Occupational health research round-up: August 2016

People leaving flowers outside the courthouse during the trial of Anders Behring Breivik, responsible for a terrorist attack on a Norwegian summer camp in 2011. Allover Norway/REX/Shutterstock

This month’s round-up of occupational health research includes studies on the impact of resilience building and post-traumatic stress of workers responding to emergencies.

Resilience building has “modest” effect

Resilience-building programmes have only a “modest” effect in the workplace, and this effectiveness diminishes over time, according to a meta-analysis of 37 research studies. The impact of resilience programmes is weaker than that associated with secondary prevention tools, but similar to those shown for other primary interventions, the analysis suggests. Resilience programmes using a one-to-one approach, such as coaching, were most effective, followed by classroom-based sessions. Interventions based on a “train-the-trainer” approach, and web-based programmes, were least effective.

Vanhove AJ et al. “Can resilience be developed at work? A meta-analytic review of resilience-building programme effectiveness”. Journal of Occupational & Organizational Psychology, vol.89, issue 2, pp.278-307, June 2016.

Post-traumatic stress and emergency responders

Professional rescue workers appear better equipped psychologically to deal with potential post-traumatic stress reactions following a terror attack than volunteers. This is according to a study of Norwegian rescue workers in the aftermath of two terrorist incidents in 2011.

Among professional rescue workers, the prevalence of sub-threshold post-traumatic stress disorder (PTSD) 10 months after the attacks was 2%, compared with 24% among volunteers. Other factors associated with a higher risk of PTSD included being a woman, witnessing injured and dead people, and possessing a lower degree of training.

A second study explores whether or not the degree of PTSD experienced by rescue workers is influenced by the nature of workplace support available to staff and volunteers. The Canadian case study finds that organisational support influences the life course of an individual’s traumatisation to a lesser or greater degree, depending on a range of factors, including organisational culture, the emphasis placed on overall employee wellbeing, and the quality and quantity of practices covering employee health.

In practice: the authors of the second study suggest improving organisational support for emergency responders by providing additional post-event information to permit “emotional closure”, empowering line managers to provide timely and appropriate treatment options, and developing an organisational culture that recognises the importance of employees’ psychological wellbeing to the operation of the organisation.

Skogstad L et al. “Post-traumatic stress among rescue workers after terror attacks in Norway”. Occupational Medicine, published online 20 June 2016.

Vaughan AD et al. “The influence of organizational support on the life course of trauma in emergency responders from British Columbia”. Journal of Workplace Behavioral Health, published online 24 June 2016.

Nightshifts and DNA repair

The DNA of night-shift workers may be damaged because the release of melatonin, an antioxidant, is suppressed. In this study, night-shift workers excreted less of a chemical marker for DNA repair during sleep, which the authors suggest may reflect a reduced functioning of individuals’ DNA repair machinery. The disruption of melatonin associated with shift working may be responsible for this effect, as melatonin is known to enhance repair of oxidative DNA damage. Poor-quality sleep, experienced by night-shift workers in particular, may similarly affect DNA repair.

Bhatti P et al. “Oxidative DNA damage during sleep periods among night-shift workers”. Occupational & Environmental Medicine, published online 15 June 2016.

Co-morbidity and mental health rehabilitation

Co- or multi-morbidity negatively affects an individual’s ability to function after returning to work from sick leave due to common mental health disorders, according to this study of 156 workers. A total of 44% of people in the sample had multi-morbidity (defined as two or more co-occurring chronic health conditions, including a common mental disorder). The study identifies four pathways of work functioning following rehabilitation – for example, 12% of the workers followed a path of increasing work functioning scores one year after a return to work, while between 23% and 41% followed the three other trajectories, each of which showed low functioning. Although co-morbidity did not predict which path the individual would follow, within the group with rising functioning, this effect was lower among those with high baseline multi-morbidity scores.

Ubalde-Lopez M et al. “Beyond return to work: the effect of multimorbidity on work functioning trajectories after sick leave due to common mental disorders”. Journal of Occupational Rehabilitation, published online 1 June 2016.

Chronic disease and long-hours working

Working long hours over many years increases the risk of some specific chronic diseases, especially for women, according to this study, which used data from the “National longitudinal survey of youth 1979”. Looking at 32 years of job history, the authors show that working long hours over this period was significantly associated with higher risks of heart disease, non-skin cancer, arthritis and diabetes.

Dembe AE et al. “Chronic disease risks from exposure to long-hour work schedules over a 32-year period”. Journal of Occupational & Environmental Medicine, published online 14 June 2016.

Workplace bullying in teaching

Almost half of a sample of teachers reported experiencing bullying at work, according to this study using data from the “5th European working conditions survey”. The study summarises an array of outcomes and proposes that workplace bullying may be reduced by limiting job demands and increasing resources.

Ariza-Montes A et al. “Workplace bullying among teachers: an analysis from the job demands-resources model perspective”. Journal of Occupational & Environmental Medicine, published online 14 June 2016.

Lifestyle changes in middle age

Making favourable changes to lifestyle in middle age (50-60 years old) – for example, quitting smoking, increasing physical activity or reducing body mass index – may prevent early death, according to this Norwegian longitudinal study. It finds that at the baseline in 2001, each increment in lifestyle score (on a scale where 0 is poorest and is 4 best) is associated with a 21% lower all-cause mortality. A one-point increase in lifestyle score from 2001-04 was associated with a 38% reduction in all-cause mortality. The group reporting a change in score from 0-1 in 2001 to a score of 2-4 in 2004 had 4.8 fewer deaths per 1,000 person years compared with those people keeping an “unfavourable” lifestyle.

Berstad P et al. “Lifestyle changes at middle age and mortality: a population-based prospective cohort study”. Journal of Epidemiology and Community Health, published online 16 June 2016.

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