Occupational health research round-up: August 2018

Fit notes “not implemented as intended”

The “fit note” was introduced in 2010 and was designed to radically change the way GPs certificated sickness and absence from work; switching the premise from advising patients on their inability to work to advising them on what they might do if work were adapted. This review of 13 research papers evaluated the extent to which GPs tick a “maybe fit” box on fit notes and whether the new process has increased return to work. It finds that, in the largest study, the “maybe fit” for work box was used in 6.5% of fit notes completed by GPs, although a second study finds that this proportion rose to 10%-32% amongst GPs with a diploma in occupational medicine. “Maybe fit” was used more for women patients, those with higher socioeconomic status and for patients with physical rather than psychiatric disorders. There was little evidence in the research suggesting that the introduction of “fit notes” has reduced sickness absence duration amongst patients in work. The authors conclude that, although the introduction of the “fit note” represented a major shift in public policy, they have been “incompletely researched and not implemented as intended”.

Dorrington S et al. “Systematic review of fit note use for workers in the UK”. Occupational & Environmental Medicine, 2018, volume 75, pp530-539.

Self-efficacy and job burnout

Employees who believe they can manage their own negative emotions at work are likely to be more successful at mediating the negative relationship between emotional stability and job burnout, according to this study of Italian military cadets. Self-efficacy in managing negative emotions proved to be an important resource for workers dealing with job-related stress over time, even after controlling for other traits including education, previous experience, gender and age. The authors of the study suggest that practitioners should look to develop coaching and training programmes that aim to strengthen employees’ self-efficacy in managing emotions at work.

Alessandri G et al. “Job burnout: the contribution of emotional stability and emotional self-efficacy beliefs”. Journal of Occupational and Organizational Psychology, published online 13 June 2018.

Cardiovascular disease in women firefighters

A high proportion of women firefighters in a study of the Quebec service were at moderate to high risk of developing cardiovascular disease. Just over three-quarters of the 41 female firefighters in the study had this level of risk, using the 2013 American College of Sports Medicine guidelines; for example, 62% had low levels of physical activity and 14% smoked. Eighty-two percent of the women did not meet the Canadian fire service’s own required cardiorespiratory fitness standard, prompting the authors to suggest that “they would benefit from healthy lifestyle initiatives”.

Gendron P et al. “Cardiovascular disease risk in female firefighters”. Occupational Medicine, published online 28 May 2018.

Older workers with depression less likely to return to work after stroke

Older workers, and particularly those who also have poor psychological health, are at an increased risk of not returning to work one year after a stroke, according to this study. It explores the relationship between age, gender, race, marital status, anxiety and depression and return to work 12-months post-stroke, finding that high scores of depression and anxiety had significant associations with failure to return to work one year after suffering a stroke, particularly amongst older workers.

Turi E R et al. “Psychological comorbidities related to return-to-work rates following aneurysmal subarachnoid haemorrhage”. Journal of Occupational Rehabilitation, published online 21 May 2018.

Younger men at higher risk of burnout than older colleagues

The symptoms of burnout vary greatly according to different life stages, with younger men and women aged between 20 and 35, and 55-plus, being particularly susceptible to the highest levels of burnout, this study of 2,073 employees suggests. Whilst the study reveals a non-linear relationship between age and burnout, it finds a linear one between self-reported cynicism at work/reduced professional efficacy and burnout.

Marchand A et al. “Do age and gender contribute to workers’ burnout symptoms?”. Occupational Medicine, published online 15 June 2018.

Permanent night work and aggressive prostate cancer “may” be linked

Working permanent night shifts over many years, coupled with a long shift length of at least 10 hours, “may” be associated with prostate cancer, particularly in its most aggressive form, according to this French study. It looked at the cases of 818 individuals with a prostate cancer diagnosis (and 875 controls), finding that night work, either on a permanent or rotating basis, was not generally associated with prostate cancer, but that that the risk of aggressive prostate cancer rose in the case of those who had worked shifts of more than 10 hours on a permanent basis for at least 20 years.

Wendeu-Foyet M G et al. “Night work and prostate cancer risk: results from the EPICAP study”. Occupational & Environmental Medicine, published online 19 June 2018.

Breast cancer survivors and work transition

Breast cancer survivors in low socioeconomic groups and with lower educational attainment are at greater risk of exiting the workforce, or dropping from full- to part-time hours, after a breast cancer diagnosis and treatment, according to this survey of 206 individuals. Half of the group were employed prior to diagnosis, of whom 12% stopped work and 79% downgraded to part-time work during treatment. At the time of follow-up several years later, a third of those employed prior to their diagnosis had stopped work or retired altogether, 48% had dropped to part-time employment and 19% had no change in their work situation. Changing work status between the initial diagnosis and the follow-up some years later was significantly associated with poorer quality of life and lower education attainment.

Hamood R et al. “Work transitions in breast cancer survivors and effects on quality of life”. Journal of Occupational Rehabilitation, published online 15 June 2018.

SMEs fail to engage in workplace wellbeing

Successive government-sponsored occupational health services have found it challenging to engage the owners and managers of small and medium-sized enterprises (SMEs) in workplace mental health interventions. This study of 297 SME owner/managers analyses why this group fails to engage in mental health and wellbeing interventions, finding that the small business owner’s own psychological wellbeing (particularly distress) is a factor, particularly if they have recently worked in a stressful environment, or have low business confidence.

Dawkins S et al. “Reasons for engagement: SME owner-manager motivations for engaging in a workplace mental health and wellbeing intervention”. Journal of Occupational and Environmental Medicine, published online 30 May 2018.

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