Framingham score and work-related variables for predicting cardiovascular disease in the working population

Abstract Background The Framingham score is commonly used to estimate the risk of cardiovascular disease (CVD). This study investigated whether work-related variables improve Framingham score predictions of sickness absence due to CVD. Methods Eleven occupational health survey variables (descent, marital status, education, work type, work pace, cognitive demands, supervisor support, co-worker support, commitment to work, intrinsic work motivation and distress) and the Framingham Point Score (FPS) were combined into a multi-variable logistic regression model for CVD sickness absence during 1-year follow-up of 19 707 survey participants. The Net Reclassification Index (NRI) was used to investigate the added value of work-related variables to the FPS risk classification. Discrimination between participants with and without CVD sickness absence during follow-up was investigated by the area under the receiver operating characteristic curve (AUC). Results A total of 129 (0.7%) occupational health survey participants had CVD sickness absence during 1-year follow-up. Manual work and high cognitive demands, but not the other work-related variables contributed to the FPS predictions of CVD sickness absence. However, work type and cognitive demands did not improve the FPS classification for risk of CVD sickness absence [NRI = 2.3%; 95% confidence interval (CI) −2.7 to 9.5%; P = 0.629]. The FPS discriminated well between participants with and without CVD sickness absence (AUC = 0.759; 95% CI 0.724–0.794). Conclusion Work-related variables did not improve predictions of CVD sickness absence by the FPS. The non-laboratory Framingham score can be used to identify health survey participants at risk of CVD sickness absence.

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External validation of a prediction model and decision tree for sickness absence due to mental disorders

International Archives of Occupational and Environmental Health ◽

10.1007/s00420-020-01548-z ◽

2020 ◽

Vol 93 (8) ◽

pp. 1007-1012

Author(s):

Marieke F. A. van Hoffen ◽

Giny Norder ◽

Jos W. R. Twisk ◽

Corné A. M. Roelen

Keyword(s):

Mental Disorders ◽

Occupational Health ◽

Decision Tree ◽

Prediction Model ◽

Sickness Absence ◽

Health Survey ◽

Characteristic Curve ◽

External Validation ◽

Increased Risk

Abstract Purpose A previously developed prediction model and decision tree were externally validated for their ability to identify occupational health survey participants at increased risk of long-term sickness absence (LTSA) due to mental disorders. Methods The study population consisted of N = 3415 employees in mobility services who were invited in 2016 for an occupational health survey, consisting of an online questionnaire measuring the health status and working conditions, followed by a preventive consultation with an occupational health provider (OHP). The survey variables of the previously developed prediction model and decision tree were used for predicting mental LTSA (no = 0, yes = 1) at 1-year follow-up. Discrimination between survey participants with and without mental LTSA was investigated with the area under the receiver operating characteristic curve (AUC). Results A total of n = 1736 (51%) non-sick-listed employees participated in the survey and 51 (3%) of them had mental LTSA during follow-up. The prediction model discriminated (AUC = 0.700; 95% CI 0.628–0.773) between participants with and without mental LTSA during follow-up. Discrimination by the decision tree (AUC = 0.671; 95% CI 0.589–0.753) did not differ significantly (p = 0.62) from discrimination by the prediction model. Conclusion At external validation, the prediction model and the decision tree both poorly identified occupational health survey participants at increased risk of mental LTSA. OHPs could use the decision tree to determine if mental LTSA risk factors should be explored in the preventive consultation which follows after completing the survey questionnaire.

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Work-Related Exposures and Sickness Absence Trajectories: A Nationally Representative Follow-up Study among Finnish Working-Aged People

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16122099 ◽

2019 ◽

Vol 16 (12) ◽

pp. 2099 ◽

Cited By ~ 4

Author(s):

Tea Lallukka ◽

Leena Kaila-Kangas ◽

Minna Mänty ◽

Seppo Koskinen ◽

Eija Haukka ◽

...

