained from the employer's personnel register and DP events from the Finnish Centre for Pensions. Negative binomial regression models with generalized estimation equations were used to model the incidence of self-certified short- (1-3 days), and medically certified medium- (4-14 days) and long-term (more than 14 days) SA episodes. Cox regression models were fitted for the associations between pain and all-cause DP and competing risk models for DP by diagnostic groups. Social and health-related covariates were adjusted for.ResultsRecurrent pain was associated with short-, medium- and long-term SA. Additionally, recurrent single- and multisite pain increased the risk of long-term SA. Recurrent single or multisite pain was further associated with an increased risk of DP, while a single instance of pain did not increase the risk.ConclusionsThese results suggest that recurrent pain is a robust determinant of subsequent SA and DP risk. Improved understanding of determinants of recurrent pain is needed to inform the development of targeted measures to reduce SA and premature exit from employment.
| S-EPMC7118055 | biostudies-literature
Project description:ObjectivesWork engagement is related to mental health, but studies of physical health's association with work engagement are scarce. This study aims to evaluate the relationship between physical health, psychosocial risk factors and work engagement among Finnish women in municipal work units.MethodsA cross-sectional study was conducted in 2014 among 726 female employees from 10 municipal work units of the city of Pori, Finland. Work engagement was assessed with the nine-item Utrecht Work Engagement Scale. The American Heart Association's concept of ideal cardiovascular health (CVH) was used to define physical health (non-smoking, body mass index <25.0 kg/m2, physical activity at goal, healthy diet, total cholesterol <5.18mmol/L, blood pressure <120/80 mm Hg, normal glucose tolerance). Psychosocial risk factors (social isolation, stress, depressive symptoms, anxiety, hostility and type D personality) were included as core questions suggested by 2012 European Guidelines on cardiovascular disease prevention.ResultsOf the study subjects, 25.2% had favourable 5-7 CVH metrics. The sum of CVH metrics, healthy diet and physical activity at goal were positively associated with work engagement. In subjects without psychosocial risk factors (36.7%), work engagement was high and stable. Presence of even one psychosocial risk factor was associated with a lower level of work engagement regardless of the sum of ideal CVH metrics.ConclusionsBoth physical and mental health factors have a positive relationship with work engagement, whereas the presence of even one psychosocial risk factor has a negative association regardless of the level of classic cardiovascular risk factors.
| S-EPMC5640058 | biostudies-literature
Project description:Self-management tools for people with chronic or persistent pain tend to focus on symptom reporting, treatment programmes or exercise and do not address barriers to work, facilitators of work ability, or workplace pain self-management strategies. We developed the Pain at Work (PAW) toolkit, an evidence-based digital toolkit to provide advice on how employees can self-manage their pain at work. In a collaborative-participatory design, 4-step Agile methodology (N = 452) was used to co-create the toolkit with healthcare professionals, employers and people with chronic or persistent pain. Step 1: stakeholder consultation event (n = 27) established content and format; Step 2: online survey with employees who have persistent pain (n = 274) showed employees fear disclosing their condition, and commonly report discrimination and lack of line manager support. Step 3: online employer survey (n = 107) showed employers rarely provide self-management materials or education around managing pain at work, occupational health recommendations for reasonable adjustments are not always actioned, and pain-related stigma is common. Step 4: Toolkit development integrated findings and recommendations from Steps 1-3, and iterative expert peer review was conducted (n = 40). The PAW toolkit provides (a) evidence-based guidelines and signposting around work-capacity advice and support; (b) self-management strategies around working with chronic or persistent pain, (c) promotion of healthy lifestyles, and quality of life at work; (d) advice on adjustments to working environments and workplace solutions to facilitate work participation.
| S-EPMC8775489 | biostudies-literature
Project description:PurposeThe primary aim of this study was to evaluate the predictive ability of the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ) concerning long-term sick leave, sickness presenteeism and disability pension during a follow-up period of 2 years.MethodsThe study group consisted of 195 employees visiting the occupational health service (OHS) due to back pain.ResultsUsing receiver operating characteristic (ROC) curves, the area under the curve (AUC) varied from 0.67 to 0.93, which was from less accurate for sickness presenteeism to highly accurate for the prediction of disability pension. For registered sick leave during 6 months following the baseline the AUC from the ROC analyses was moderately accurate (0.81) and a cut off score of 90 rendered a high sensitivity of 0.89 but a low specificity of 0.46 whereas a cut off score of 105 improves the specificity substantially but at the cost of some sensitivity. The predictive ability appears to decrease with time. Several workplace factors beyond those included in the ÖMPSQ were considered but only social support at the workplace was significantly related to future long-term sick leave besides the total score of the ÖMPSQ.ConclusionsThe results of this study extend and confirm the findings of earlier research on the ÖMPSQ. Assessment of psychosocial risk factors among employees seeking help for back pain at the OHS could be helpful in the prevention of work disabling problems.
