Occupational Health & Wellbeing research round-up: February 2020

People bullied at school are at increased risk of later enacting such behaviours at work, according to a Japanese study

Childhood experiences and bullying at work

People who have had adverse childhood experiences (ACEs), including being bullied at school, are at increased risk of enacting workplace bullying behaviours later in life, according to this Japanese study. It uses cross-sectional survey data to show a positive, dose-response association between the level of ACEs and the frequency of workplace bullying victimisation. Workers with the highest number of ACEs were more than three times as likely to have perpetrated bullying behaviour at work compared with those with the lowest number of adverse experiences in childhood.

Kizuki M et al. “Adverse childhood experiences and bullying behaviours at work among workers in Japan”, Occupational & Environmental Medicine, published online 19 November 2019.

Low-dose radiation and cataract risk

Workers exposed to low-dose radiation at work have an elevated additive risk of developing cataracts, according to this cohort study of US radiology technicians. There were 11,345 cataract diagnoses and 5,440 cataract operations amongst the population studied. Cumulative occupational radiation exposure was associated with self-reported cataracts, but not with cataract surgery. There was evidence of elevated risk of developing cataracts amongst those with higher ultraviolet B radiation exposure, white workers and those with higher levels of cigarette smoking.

Little M P et al. “Occupational radiation exposure and excess additive risk of cataract incidence in a cohort of US radiologic technologists”, Occupational & Environmental Medicine, published online 2 December 2019.

Return-to-work after prostate cancer diagnosis

Individuals’ perceptions about returning to work after a diagnosis of prostate cancer play an important part in determining the duration of sickness absence, according to this study exploring the factors associated with delayed return to work. Factors increasing the likelihood that rehabilitation is delayed include a late-stage cancer diagnosis, lower subjective work ability, and a perceived inability to return to the former job. The study authors suggest that rehabilitation interventions need to focus interventions on adjusting workers’ negative expectations about return-to-work in order to “empower cancer rehabilitation participants to develop appropriate expectations for work recovery.”

Ullrich A et al. “Identifying expectations of delayed return to work in patients with prostate cancer at the beginning of a cancer rehabilitation program”, Journal of Occupational Rehabilitation, published online 16 November 2019.

Eight-year evaluation of a health promotion programme

A comprehensive workplace health promotion programme reached a “reasonable” proportion of the workforce over an eight-year period, according to this study. The annual participation rate was 24% and total reach was 58%. Impact scores achieved by the programme were 18% for 2010-13 and 14% for 2014-17, prompting the authors to conclude the programme’s impact to be “moderate”.

Aikas A H et al. “What can you achieve in 8 years? A case study on participation, effectiveness, and overall impact of a comprehensive workplace health promotion program”, Journal of Occupational & Environmental Medicine, December 2019, vol 61, issue 12, pp964-977.

Employment retention for those with personality disorders

Personality disorders (PDs) are associated with severe functional impairment, and individuals with PDs often find it difficult to get and keep work. Individual placement and support (IPS) is an effective, evidence-based method of supported employment for those with severe mental illness, but its effectiveness in the case of individuals with PDs is relatively poorly understood. This study finds that IPS could be as effective in helping those with PDs obtain employment as it is for those with other severe mental illness, but further study is needed to determine whether the standard IPS model needs altering to best support those with PDs.

Juurlink T T et al. “Employment in personality disorders and the effectiveness of Individual Placement and Support: outcomes from a secondary data analysis”, Journal of Occupational Rehabilitation, published online 9 December 2019.

Cost-benefit analysis of sun protection policies

Protecting outdoor workers from excessive exposure to ultraviolet radiation and associated skin cancer risk is an important health policy objective. This randomised controlled trial of a 24-month sun protection intervention in Colorado concludes that it expanded the adoption of safe working practices at a reasonable cost per employee, and at a cost that was comparable to other worksite health interventions.

Meenan R T et al. “Economic evaluation of an intervention promoting adoption of occupational sun protection policies”, Journal of Occupational and Environmental Medicine, December 2019, Vol 61, issue 12, pp978-983.

Psychological distress and use of mental health services

Over a quarter of Australian workers reporting musculoskeletal disorders or a mental health condition also report “moderate” psychological distress according to this study of workers’ compensation claims. Poor general health, low work ability, financial stress, stressful interactions with healthcare providers and having a diagnosed mental health condition all had the strongest associations with the presence of psychological distress. However, most of those with psychological distress do not access mental health services.

Collie A et al. “Psychological distress in workers’ compensation claimants: prevalence, predictors and mental health service use”, Journal of Occupational Rehabilitation, published online 23 October 2019.

Sleep problems and chronic low back pain

Preventing sleep problems has the potential to improve the rehabilitation prognosis for people with low back pain (LBP), according to this two-time-point study of 3,712 women and 2,488 men with the condition. Compared with those not reporting sleeplessness, those who “often/always” experience sleeplessness have a lower probability of recovering from chronic LBP. This is particularly the case for those with five or more additional chronic pain sites.

Schjelderup Skarpsno E et al. “Influence of sleep problems and co-occurring musculoskeletal pain on long-term prognosis of chronic low back pain: the HUNT study”, Journal of Epidemiology & Community Health, published online 4 December 2019.

Who does what in rehabilitation?

A lack of clarity around the roles and actions of different stakeholders in the rehabilitation process creates confusion about how and when to return to work after experiencing common mental health problems, this literature review suggests. It identifies 11 different stakeholders from the work, health and medical insurance fields, and recommends roles for each. It also identifies around 200 stakeholder actions, spread over the different return to work phases.

Corbiere M et al. “Stakeholders’ role and actions in the return-to-work process of workers on sick leave due to common mental disorders: a scoping review”, Journal of Occupational Rehabilitation, published online 31 October 2019.

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