Keyword(s):

Sickness Absence ◽

Developmental Trajectories ◽

Physical Workload ◽

Physical Work ◽

Annual Number ◽

Related Factors ◽

Aged People ◽

Work Related ◽

Nationally Representative

The contribution of physically demanding work to the developmental trajectories of sickness absence (SA) has seldom been examined. We analyzed the associations of 12 physical work exposures, individually and in combination, with SA trajectories among the occupationally active in the Finnish nationally representative Health 2000 survey. We included 3814 participants aged 30–59 years at baseline, when exposure history to work-related factors was reported. The survey and interview responses were linked with the annual number of medically confirmed SA spells through 2002–2008 from national registries. Trajectory analyses identified three SA subgroups: 1 = low (54.6%), 2 = slowly increasing (33.7%), and 3 = high (11.7%). After adjustments, sitting or use of keyboard >1 year was inversely associated with the high SA trajectory (odds ratio, OR, 0.57; 95% 95% confidence interval, CI, 0.43–0.77). The odds of belonging to the trajectory of high SA increased with an increasing number of risk factors, and was highest for those with ≥4 physical workload factors (OR 2.71; 95% CI 1.99–3.69). In conclusion, these findings highlight the need to find ways to better maintain the work ability of those in physically loading work, particularly when there occurs exposure to several workload factors.

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Preventing sickness absence among employees with common mental disorders or stress-related symptoms at work: a cluster randomised controlled trial of a problem-solving-based intervention conducted by the Occupational Health Services

Occupational and Environmental Medicine ◽

10.1136/oemed-2019-106353 ◽

2020 ◽

Vol 77 (7) ◽

pp. 454-461 ◽

Cited By ~ 1

Author(s):

Marijke Keus van de Poll ◽

Lotta Nybergh ◽

Caroline Lornudd ◽

Jan Hagberg ◽

Lennart Bodin ◽

...

Keyword(s):

Mental Health ◽

Problem Solving ◽

Mental Disorders ◽

Occupational Health ◽

Sickness Absence ◽

Primary Outcome ◽

Common Mental Disorders ◽

Significant Group ◽

Secondary Outcomes

ObjectivesCommon mental disorders (CMDs) are among the main causes of sickness absence and can lead to suffering and high costs for individuals, employers and the society. The occupational health service (OHS) can offer work-directed interventions to support employers and employees. The aim of this study was to evaluate the effect on sickness absence and health of a work-directed intervention given by the OHS to employees with CMDs or stress-related symptoms.MethodsRandomisation was conducted at the OHS consultant level and each consultant was allocated into either giving a brief problem-solving intervention (PSI) or care as usual (CAU). The study group consisted of 100 employees with stress symptoms or CMDs. PSI was highly structured and used a participatory approach, involving both the employee and the employee’s manager. CAU was also work-directed but not based on the same theoretical concepts as PSI. Outcomes were assessed at baseline, at 6 and at 12 months. Primary outcome was registered sickness absence during the 1-year follow-up period. Among the secondary outcomes were self-registered sickness absence, return to work (RTW) and mental health.ResultsA statistical interaction for group × time was found on the primary outcome (p=0.033) and PSI had almost 15 days less sickness absence during follow-up compared with CAU. Concerning the secondary outcomes, PSI showed an earlier partial RTW and the mental health improved in both groups without significant group differences.ConclusionPSI was effective in reducing sickness absence which was the primary outcome in this study.

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Association of alcohol consumption with morbidity and mortality in patients with cardiovascular disease: original data and meta-analysis of 48,423 men and women

BMC Medicine ◽

10.1186/s12916-021-02040-2 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Chengyi Ding ◽

Dara O’Neill ◽

Steven Bell ◽

Emmanuel Stamatakis ◽

Annie Britton

Keyword(s):