| S-EPMC4000420 | biostudies-literature
Project description:BackgroundStudies of work disability in diabetes have examined diabetes as a homogeneous disease. We sought to identify subgroups among persons with diabetes based on potential risk factors for work disability.MethodsParticipants were 2,445 employees with diabetes from three prospective cohorts (the Finnish Public Sector study, the GAZEL study, and the Whitehall II study). Work disability was ascertained via linkage to registers of sickness absence and disability pensions during a follow-up of 4 years. Study-specific latent class analysis was used to identify subgroups according to prevalent comorbid disease and health-risk behaviours. Study-specific associations with work disability at follow-up were pooled using fixed-effects meta-analysis.ResultsSeparate latent class analyses for men and women in each cohort supported a two-class solution with one subgroup (total n = 1,086; 44.4%) having high prevalence of chronic somatic diseases, psychological symptoms, obesity, physical inactivity and abstinence from alcohol and the other subgroup (total n = 1,359; 55.6%) low prevalence of these factors. In the adjusted meta-analyses, participants in the 'high-risk' group had more work disability days (pooled rate ratio = 1.66, 95% CI 1.38-1.99) and more work disability episodes (pooled rate ratio = 1.33, 95% CI 1.21-1.46). These associations were similar in men and women, younger and older participants, and across occupational groups.ConclusionsDiabetes is not a homogeneous disease in terms of work disability risk. Approximately half of people with diabetes are assigned to a subgroup characterised by clustering of comorbid health conditions, obesity, physical inactivity, abstinence of alcohol, and associated high risk of work disability; the other half to a subgroup characterised by a more favourable risk profile.
| S-EPMC4646666 | biostudies-literature
Project description:ObjectivesStudies usually investigate a limited number or a predefined combinations of risk factors for sickness absence in employees with pain. We examined frequently occurring combinations across a wide range of work-related factors and pain perceptions.DesignCross-sectional study.SettingBelgian companies that are under supervision of IDEWE, an external service for prevention and protection at work.ParticipantsIn total, 249 employees experiencing pain for at least 6 weeks were included and filled out an online survey.OutcomesLatent profile analysis was used to differentiate profiles of work-related factors (physical demands, workload, social support and autonomy) and pain perceptions (catastrophising, fear-avoidance beliefs and pain acceptance). Subsequently, profiles were compared on sociodemographics (age, gender, level of education, work arrangement, duration of complaints, multisite pain and sickness absence in the previous year) and predictors of sickness absence (behavioural intention and perceived behavioural control).ResultsFour profiles were identified. Profile 1 (38.2%) had favourable scores and profile 4 (14.9%) unfavourable scores across all indicators. Profile 2 (33.3%) had relatively high physical demands, moderate autonomy levels and favourable scores on the other indicators. Profile 3 (13.7%) showed relatively low physical demands, moderate autonomy levels, but unfavourable scores on the other indicators. Predictors of profiles were age (OR 0.93 and 95% CI (0.89 to 0.98)), level of education (OR 0.28 and 95% CI (0.1 to 0.79)) and duration of sickness absence in the previous year (OR 2.29 and 95% CI (0.89 to 5.88)). Significant differences were observed in behavioural intention (χ2=8.92, p=0.030) and perceived behavioural control (χ2=12.37, p=0.006) across the four profiles.ConclusionThis study highlights the significance of considering the interplay between work-related factors and pain perceptions in employees. Unfavourable scores on a single work factor might not translate into maladaptive pain perceptions or subsequent sickness absence, if mitigating factors are in place. Special attention must be devoted to employees dealing with unfavourable working conditions along with maladaptive pain perceptions. In this context, social support emerges as an important factor influencing sickness absence.
| S-EPMC11331899 | biostudies-literature
Project description:BACKGROUND:The experience of persistent pain in multiple locations is common in youth. Based on current literature, youth with multiple pain sites (MPS) are at risk of experiencing poorer emotional outcomes and a spread of symptoms into late adolescence and adulthood. Little is known regarding the association between MPS with physical and school functioning domains, particularly after initiation of multidisciplinary pain treatment. Therefore, the objective of this study was to examine the association of MPS with disability and school functioning among youth with chronic pain. METHODS:A total of 195 patients with chronic pain, aged 8-17, and their parents completed measures assessing patient distress and functioning at a multidisciplinary pain clinic evaluation and at 4-month follow-up. RESULTS:At evaluation, 63% of patients presented with MPS; 25% reporting MPS endorsed pain in five or more locations. When controlling for relevant demographic and emotional distress factors, MPS were associated with lower school functioning at evaluation with a persistent trend at follow-up. Although MPS were not a significant predictor of pain-related disability at evaluation, it emerged as significant at follow-up. CONCLUSIONS:Potentially due to the MPS load and the inverse effects that such a pain state has on function, such patients may be at risk for poorer health and school-related outcomes. The mechanisms influencing these relationships appear to extend beyond psychological/emotional factors and warrant further investigation in order to aid in our understanding of youth with MPS. SIGNIFICANCE:Youth with MPS may be at risk for experiencing poorer physical and school functioning in comparison with single-site peers, despite treatment initiation. Further research is warranted to inform assessment and treatment approaches for this subgroup of patients.
| S-EPMC5995652 | biostudies-literature