Cardiovascular Disease ◽

Alcohol Consumption ◽

Health Survey ◽

Cardiovascular Mortality ◽

Cardiovascular Events ◽

Polynomial Regression ◽

De Novo ◽

New Findings ◽

All Cause Mortality

Abstract Background Light-to-moderate alcohol consumption has been reported to be cardio-protective among apparently healthy individuals; however, it is unclear whether this association is also present in those with disease. To examine the association between alcohol consumption and prognosis in individuals with pre-existing cardiovascular disease (CVD), we conducted a series of meta-analyses of new findings from three large-scale cohorts and existing published studies. Methods We assessed alcohol consumption in relation to all-cause mortality, cardiovascular mortality, and subsequent cardiovascular events via de novo analyses of 14,386 patients with a previous myocardial infarction, angina, or stroke in the UK Biobank Study (median follow-up 8.7 years, interquartile range [IQR] 8.0–9.5), involving 1640 deaths and 2950 subsequent events, and 2802 patients and 1257 deaths in 15 waves of the Health Survey for England 1994–2008 and three waves of the Scottish Health Survey 1995, 1998, and 2003 (median follow-up 9.5 years, IQR 5.7–13.0). This was augmented with findings from 12 published studies identified through a systematic review, providing data on 31,235 patients, 5095 deaths, and 1414 subsequent events. To determine the best-fitting dose-response association between alcohol and each outcome in the combined sample of 48,423 patients, models were constructed using fractional polynomial regression, adjusting at least for age, sex, and smoking status. Results Alcohol consumption was associated with all assessed outcomes in a J-shaped manner relative to current non-drinkers, with a risk reduction that peaked at 7 g/day (relative risk 0.79, 95% confidence interval 0.73–0.85) for all-cause mortality, 8 g/day (0.73, 0.64–0.83) for cardiovascular mortality and 6 g/day (0.50, 0.26–0.96) for cardiovascular events, and remained significant up to 62, 50, and 15 g/day, respectively. No statistically significant elevated risks were found at higher levels of drinking. In the few studies that excluded former drinkers from the non-drinking reference group, reductions in risk among light-to-moderate drinkers were attenuated. Conclusions For secondary prevention of CVD, current drinkers may not need to stop drinking. However, they should be informed that the lowest risk of mortality and having another cardiovascular event is likely to be associated with lower levels of drinking, that is up to approximately 105g (or equivalent to 13 UK units, with one unit equal to half a pint of beer/lager/cider, half a glass of wine, or one measure of spirits) a week.

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Organizational climate and work commitment as predictor of 10-year registered sickness absence

European Journal of Public Health ◽

10.1093/eurpub/ckz185.337 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

M Knapstad ◽

L Lissner ◽

C Bjorkelund ◽

K Holmgren

Keyword(s):

General Population ◽

Organizational Climate ◽

Sickness Absence ◽

Perceived Stress ◽

Elevated Risk ◽

Work Commitment ◽

Work Related ◽

Influence At Work ◽

Related Stress

Abstract Background Early identification of persons at risk for sickness absence offers an opportunity to put in place preventive measures in the future. The Work Stress Questionnaire (WSQ) is specifically designed to identify people at risk for sickness absence due to work-related stress. In this study we examine prospective associations between work-related stress as measured by the WSQ and registered sickness absence up till 10 years later among employed and self-employed women in the general population in Gothenburg. Methods This is a survey-linkage study based on the 2004-05 wave of the Swedish “Population Study of Women in Gothenburg (PSWG)” and 10-year follow-up in the MiDAS sickness absence register. Participants registered as employed or self-employed were included (n = 396). Outcomes were number of sickness absence episodes during follow-up and sickness absence during each two-year time band of follow-up. Results High perceived stress due to poor organizational climate, compared to low stress, gave an adjusted Incidence Risk Rate (IRR) of 1.99 [95% CI 1.19-3.34] for sickness absence episodes. Combining high perceived stress due to poor organizational climate with high perceived stress due to work commitment gave an IRR of 2.32 [95% CI 1.26-4.26]. Examining separate time periods, similar associations were found during years 5-6 and 7-8. Perceived low influence at work also gave increased odds for sickness absence, at both in the shorter term (1st-2nd year) and longer term (7th-8th year). Conclusions The findings align with previous studies that WSQ may successfully identify women with elevated risk for future sickness absence, and adds that this is even true in a general population context and using a very long follow-up period. Nevertheless, the findings should preferably be confirmed using a larger sample to improve precision of the observed associations. Key messages The present study contribute with knowledge about screening instruments that may identify women in the general working population with elevated risk for sickness absence. The findings suggest that high perceived stress due to organizational climate, alone and in combination with high work commitment, as well as low influence at work, increase risk of sickness absence.

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Early intervention, treatment and rehabilitation of employees with common mental disorders by using psychotherapeutic consultation at work: study protocol of a randomised controlled multicentre trial (friaa project)

BMC Public Health ◽

10.1186/s12889-021-11195-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jeannette Weber ◽

Peter Angerer ◽

Lorena Brenner ◽

Jolanda Brezinski ◽

Sophia Chrysanthou ◽

...

Keyword(s):

Mental Disorders ◽

Sickness Absence ◽

Multicentre Trial ◽

Common Mental Disorders ◽

Intervention Group ◽

Control Group ◽

Medical Indication ◽

Work Related ◽

Randomised Controlled

Abstract Background Common mental disorders are one of the leading causes for sickness absence and early retirement due to reduced health. Furthermore, a treatment gap for common mental disorders has been described worldwide. Within this study, psychotherapeutic consultation at work defined as a tailored, module-based and work-related psychotherapeutic intervention will be applied to improve mental health care. Methods This study comprises a randomised controlled multicentre trial with 1:1 allocation to an intervention and control group. In total, 520 employees with common mental disorders shall be recruited from companies being located around five study centres in Germany. Besides care as usual, the intervention group will receive up to 17 sessions of psychotherapy. The first session will include basics diagnostics and medical indication of treatment and the second session will include work-related diagnostics. Then, participants of the intervention group may receive work-related psychotherapeutic consultation for up to ten sessions. Further psychotherapeutic consultation during return to work for up to five sessions will be offered where appropriate. The control group will receive care as usual and the first intervention session of basic diagnostics and medical indication of treatment. After enrolment to the study, participants will be followed up after nine (first follow-up) and fifteen (second follow-up) months. Self-reported days of sickness absence within the last 6 months at the second follow-up will be used as the primary outcome and self-efficacy at the second follow-up as the secondary outcome. Furthermore, a cost-benefit assessment related to costs of common mental disorders for social insurances and companies will be performed. Discussion Psychotherapeutic consultation at work represents a low threshold care model aiming to overcome treatment gaps for employees with common mental disorders. If successfully implemented and evaluated, it might serve as a role model to the care of employees with common mental disorders and might be adopted in standard care in cooperation with sickness and pension insurances in Germany. Trial registration The friaa project was registered at the German Clinical Trial Register (DRKS) at 01.03.2021 (DRKS00023049): https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00023049.

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Development and validation of a prediction model for long-term sickness absence based on occupational health survey variables

Disability and Rehabilitation ◽

10.1080/09638288.2016.1247471 ◽

2016 ◽

Vol 40 (2) ◽

pp. 168-175 ◽

Cited By ~ 10

Author(s):

Corné Roelen ◽

Sannie Thorsen ◽

Martijn Heymans ◽

Jos Twisk ◽

Ute Bültmann ◽

...

Keyword(s):

Occupational Health ◽

Prediction Model ◽

Sickness Absence ◽

Health Survey ◽

Development And Validation

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Linha de cuidado em saúde mental do trabalhador: discussão para o SUS / Occupational mental health hotline: a discussion on the Brazilian Unified Health Care System (SUS)

Revista Polis e Psique ◽

10.22456/2238-152x.63889 ◽

2017 ◽

Vol 6 (3) ◽

pp. 77

Author(s):

Carla Garcia Bottega ◽

Alvaro Crespo Merlo

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Illness ◽

Occupational Health ◽

Healthcare System ◽

Care Service ◽

Health Clinic ◽

Work Related ◽

Follow Up Care

ResumoEste artigo discute a construção de uma linha de cuidado (LC)/escuta em saúde mental do trabalhador e da trabalhadora como expressão da Clínica do Trabalho no Sistema Único de Saúde (SUS), com base na Psicodinâmica do Trabalho, e inserida narede já existente. Entende-se que a LC deve estar na discussão da implantação da Política Nacional de Saúde do Trabalhador e da Trabalhadora conforme apontado nas diretrizes da Portaria nº1.823/2012. A partir da escuta de 24 trabalhadores e trabalhadoras usuários de ambulatório de doenças do trabalho, em situação de sofrimento e adoecimento psíquico, emergirampossibilidades para pensar esta clínica. A demanda foi escutada como uma necessidade de cuidado a estes que sofrem emmomento específico de sua vida, pois se entende que essasituação seja passageira, por ser relacionada ao trabalho e, por essa razão, possa ser superada com acompanhamento em atendimentos e encaminhamentos relacionados à saúde mental e trabalho.Palavras-chave: Saúde Mental e Trabalho; Clínica do Trabalho;SUS; Linha de Cuidado.AbstractThis article discusses the effectuation of an occupational mental health hotline as part of the Occupational Health Clinic of the Brazilian Unified Healthcare System (SUS) based on a psychodynamic view of work within the already established system. It is understood that the hotline is to be a component under discussion within the implementation of the NationalOccupational Health Policy according to the guidelines of Ordinance No. 1,823/2012. From consideration of testimonials provided by 24 workers using the outpatient occupational health clinic on account of mental illness related to their work, possibilities arose to think the realization of this clinic. The demand was conceived as a necessary care service for workers afflicted by this transitory condition during specific times in their lives because it is work-related and can therefore be overcome with follow-up care and referrals to appropriate occupational mental health care ministrations.Keywords: Mental Health and Work; Occupational Health Clinic; Brazilian Unified Healthcare System; Hotline.

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O7C.3 Effectiveness of a multi-faceted intervention to prevent musculoskeletal pain in nurses and aides: results of a cluster-randomized controlled trial

Occupational and Environmental Medicine ◽

10.1136/oem-2019-epi.174 ◽

2019 ◽

Vol 76 (Suppl 1) ◽

pp. A65.1-A65

Author(s):

Mercè Soler Font ◽

José Maria Ramada Rodilla ◽

Sander van Zon ◽

Josué Almansa Ortega ◽

Ute Bültmann ◽

...

Keyword(s):

Health Promotion ◽

Randomized Controlled Trial ◽

Occupational Health ◽

Sickness Absence ◽

Controlled Trial ◽

Intervention Group ◽

Control Group ◽

Randomized Controlled ◽

Cluster Randomized

BackgroundHealth workers are at high risk of developing musculoskeletal pain (MSP). This study aimed to evaluate a multi-faceted intervention in two public tertiary hospitals, encompassing three levels of prevention and health promotion to prevent and manage MSP.MethodsA two-armed cluster randomized controlled trial, with a late intervention control group was performed. Clusters were independent hospital units, and participants were the nursing staff. The intervention comprised three components: participatory ergonomics, case management, and health promotion. The control group received usual occupational health care. The intervention lasted one year and data were collected at baseline, 6 and 12 months follow-up. Primary outcomes were self-perceived MSP and its associated sickness absence. The process evaluation included recruitment, context, reach, dose administered and received, fidelity, satisfaction, implementation strategy, and discussion groups of experts and participants.ResultsEight clusters, including 445 participants, were randomized. In the intervention group a 20% statistically significant reduction of neck, shoulders and upper back pain compared to the control group (OR=0.37; 95% CI=0.14–0.96) was observed at 12 months follow-up. We found no significant differences in incidence and duration of sickness absence. Organizational culture (secondary outcome) improved significantly in the intervention group in the domains of ‘formal safety audits’, ‘availability of information for safety at work’, and ‘involvement of workers in decisions that affect their safety and health’ compared to the control group. The intervention was implemented with 96.6% fidelity, and participants’ adherence was 75.5%. Participant’s satisfaction was 9.1/10.ConclusionsThis intervention showed effectiveness to reduce MSP and improve organizational culture, through to an integral management of MSP. Although our results are modest, strategies should focus on multi-faceted interventions, and occupational health services might be excellent opportunity for.

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